Can J Emerg Med
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Etomidate is a sedative-hypnotic chemically unrelated to other induction agents. The pharmacological and safety profile of etomidate offers many advantages for induction during rapid sequence intubation (RSI) in the emergency department (ED). Its onset of action is within 5 to 15 seconds, and its duration of action is 5 to 15 minutes. ⋯ Etomidate may cause pain on injection, myoclonic movements on induction, hiccups, nausea and vomiting. Transient adrenal suppression has been reported, but not to a clinically significant degree, after single induction doses for ED RSI. Etomidate has been well studied in the ED and should be adopted for RSI in specific ED patient groups.
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Clinical prediction rules are decision-making tools that incorporate three or more variables from the history, physical examination or simple tests. They help clinicians make diagnostic or therapeutic decisions by standardizing the collection and interpretation of clinical data. There is growing interest in the methodological standards for their development and validation. This article describes the methods used to derive the Canadian C-Spine Rule and provides a valuable reference for investigators planning to develop future clinical prediction rules.