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Thiopental vs. Etomidate for Rapid Sequence Intubation in Aeromedicine

Published online by Cambridge University Press:  28 June 2012

Charles J. Sonday ,
Robert Higgins ,
Jennifer Axelband ,
Jeanne Jacoby  and
Duane Crider
Charles J. Sonday
Affiliation:
University of Pennsylvania, Philadelphia, Pennsylvania, USA
Robert Higgins
Affiliation:
University of Pennsylvania, Philadelphia, Pennsylvania, USA
Jennifer Axelband*
Affiliation:
Emergency Medicine Residency, St. Luke's Hospital, Bethlehem, Pennsylvania, USA
Jeanne Jacoby
Affiliation:
Emergency Medicine Residency, St. Luke's Hospital, Bethlehem, Pennsylvania, USA
Duane Crider
Affiliation:
Kutztown University, Kutztown, Pennsylvania, USA
*
Emergency Medicine ResidencySt. Luke's Hospital801 Ostrum StreetBethlehem, PA 18015USA E-mail: [email protected]
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Abstract

Introduction:

Although there is a general agreement that rapid sequence intubation (RSI) is thepreferred technique for intubation in aeromedical care, several pharamacological regimens have been employed without clear evidence of which is superior.

Hypothesis:

This study was designed to compare the use of etomidate (ETOM) with that of thiopental (THIO)as an adjunctive agent used with succinylcholine (SCh) for rapid sequence intubation in an urban, aeromedicalsystem.

Methods:

This was a retrospective, before-and-after study utilizing computer-assisted chart review. Adultpatients who received thiopental for rapid sequence intubation over a two-year period were compared to adult patients who received etomidate for rapid sequence intubation over a similar period, after a change in protocol, which mandated etomidate rather than thiopental for all intubations.

Results:

No difference was found in any of the primary endpoints. Stabilization time (13.1 vs. 12.9 minutes), number of intubation attempts (1.1 vs. 1.2), successful first intubation attempts (90% vs. 82%), overallsuccessful intubations (100% vs. 96%), and intubation time (18.4 vs. 21.7 seconds) were similar for all comparisons of thiopental vs. etomidate (all p >0.05).

Conclusion:

This study found no clinically relevant differences between the use of etomidate or thiopental as adjuncts with succinylcholine for rapid sequence intubation in the aeromedical setting.

Keywords

aeromedicineetomidateflight medicineprehospitalrapid sequence intubation (RSI)sedationthiopental
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 20 , Issue 5 , October 2005 , pp. 324 - 326
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2005

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