T HE U TILIZATION OF M IDAZOLAM AS A P HARMACOLOGIC A DJUNCT TO E NDOTRACHEAL I NTUBATION BY P ARAMEDICS
| Autor: | Beth Bratton-Heck, Marianne Bitner, Robert E. O'Connor, Ross E. Megargel, Robert Stuart, Lawrence Tan, Henry E. Wang, Mary Lamborn |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Clenched teeth
business.industry Midazolam medicine.medical_treatment Treatment outcome Retrospective cohort study Endotracheal intubation Emergency Nursing Delaware Treatment Outcome Anesthesia Injections Intravenous Intubation Intratracheal Emergency Medicine Humans Hypnotics and Sedatives Medicine Intubation business Emergency Treatment Retrospective Studies medicine.drug |
| Zdroj: | Prehospital Emergency Care. 4:14-18 |
| ISSN: | 1545-0066 1090-3127 |
| Popis: | Pharmacologic agents have been used in the prehospital setting for facilitating endotracheal intubation (ETI). The purpose of this study was to determine the utility of intravenous midazolam for prehospital patients who require pharmacologic relaxation to facilitate ETI.Data were reviewed retrospectively using paramedic charts from an eight-month period for a three-county state EMS system.There were 26,133 paramedic dispatches during the study period. Six hundred eighty-three ETIs were attempted, including 72 midazolam-facilitated intubations (MFIs). The most common indications for MFI were "clenched teeth," "gag," and "combativeness." Successful MFI was achieved in 45 of 72 cases (62.5%). Midazolam-facilitated intubation was less successful for trauma patients (41.2%) than for medical patients (69.1 %) (p = 0.04). Of the 58 failed conventional ETIs that occurred during the study period, 25 (43.1%) were identified as having one or more indications for the use of MFI. Although the use of intravenous midazolam was effective in facilitating ETI, a high MFI failure rate (37.5%) was noted.Although it is of limited efficacy, MFI is underutilized and should be considered by medical direction as a pharmacologic adjunct to ETI in selected field patients. |
| Databáze: | OpenAIRE |
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