Etomidate and Trauma

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Ok, I'll bite, but probably not where you wanted me to:

> c) an H1 blocker: 25 - 50 mg`diphenhydramine (to mitigate any 
> histamine-releasing reaction)

I use morphine liberally amongst trauma cases, in small IV titrated boluses,
and have only seen noticeable histamine reactions (above and beyond small BP
fluctuations) on a few occasions.  (Granted, I would prefer fentanyl for
acute trauma but our resources are constrained).  May I ask:

1) What percentage of people are regularly using an antihistamine of some
sort in trauma patients who receive opioids, and

2) How often do those who _don't_ give histamine antagonist with opioids see
a noticeable histaminic response?


Ross
Ex trauma-unit flunky
Now parked on ice.

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