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oh well, if its a respiratory arrest early epi helps, if its a witnessed cardiac arrest early epi helps, if it is a PE turned arrest early epi helps. i am a fan of the peri-arrest/pretty sure its an arrest period just starting CPR and ACLS. although ive never done the pericardial hump.

I am kinda too lazy to read ALL the comments, has someone already suggested a PE as the etiology? i think this lady wouldve arrested anyways.

Im pretty agressive when it comes to asthmatics, i usually hit them with epi early, even the moderatly severe payients. But am usually hesitant with the CPAP. Ive seen it make the patient better in the short term (oxygenation) but do little about the airtrapping that is occurring. But every...

at dosing ranges LESS than 0.2-0.3mg/kg does it provide good enough anesthia ?

I have a decent amount of experience with different kinds of dosing with ketamine for induction but none with etomidate (ive only used 0.3mg/kg), i guess with the popularity of ketamine the education on etomidate and different ways you can use the drug for induction have dwindled.

Interesting sir, my base (and immediate area) have had a recent cluster of cardiac patients requiring RSI (late stage CHF, STEMI, balloon pump). and ive been working my hardest to find educational materials that can outline airway plans for these patients as i absolutely hate the "classic RSI"...

Interesting, ive havent seen it in the prehospital setting.

With the growing popularity of this, it wouldnt suprise me if we saw epi 1:100 prefilled in a few years.

I just squeeze out 9ml of epi 1:10 pre-filled, hook it to a saline bag that is running and draw back 9ml of saline. (wasteful i know but fast and easy). I love push-dose epi, i think epi as a whole is under utilized and often times people act scared of it. But i think epi drips and push-dose...

https://www.ncbi.nlm.nih.gov/pubmed/20422466

Ive heard some promisimg things about sodium bicarb for head injury with seizures or one blown pupil as a quick rescue. But his has to be given as a fast bolus.

Im not exactly a fan of adding a pressor just for the purpose of higher sedation with propofol. I prefer to add a ketamine drip/fentanyl drip to the propofol (i like to mix &match rather one med). But that is preference and there are patients where its somewhat appropriet *grits teeth*

http://emcrit.org/podcasts/post-intubation-sedation/

If i am committing to a RSI/DSI procedure i am fully committing. With asthmatic/COPD patients their sats can improve but you still have to address the hypercarbia, respiratory muscle fatigue, and bronchospasm that will possibly come back when their ketamine level drops. I also do this for...

I do agree with @Remi, with the popularity of ketamine some people have begun to frown on etomidate but i do not believe it is earned. I personally use ketamine for the majority of my RSI's because it is very versatile with its dosages. For instance I will give asthmatics 2mg/kg, shock patients...

I beleive the shift to ketamine for sedation pre-hospital is that most providers to contain the knowledge of the people in this forum, so it is safer to let them push ketamine than it is versed/fent/propofol with lesser education. I love propofol+ketamine with small amounts of fentanyl pushed...

Ive heard mag has shown some promise in this area. Really this isnt a super common problem pre-hospital and alot of my experience dooing CCT is ER doctors treat it a little too agressive (often making the ventricular rate brady). Ive had success giving fluid bolus and re-assessing ETCO2 for...