Unintentional intracerebroventricular administration of etomidate and rocuronium.
case_report · Level V
Where this comes from
- Record sourced from PubMed, PMID 18227309.
- Also identified by DOI 10.1213/ane.0b013e3181606ae5.
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Abstract
We report the unintentional intracerebroventricular administration of etomidate and rocuronium through a ventriculostomy catheter in the intensive care unit during a rapid sequence induction for endotracheal intubation. Rapid loss of consciousness, apnea, and vocal cord abduction occurred, creating excellent intubating conditions. The patient remained hemodynamically stable throughout induction and intubation. Inexperience of nursing personnel and systems errors were factors contributing to the drug error. The management, clinical course, predisposing factors, and strategies for prevention will be discussed.
Medical subject headings
- Androstanols
- Etomidate
- Medication Errors