My First Few days of ER Pharmacy

Today will be my third day in the ER.  You are probably wondering why I am posting this at 11:30 am….well my hours are a bit different than other rotations.  Since the Emergency Room sees the most traffic during the evening hours, most of my days start at 1pm and end at 9:30 pm.  I welcome this change of pace from other rotations, where getting up early is common.  I also appreciate the fact that I am there during the most eventful times, so I have the most opportunities to learn!

Day 1 and 2 were very eventful, and I got to see a number of different critical patients being cared for.  A number of patients required intubation, so I have gotten very familiar with Rapid Sequence Intubation (RSI), and the role of the Pharmacist in these situations.

During a RSI At Mercy Hospital, the pharmacist is in charge of the medications needed to sedate and paralyze the patient for intubation.  All of these medications are dosed based on weight, so the pharmacist has to be sure to know the dosing and be able to calculate things quickly.  There are a few options for sedation and paralyzation that should be selected according to the patient’s reason for needing intubation, lab values, and other medical conditions.  The pharmacist will help the physician to select the most appropriate medication, draw up the correct dose, and pass it along to the ER nurses for administration.

The pharmacists in this situation also ensure that the medications are given in the correct order:  so the patient is sedated BEFORE they are paralyzed for intubation.  Once the patient is paralyzed, they cannot communicate in any way that they are still awake and feeling pain or discomfort, so it is important to make sure the patient is sedated before administering paralytics.

Mercy Hospital is a Level II trauma center, and received this designation in 2010.  This means they have 24 hour care for patients, among other things.  Here is a link to their webpage with a video describing what needed to be done to gain this Level II status:

Im excited to continue learning about the roles of Pharmacists in Critical Care!

Thanks for reading!

– Heather

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