Intubators Fail to Sedate Children Who Receive Long-Acting Paralytics

With its rapid onset and short duration of action, etomidate is an ideal induction agent for rapid sequence intubation. If the airway has been secured with the aid of a long-acting paralytic, the intubator should provide an additional sedative, because paralysis persists long after etomidate sedation wears off. These authors reviewed the charts of 84 children (mean age, 7 years) who were intubated using etomidate and vecuronium or rocuronium at a single academic pediatric emergency department in Alabama from 2001 through 2005 to determine how many patients received appropriate sedation after intubation (defined as sedative administration within 15 minutes of etomidate administration).

The average time from administration of etomidate to admi…