Jump to content


  • Content Count

  • Joined

  • Last visited

Community Reputation

1 Neutral

Profile Information

  • Gender
  • Location
    South, North-East Estonia

Previous Fields

  • Occupation
    CRNA, EM nurse from Estonia
  1. Do ALS ambulance (paramedic) can use this drugs? Propofol, Etomidate ... for intubation? Or every state is different? CRNA - nurse specialised into anesthesia?
  2. Hi! People from different countries please write about ambulance service in your countries. 1. who works in ambulance? (paramedic teams?, phisician teams? Nurses? nurse=paramedic?) 2. What drugs do you have and which drugs you can use without a doctor (especially write about sedative/anestetics, muscle relaxants,....)? 3. Are there any drugs that you can administer only after "call" to a doctor? 4. Which procedures can you do without doctor (intubation, cardioversion,...)? 5. EM studies - paramedic studies (years?), team leader-ambulance nurses (EM?/anestesia? specialisati
  3. I agree Suxamethon creates good condition for intubation. If use paralytics Midazolam sedation is ok, better with opiate premedication. I work in two services in the "south" and in the "north". In the south we have suxamethon, pipicuronium, propofol, midazolam, Sodium Oxybate, morphine. But some leader phisicians say that we - nurses, shouldnt use propofol or paralytics for intubation. Here I have used anestetics. Comatose patient in septic shock, hyperventilating. I ensured vasopressive and inotrope support and inducted anesthesia with ~15 mg Midazolam (less hypotensive drug) and 40 Pro
  4. Hi! Have you used Midazolam to induce anesthesia for intubation pre-hosp. without using muscle relaxants? It means you have breathing patient who must be intubated and mechanically ventilated. Midazolam in doses 0,2-0,35 mg/kg. And no use of relaxant (Succinylcoline). If you did Midaz. anestesia, please describe situation, how midazolam had effect on reflexes, blood pressure, spontaneous breathing. Thanks
  5. We have Diazepam, Midazolam and Haloperidol. I prefer Midazolam 1-5 mg i.v. I.M. way --> Diazepam is not the best option for i.m. - absorbtion from muscle takes too much time.
  6. I dont agree about muscle relaxants. If you use only anaesthetics/sedatives in appropriate doses you can get good conditions for intubation without using NM-blockers. I agree using of relaxants for intubation needs great experience and paramedics or nurses mustn't use that. Anaesthetics can be enough. Sometime we have to secure airway prehospitally and intubation is the best for it. Patient with status epilepticus, SpO2 with O2-mask was ~82%, temperature 39,5; Diazepam 10 mg and Midazolam, little of Fenytoin didnt help. BP after Diazepam 80... what to do. We started infusion 1 L of crista
  7. And brain injury with coma must be intubated with using opiates - decreases reflexes --> intubation without ICP increasement. For example Midazolam 10 mg + Morphine 10 mg/Fentanyl. When intubated patient breaths in to the tube - Midazolam only probably doesnt help. It is good to combine midazolam sedation with myorelaxants. Can help also deep sedation/anaesthesia with propofol or Midazolam+opiate infusion. Example from my job. We had patient in septic shock, noradrenaline didnt help,--> BP 80. I decided to intubate him. But we dont have Etomidate nor Ketamine. We administ
  8. Hi, Patients with gag reflex should be sedated or done RSI. If you dont use muscle relaxants you should to sedate patient. If patient has lively gag reflexes it is better to use anesthetics like propofol (causes apnea and hypotension). - Propofol slow boluses 40+40.... mg - Midazolam - may need large doses for deep sedation - 10-20 mg - If you have only Midazolam, you can combine it with opiates - Fentanyl or Morphine --> does deeper sedation/aneasthesia = better conditions.
  • Create New...