RSI

[FL_Medic]

Just curious. Does anyone use RSI ( Rapid Sequence Intubation ) in there service?

Yep

etomidate, succs, diprivan gtt.

atropine for Peds.

[Ace844]

Yep

etomidate, succs, diprivan gtt.

atropine for Peds.

What do you use for analgesia as part of your induction and ongoing paralysis s/p RSI?

[Ridryder 911]

Part of the problem, is Paramedics are not usually taught airway procedures in-depth enough. Yes, patients in severe respiratory distress, the

use of the Mallampati scale will be excused; however, ALL Paramedics should know it in detail and be very familiar with it. Yes, there are times that one can properly evaluate the tongue, thyroid, etc.. especially patients with COPD, etc.. a few extra seconds will be far beneficial in the long run, as your partner prepares equipment.

Let's not excuse ourselves from proper knowledge and procedures, albeit there are times one has to expedite and eliminate steps, in lieu of the patients status.

R/r 911

[FL_Medic]

What do you use for analgesia as part of your induction and ongoing paralysis s/p RSI?

we may also administer a benzo, hopefully we don't have that long a transport to were repeated sedation is necessary. We have a great air transport system for our airway alerts as well to cut down transport.

[Ace844]

we may also administer a benzo, hopefully we don't have that long a transport to were repeated sedation is necessary. We have a great air transport system for our airway alerts as well to cut down transport.

You should be giving your patients narcotics-analgesia coverage as part of your sequence...DO YOU??!!

[FL_Medic]

You should be giving your patients narcotics-analgesia coverage as part of your sequence...DO YOU??!!

Benzodiazapines are narcotics.

[Ace844]

You seem like a smart guy....Kindly back up your claim with evidence, and studies to support your position of

Benzodiazapines are narcotics..

Thanks,

ACE844

[FL_Medic]

You seem like a smart guy....Kindly back up your claim with evidence, and studies to support your position of

Thanks,

ACE844

Are you just an angry person that likes to argue? I read these forums for learning purposes not for argument. This is our sequence.

Versed if needed

Etomidate, Succs, Diprivan drip

We are being asked by agencies all over the country to come teach Crash Airway Management. If you have a problem with it contact our medical director. I am not here to argue.

[AZCEP]

I think the direction Ace is coming from is that being paralyzed is a quite painful situation. One that would be lessened through the use of an opioid analgesic. Fentanyl and/or Morphine are commonly used for this purpose. Do you have this ability in your system?

Benzodiazepines and even Etomidate do nothing to relieve pain. They are only able to make the CNS less able to respond to the stimuli.

To quote eMedicine:

In current practice, narcotic refers to any of the many opioids or opioid derivatives. In cultivation since approximately 300 BC, pure opium is a mixture of alkaloids extracted from the sap of unripened seedpods of Palaver somniferous (poppy). Opiates, such as heroin, codeine, or morphine, are natural derivatives of these alkaloids. The term opiate is often used (albeit slightly incorrectly) to refer to synthetic opiate derivatives, such as oxycodone, as well as true opiates.

So in actuality BZD's are not narcotics, in a strict sense of the term.

[FL_Medic]

I think the direction Ace is coming from is that being paralyzed is a quite painful situation. One that would be lessened through the use of an opioid analgesic. Fentanyl and/or Morphine are commonly used for this purpose. Do you have this ability in your system?

Benzodiazepines and even Etomidate do nothing to relieve pain. They are only able to make the CNS less able to respond to the stimuli.

To quote eMedicine:

In current practice, narcotic refers to any of the many opioids or opioid derivatives. In cultivation since approximately 300 BC, pure opium is a mixture of alkaloids extracted from the sap of unripened seedpods of Palaver somniferous (poppy). Opiates, such as heroin, codeine, or morphine, are natural derivatives of these alkaloids. The term opiate is often used (albeit slightly incorrectly) to refer to synthetic opiate derivatives, such as oxycodone, as well as true opiates.

So in actuality BZD's are not narcotics, in a strict sense of the term.

No, we don't treat the pain of being paralyzed, I've never heard of that to be honest. I always thaught we sedated for alert pt.'s so they don't go through being paralyzed alert and oriented and/or remember that experience.

we are able to stray away from our protocols when ever we feel necessary I will research the practice of giving opiates during RSI, and if it's a bennifit by all means I may adapt it, and will speak to my medical director. If you have a link to a good site let me know.

And about the Narcs thing, if you go to any pharmacy benzo's are controlled narcs, that's what they call them. At the hospital the call benzo's narcs, and in the back of an ambulance as well. I don't know when we stopped calling valium/versed a narc.