Boston Bombing Suspect Sedated and Communicating

We continue to follow the reports of the medical care being given by Boston bombing suspect Dzhokhar Tsaranaev. The patient is reportedly intubated and sedated but able to communicate with investigators via writing. CNN has a report that discusses this written in part by health reporter Elizabeth Cohen that uses quotes from several physicians commenting on the case. Unfortunately, these characterizations are inaccurate and wrong and were given by two physicians (Dr. Albert Wu and Dr. Corey Siegel) that obviously do not routinely sedate patients trauma patients in an ICU. Only Dr. Athos Rassias of Dartmouth, who is Director of the Critical Care Fellowship at Dartmouth, would have direct daily experience in sedating patients in the ICU. ICU sedation is a tricky and difficult thing to optimally effect. Generally, almost all surgical trauma patients who are intubated through the mouth or nose require some sedation. Having an endotracheal tube in the pharynx and trachea can cause a gag reflex. In addition, the mode of ventilation sometimes does not always “sync up” with the normal breathing pattern and this can cause distress. The two most common regimens to effect sedation in the ICU are a combination of narcotic and benzodiazepine or the use of propofol. There are advantages and disadvantages to each. In the narcotic/benzo regimen typical drugs used are fentanyl and midazolam, sometimes if the need is thought to be some a longer duration given as a continuous drip. ...
Source: Inside Surgery - Category: Surgeons Authors: Tags: Musings Albert Wu bomb breathing communicating Corey Siegel ICU propofol Ramsey sedation suspect Tsarnaev Source Type: blogs