Etomidate

Indications: Sedation to for pharmacologically-assisted intubation (PAI)

Contraindications:

• For EMS use, no contraindications.
• Relative contraindications:
  • Known adrenal insufficiency (known to suppress cortisol production)
  • Known history of focal seizure disorder (may exacerbate condition)
  • Pregnancy
• Use with caution:
  • Hypotension
  • Severe asthma
  • Sepsis

Precautions:

• May cause myoclonic activity (e.g., coughing, hiccups)
• May exacerbate focal seizure disorder

Side Effects:

• Nausea and/or vomiting
• Temporary involuntary muscle contractions
  

Adult Dose:

• 0.3 mg/kg slow push administered one minute prior to intubation
• Additional doses of 0.1 mg/kg as necessary to achieve adequate sedation to a maximum total dose of 40 mg

Pediatric Dose:

BIOTEL AUTHORIZATION REQUIRED

• 0.6 mg/kg slow push administered one minute prior to intubation
• Additional doses of 0.1 to 0.2 mg/kg as necessary to achieve adequate sedation, to a maximum total, cumulative dose of 20 mg
  

Route: IV or IO push

Drug Action: Suppresses central nervous system activity thereby inducing rapid unconsciousness

Class:

• Short-acting intravenous anesthetic
• Hypnotic
• Sedative

Onset: 1 minute – 2 minutes

Duration: Dose dependent, but usually 3 to 5 minutes