Annals of Emergency Medicine
Volume 47, Issue 6 , Pages 525-530 , June 2006

Etomidate Versus Midazolam for Out-of-Hospital Intubation: A Prospective, Randomized Trial

Presented as a poster at the American College of Emergency Physicians Research Forum, October 2003, Boston, MA.

  • Jeanne Jacoby, MD

      Affiliations

    • Emergency Medicine Residency, St. Luke’s Hospital, Bethlehem, PA
    • Corresponding Author InformationAddress for correspondence: Jeanne Jacoby, MD, Emergency Medicine Residency, St. Luke’s Hospital, 801 Ostrum Street, Bethlehem, PA 18015; 610-954-4903, fax 610-954-2153
    • ,
  • Michael Heller, MD

      Affiliations

    • Emergency Medicine Residency, St. Luke’s Hospital, Bethlehem, PA
    • ,
  • Jonathan Nicholas, NREMT-P

      Affiliations

    • Bethlehem Township EMS, Bethlehem, PA
    • ,
  • Nilesh Patel, MD

      Affiliations

    • Emergency Medicine Residency, St. Luke’s Hospital, Bethlehem, PA
    • ,
  • Mark Cesta, MD

      Affiliations

    • Emergency Medicine Residency, St. Luke’s Hospital, Bethlehem, PA
    • ,
  • Gordon Smith, EMT-P

      Affiliations

    • Bethlehem City EMS, Bethlehem, PA.
    • ,
  • Sharon Jacob, MD

      Affiliations

    • Emergency Medicine Residency, St. Luke’s Hospital, Bethlehem, PA
    • ,
  • James Reed, PhD

      Affiliations

    • Emergency Medicine Residency, St. Luke’s Hospital, Bethlehem, PA

Received 1 September 2005 ,Revised 2 December 2005 ,Accepted 9 December 2005.

References 

  1. American College of Emergency Physicians Policy Statement. Drug-assisted intubation in the prehospital setting . [abstract] Ann Emerg Med . 2005;46:214
  2. Reed DB , Snyder G , Hogue TD . Regional EMS experience with etomidate for facilitated intubation . Prehosp Emerg Care . 2002;6:50–53
  3. Choi YF , Wong TW , Lau CC . Midazolam is more likely to cause hypotension than etomidate in emergency department rapid sequence intubation . Emerg Med J . 2004;21:700–702
  4. Davis DP , Kimbro TA , Vilke GM . The use of midazolam for prehospital rapid-sequence intubation may be associated with a dose-related increase in hypotension . Prehosp Emerg Care . 2001;5:163–168
  5. Dickinson ET , Cohen JE , Mechem CC . The effectiveness of midazolam as a single pharmacologic agent to facilitate endotracheal intubation by paramedics . Prehosp Emerg Care . 1999;3:191–193
  6. Wang HE , O’Connor RE , Megargel RE , et al.   The utilization of midazolam as a pharmacologic adjunct to endotracheal intubation by paramedics . Prehosp Emerg Care . 2000;4:14–18
  7. Lauder CT , Megargel RD , Barnes TA , et al.   Comparison of midazolam and etomidate as pharmacologic adjuncts to endotracheal intubation . Ann Emerg Med . 2001;38:S9
  8. Swanson ER , Fosnocht DE , Jensen SC . Comparison of etomidate and midazolam for prehospital rapid-sequence intubation . Prehosp Emerg Care . 2004;8:273–279
  9. Wang HE , Kupas DF , Greenwood MJ . An algorithmic approach to prehospital airway management . Prehosp Emerg Care . 2005;9:145–155
  10. Davis DP , Dunford JV , Poste JC . The impact of hypoxia and hyperventilation on outcome after paramedic rapid sequence intubation of severely head-injured patients . J Trauma . 2004;57:1–8
  11. Bozeman WP , Young S . Etomidate as a sole agent for endotracheal intubation in the prehospital air medical setting . Air Med J . 2002;21:32–35
  12. Rosen P . In: Rosen’s Emergency Medicine (Concepts and Clinical Practice) . 5th ed.. St. Louis, MO: Mosby; 2002;
  13. Walls RM . Manual of Emergency Airway Management . Philadelphia, PA: Lippincott Williams and Wilkins; 2000;

 Supervising editor: Donald M. Yealy, MD

 Author contributions: JJ, MH, JN conceived the study and designed the trial. JJ, GS, JM supervised the conduct of the trial and data collection. JR provided statistical advice on study design and analyzed the data and performed interim analysis. MC, JJ, GS, JN were responsible for paramedic teaching and field implementation. NP performed data collection and formatting (pre-hospital). SJ performed data collection and formatting (follow-up). JJ and MH drafted the manuscript. JJ takes responsibility for the paper as a whole.

 Funding and support: The authors report this study did not receive any outside funding or support.

 Reprints not available from the authors.

PII: S0196-0644(05)02042-1

doi: 10.1016/j.annemergmed.2005.12.009

Annals of Emergency Medicine
Volume 47, Issue 6 , Pages 525-530 , June 2006

Article Tools