Since 2000, there have been over 500,000 opioid related overdose deaths in the US. (Burke 2016). Despite the epidemic of opioid deaths, these drugs continue to be used as first line agents for treatment of moderate to severe pain in Emergency Departments (EDs).
This post is cross-posted on REBEL EM here.
Etomidate and ketamine are both routinely used as induction agents during rapid sequence intubation (RSI) in trauma patients. It is well established that etomidate transiently suppresses the adrenal gland through inhibition of the 11-beta hydroxylase enzyme.