Hey y'all, have an interesting question:
So, I understand a lot of protocols call for lidocaine IV prior to RSI, the idea being that it blunts the cardiac response to laryngoscopy, protects ICP from spiking, etc. But here's something I got to thinking about after watching a megacode on youtube. Pt is in full arrest, ALS protocols are initiated, first round of epi is given. Fingerstick is 22, so lead medic instructs to prepare D50 and lido for intubation.
Here's the core of my question:
If you're giving epi because your BP (and ultimately your CPP) is in the crapper, (and, there is no reason to suspect the need for a neuro-protective intubation) why would you go ahead and give the lido to keep your pts pulse, BP and ICP from going up a little bit?
So, I understand a lot of protocols call for lidocaine IV prior to RSI, the idea being that it blunts the cardiac response to laryngoscopy, protects ICP from spiking, etc. But here's something I got to thinking about after watching a megacode on youtube. Pt is in full arrest, ALS protocols are initiated, first round of epi is given. Fingerstick is 22, so lead medic instructs to prepare D50 and lido for intubation.
Here's the core of my question:
If you're giving epi because your BP (and ultimately your CPP) is in the crapper, (and, there is no reason to suspect the need for a neuro-protective intubation) why would you go ahead and give the lido to keep your pts pulse, BP and ICP from going up a little bit?