Comments on: Procedural Sedation – Part I http://emcrit.org/lectures/procedural-sedation-part-1/ Online Medical Education on Emergency Department (ED) Critical Care, Trauma, and Resuscitation Fri, 10 Feb 2012 00:41:26 +0000 hourly 1 http://wordpress.org/?v=3.3.1 By: On the relative wisdom of synchronized cardioversion without sedation – Part IV | Rogue Medic http://emcrit.org/lectures/procedural-sedation-part-1/#comment-2977 On the relative wisdom of synchronized cardioversion without sedation – Part IV | Rogue Medic Wed, 24 Nov 2010 11:33:18 +0000 http://emcrit.org/?p=669#comment-2977 [...] sedation, so this is not entirely the same as pre-cardioversion sedation. He does cover this in Procedural Sedation – Part I and EMCrit Podcast 29 – Procedural Sedation, Part [...] [...] sedation, so this is not entirely the same as pre-cardioversion sedation. He does cover this in Procedural Sedation – Part I and EMCrit Podcast 29 – Procedural Sedation, Part [...]

]]> By: emcrit http://emcrit.org/lectures/procedural-sedation-part-1/#comment-2233 emcrit Sat, 31 Jul 2010 17:26:55 +0000 http://emcrit.org/?p=669#comment-2233 An anonymous reader wrote: Great podcast ! I have a comment on the procedural sedation talk that was especially good. We have a long and successful experience using Etomidate for procedural sedation except we usually use Alfentanil instead of Fentanyl to make duration even shorter when needed. Many people bad-mouth Etomidate because of "Myoclonus" . Many studies also cite frequent Myoclonus with it's use. We rarely see myoclonus and this is why I think that is so. In our protocol the nurses are instructed to give it over 90 seconds. In studies I have read there is no mention on how long administration takes so it is probably given much more quickly. In one case of inappropriately getting the etomidate PUSH the patient looked like they were having a grand mal siezure. People should try this approach to be open to using Etomidate for selected short procedures- Cardioversion, Chest tubes, Large abscess (not IVDU). etc. Keep up the good work. An anonymous reader wrote:
Great podcast !

I have a comment on the procedural sedation talk that was especially good.

We have a long and successful experience using Etomidate for procedural sedation except we usually use Alfentanil instead of Fentanyl to make duration even shorter when needed. Many people bad-mouth Etomidate because of “Myoclonus” . Many studies also cite frequent Myoclonus with it’s use.
We rarely see myoclonus and this is why I think that is so.
In our protocol the nurses are instructed to give it over 90 seconds. In studies I have read there is no mention on how long administration takes so it is probably given much more quickly. In one case of inappropriately getting the etomidate PUSH the patient looked like they were having a grand mal siezure. People should try this approach to be open to using Etomidate for selected short procedures- Cardioversion, Chest tubes, Large abscess (not IVDU). etc.

Keep up the good work.

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