Effect of a pharmacist on timing of postintubation sedative and analgesic use in trauma resuscitations.
OBJECTIVE
Pharmacists' impact in reducing the time interval from intubation to sedative and analgesic use during trauma patient resuscitations is investigated.


METHODS
A retrospective cohort study was conducted at a level 1 trauma center to compare medication-use outcomes in consecutive cases in which trauma patients underwent rocuronium-assisted rapid-sequence intubation (RSI) and subsequent sedation and analgesia with or without a pharmacist's participation on the resuscitation team. The primary and secondary outcomes were, respectively, the time to sedative provision and the time to analgesic provision after intubation.


RESULTS
Relative to resuscitation cases not involving a pharmacist, the presence of the pharmacist during RSI was associated with decreased mean times to provision of postintubation sedation (9 minutes versus 28 minutes, p = 0.007) and analgesia (21 minutes versus 44 minutes, p = 0.057). The cumulative proportions of patients receiving appropriate sedation 5, 10, and 15 minutes after intubation were 11%, 26%, and 41% in the pharmacist-absent group and 33%, 53%, and 63% in the pharmacist-present group (p = 0.009, 0.008, and 0.045, respectively); for postintubation analgesic use, the corresponding figures were 9%, 14%, and 23% in the pharmacist-absent group and 17%, 30%, and 43% in the pharmacist-present group (p = 0.236, 0.066, and 0.039, respectively).


CONCLUSIONS
The presence of a pharmacist during RSI procedures was associated with decreased times to postintubation sedative and analgesic use, indicating that pharmacist participation in trauma-resuscitation responses can facilitate appropriate drug therapy.
Department of Surgery, College of Medicine, University of Arizona (UA), Tucson, AZ, USA.
Albert
A
Amini
Erynne A
EA
Faucett
John M
JM
Watt
Richard
R
Amini
John C
JC
Sakles
Peter
P
Rhee
Brian L
BL
Erstad
Asad E
AE
Patanwala
D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use*; D000732:Androstanols / Q000009:adverse effects; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control; D010595:Pharmacists; D024382:Professional Role; D012151:Resuscitation / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D000077123:Rocuronium; D013997:Time Factors; D014193:Trauma Centers
D000700:Analgesics; D000732:Androstanols; D006993:Hypnotics and Sedatives; D000077123:Rocuronium