Apparently I was on the drugs myself - meant Profolol.
Lisa
-----Original Message-----
From: Russ Wilshaw [mailto:russ.wilshaw@ihc.com]
Sent: Friday, November 14, 2003 9:36 AM
To: traumanurses@listserve.com
Subject: [traumanurses] Re: Combative brain injured patients
Lisa,
Are you saying etomidate? Esmolol has no sedating properties and is a
beta blocker.
Thanks,
Russ Wilshaw RN, MS
Trauma Coordinator
UVRMC
Provo, Utah
>>> Lisa.Leiding@stvin.org 11/13/03 03:28PM >>>
The brain trauma foundation -has really standardized our practice. The
"gold" standard for them is to intubate patients who are GCS < 9 to
protect
the airway. GCS between 9 and 13 has been very individualized. We have
at
times convinced the MD's to intubate if it takes all of the nursing
staff
and security staff to keep a patient safe.
Drugs - well our neurosurgeons have asked us to stop using long active
benzo's prior to their arrival so that they can assess the patient.
Our
standard at this time is to use Esmolol bolus in air and drips on
ground. Up
until we stumbled onto this happy medium the neurosurgeons were having
to
use electric muscle stimulator to ellicite neuromuscular responses. Now
they
can shut off the Esmolol and within minutes they can do a complete exam
and
we can turn the medication on and wean towards longer acting benzo's /
paralytics / sedatives / pain medications etc...
This seems to be working well for us at this time.
Lisa McLaughlin
Santa Fe, NM 87505
505-820-5708
-----Original Message-----
From: Carolyn Koehler [mailto:koehlercarolyn@hotmail.com]
Sent: Thursday, November 13, 2003 2:47 PM
To: TraumaNurses@TraumaNurseSoc.org
Subject: (no subject)
Hello All,
Our facility recently had an intoxicated combative trauma patient
with
high potential for a head injury. This case prompted discussion
regarding
sedation without intubation vs. sedation/paralytics with intubation.
Does
anyone have any literature/thoughts etc. regarding these types of
patients?
What drugs are most appropriate? When to intubate? -Lots of
legal/medical
components.
Thanks, Carolyn Koehler APRN
Trauma Coordinator
Missoula, MT
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