期刊
AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY
卷 80, 期 4, 页码 182-195出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/ajhp/zxac326
关键词
oxygenation; paralysis; pharmacist; rapid sequence intubation; sedation
This article reviews the dosing, potential adverse effects, and clinical outcomes of commonly used pharmacologic agents for rapid sequence intubation (RSI) and emphasizes the importance of the emergency medicine pharmacist's role and the need to update clinical practices.
Purpose The dosing, potential adverse effects, and clinical outcomes of the most commonly utilized pharmacologic agents for rapid sequence intubation (RSI) are reviewed for the practicing emergency medicine pharmacist (EMP). RSI is the process of establishing a safe, functional respiratory system in patients unable to effectively breathe on their own. Various medications are chosen to sedate and even paralyze the patient to facilitate an efficient endotracheal intubation. The mechanism of action and pharmacokinetic/pharmacodynamic profiles of these agents were described in a 2011 review. Since then, the role of the EMP as well as the published evidence regarding RSI agents, including dosing, adverse effects, and clinical outcomes, has grown. It is necessary for the practicing EMP to update previous practice patterns in order to continue to provide optimal patient care. Conclusion While the agents used in RSI have changed little, knowledge regarding optimal dosing, appropriate patient selection, and possible adverse effects continues to be gained. The EMP is a key member of the bedside care team and uniquely positioned to communicate this evolving data.
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