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Pharmacy 2015, 3(4), 197-209; doi:10.3390/pharmacy3040197

Use of Etomidate for Rapid Sequence Intubation (RSI) in Pediatric Trauma Patients: An Exploratory National Survey

1
St. Christopher’s Hospital for Children, Philadelphia, PA, 19134, USA
2
Drexel University College of Medicine, Philadelphia, PA, 19129, USA
3
Alfred I duPont Hospital for Children, Wilmington, DE, 19803, USA
4
NYU Langone Medical Center, New York, NY, 10016, USA
5
NYU School of Medicine, New York, NY, 10016, USA
This work, in part, was presented as an abstract presentation at the 43rd Society of Critical Care Medicine Annual Congress abstract #941, San Francisco, CA, USA.
*
Author to whom correspondence should be addressed.
Academic Editor: Sandra Benavides Caballero
Received: 6 May 2015 / Revised: 25 September 2015 / Accepted: 1 October 2015 / Published: 19 October 2015
(This article belongs to the Special Issue Pharmacy Paediatrics)
View Full-Text   |   Download PDF [435 KB, uploaded 19 October 2015]

Abstract

Objective, To survey the pediatric trauma programs to ascertain if and how etomidate is being used for rapid sequence intubation (RSI) in pediatric trauma patients. Design, A 25 question survey was created using REDCaps. A link to the survey was emailed to each of the pediatric and adult trauma programs that care for pediatric patients. Setting, Pediatric trauma programs and adult trauma programs caring for pediatric patients. Intervention, None. Measurements and Main Results, A total of 16% of programs responded (40/247). The majority of the centers that responded are urban, academic, teaching Level 1 pediatric trauma centers that provide care for > 200 pediatric trauma patients annually. The trauma program directors were the most likely to respond to the survey (18/40). 33/38 respondents state they use etomidate in their RSI protocol but it is not used in all pediatric trauma patients. 26/38 respondents believe that etomidate is associated with adrenal suppression and 24/37 believe it exacerbates adrenal suppression in pediatric trauma patients yet 28 of 37 respondents do not believe it is clinically relevant. Conclusions, Based on the results of the survey, the use of etomidate in pediatric trauma patients is common among urban, academic, teaching, level 1 pediatric trauma centers. A prospective evaluation of etomidate use for RSI in pediatric trauma patients to evaluate is potential effects on adrenal suppression and hemodynamics is warranted. View Full-Text
Keywords: etomidate; adrenal suppression; pediatric; trauma RSI etomidate; adrenal suppression; pediatric; trauma RSI
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Cies, J.J.; Moront, M.L.; Moore II, W.S.; Ostrowicki, R.; Gannon, K.B.; Da-Silva, S.S.; Chopra, A.; Parker, J. Use of Etomidate for Rapid Sequence Intubation (RSI) in Pediatric Trauma Patients: An Exploratory National Survey. Pharmacy 2015, 3, 197-209.

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