Etomidate

Provider Level

RN/Paramedic

Class

Non-barbiturate sedative-hypnotic, general anesthetic

Mechanism of Action

Produces rapid, short-acting anesthesia by depressing the reticular activating system and modulating GABA receptors in the central nervous system.

Indications

Induction agent for Rapid Sequence Intubation (RSI) and advanced airway management. Sedation for cardioversion or short painful procedures.

Contraindications

Known hypersensitivity to etomidate. Use with caution or avoid in septic shock due to adrenal suppression.

Routes

IV, IO

Onset / Duration

Onset: 10 to 20 seconds. Duration: 3 to 5 minutes.

Adverse Effects

Myoclonus, transient apnea, nausea, vomiting, injection site pain, dose-dependent suppression of adrenal steroidogenesis.

Precautions & Interactions

Caution in patients with marked hypotension, severe asthma, or cardiovascular disease. Can cause transient but clinically significant adrenal suppression.

Special Considerations

Etomidate possesses no analgesic properties. Co-administration of analgesics is required for painful procedures. Continuous hemodynamic and airway monitoring is mandatory.