Etomidate and Trauma

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1) Never ever
2) Never ever
Hypotension sometimes, due to loss of sympathetic stimulation.
As for Etomidate, if it went tomorrow it would cause me no concern.  
Not used it for 10 years at least.

H2 blockers - never

What is wrong with Thio, Sux ???  Works every time in my hands.


Nick Macartney
On 19 Aug 2008, at 11:00, Dr Ross Hofmeyr wrote:

> 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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