Emergency Medicine Cases EM Quick Hits 55 – Induction Agents, Gabapentinoids, Neuroprotective Intubation, Approach to Paresthesias, Preventing Burnout
19 snips
Feb 27, 2024 
Guest
Anand Swaminathan
Guest
Hans Rosenberg
Guest
Eric Wortmann
Guest
Katie Lin
Guest
Nour Khatib and Hamza Jalal
The podcast covers topics such as selecting induction agents for intubation, using gabapentinoids for pain control, neuroprotective intubation techniques, approaching paresthesias in the ED, and preventing burnout in emergency medicine. Experts share insights on drug choices, avoiding rapid titration, optimizing intubation, deciphering neurological symptoms, and prioritizing mental health for healthcare providers.
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Ketamine for Intubation
- Consider ketamine as a potential replacement for etomidate, especially in critically ill patients.
- Ketamine offers a longer half-life, analgesic properties, and potential neuroprotective benefits.
Hypotension and Induction Agents
- Etomidate, ketamine, and propofol do not intrinsically cause hypotension.
- Hypotension post-intubation with these agents is from removing the patient's sympathetic drive.
Propofol in Shocky Patients
- Reduce propofol dosage in hypotensive or shocky patients during RSI.
- Consider a markedly reduced dose, 10-20% of the normal dose, to minimize hemodynamic swings.