February Introduction

00:00
19:21
Sign in or subscribe to listen

No me gusta!

The flash player was unable to start. If you have a flash blocker then try unblocking the flash content - it should be visible below.

Nurses Edition Commentary

Kathy Garvin, RN and Lisa Chavez, RN
00:00
06:30

No me gusta!

The flash player was unable to start. If you have a flash blocker then try unblocking the flash content - it should be visible below.

Richard H. -

With rocuronium your status patient could be cooking their neurons for half an hour or more while you are blissfully unaware, high-fiving each other for another amazingly successful intubation. Please tell us that succinylcholine is the correct paralytic, just this once. Then you can go back to hating it all you want. Thanks!

Ben F. -

I was going to make the same comment - my practice is to scour the chart and history for contraindications to succinylcholine, and if I find none, then use it. I work in a hospital in which we have EEG in neither the ED nor the ICU, so I worry about ongoing seizure activity that I'm unable to detect for the duration of paralysis.

Anand S., M.D. -

Excellent points Richard and Ben. We'll discuss in a later episode as well. Thanks for bringing this up

Preston W., M.D. -

Sorry gents. Benzo, Benzo, PHENOBARBITAL children or adults. When I absolutely positively want you to stop seizing NOW. A loading dose of barbiturates! 20 mg/kg!

Julian M. -

Benzo, Benzo, Keppra (being made as soon as a status patients presents to ED, no reason to wait as you'll be loading them up anyways), propofol and intubate. Phenobarbital might take time to come from pharmacy -> UNLESS you have an ED satellite pharmacy or ED pharmD has it readily available. Phenobarbital is a great option, but has operational barriers. Otherwise, I would go benzo, bezno, Keppra/Phenobarb, propofol and intubate. Patient already on keppra outpatient? order it anyways but think Phenobarb or Ketamine on step 3.

Thoughts?

Ian L., Dr -

How long does this treatment midazolam by 2 then propofol rocuronium take to stop the status .

To join the conversation, you need to subscribe.

Sign up today for full access to all episodes and to join the conversation.

To download files, you need to subscribe.

Sign up today for full access to all episodes.
EM:RAP 2021 February Full episode audio for MD edition 214:23 min - 229 MB - M4AEMRAP 2021 February PA Edition PA Edition 60:19 min - 83 MB - MP3EM:RAP 2021 February German Edition Deutsche 97:11 min - 134 MB - MP3EM:RAP 2021 February Canadian Edition Canadian 16:19 min - 23 MB - MP3EMRAP 2021 February Farsi Edition Farsi 191:42 min - 263 MB - MP3EMRAP 2021 February Spanish Edition Español 43:32 min - 60 MB - MP3EMRAP 2021 February French Edition Français 23:52 min - 33 MB - MP3EMRAP 2021 February Aussie Edition Australian 0:49 min - 1 MB - MP3EM:RAP 2021 02 February Written Summary 604 KB - PDFEM:RAP 2021 February Board Review Answers 152 KB - PDFEM:RAP 2021 February Board Review Questions 109 KB - PDFEM:RAP 2021 February MP3 Files 245 MB - ZIP

To earn CME for this chapter, you need to subscribe.

Sign up today for full access to all episodes and earn CME.

6 AMA PRA Category 1 Credits™ certified by CEME (EM:RAP)

  1. Complete Quiz
  2. Complete Evaluation
  3. Print Certificate