Posts Tagged fentanyl

Trauma Resuscitation with Dr. Richard Dutton

photo from trauma.orgThis week on the EMCrit Podcast,  we discuss the resuscitation of the hemorrhagic shock patient with Dr. Richard Dutton, MD. Rick was director of trauma anesthesia at the Shock Trauma Center when I trained there. He is an incredible teacher, clinician, and researcher.

Here are the take home points:

  • Induction agent choice does not matter in these patients; what matters is DOSE! Reduce dose to 1/10 of full intubating dose.
  • Blood products need to be available in the trauma bay for when these patients arrive. If you need to give crystalloid while awaiting the products, give only small amounts just to keep the patients heart beating.
  • A systolic of 80 with good perfusion and normal sized vessels is very different than that same SBP in a patient who is clamped down. The former is a resuscitated state, the latter =spiral of death.
  • The resuscitation fluid for trauma is equal parts PRBC and FFP.

[Click Here to Read More and Listen to the Podcast]

photo from trauma.org

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Procedural Sedation in the ED, Part II

It seems the government and other specialties are trying hard to make sedation as difficult as possible in the ED. We must persevere to provide the best procedural sedation for the maximal comfort and safety for our patients. This continues the discussion started in Part I, where we discussed etomidate, ketamine, and versed/fentanyl. In this podcast, I discuss propofol, ketofol, and dexmedetomidine.

[Click Here to Read More and to hear the Podcast]

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Procedural Sedation in the ED, Part I

It seems the government and other specialties are trying hard to make sedation as difficult as possible in the ED.

We must persevere to provide the best procedural sedation for the maximal comfort and safety for our patients. This brief lecture was originally posted on the defunct EMCrit Lecture Site on 8/7/2009.

I’m reposting it here so that I can post part II sometime this week.

This episode, Part I, covers general concepts on sedation as well as ketamine and etomidate/fentanyl.

[Click Here to Read More and Hear the Lecture]

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