In adult beta blocker overdose, which drug is given for sedation prior to pacing?

In adult beta blocker overdose, which drug is given for sedation prior to pacing?

• A. Zofran 4 mg IV/IO
• B. Glucagon 1 mg IV/IO
• C. Push-Dose Epi 1 ml of 1:10,000 Epi/9 ml NS every 30 seconds
• D. Etomidate: 10 mg IV/IO SLOW (for sedation prior to Pacing)

Answer: (D)

Sedation for pacing in this setting must use a drug that keeps blood pressure and heart rate as stable as possible while quickly providing unconsciousness. Etomidate fits that need: it acts rapidly, wears off quickly, and has minimal impact on hemodynamics, making it safer for an unstable patient who may require urgent transcutaneous pacing. The other options don’t serve this purpose: Zofran is just an antiemetic, not a sedative; glucagon helps counteract beta-blocker effects by increasing cAMP but does not sedate; and a vasopressor like push-dose epinephrine would support blood pressure but adds cardiovascular stress and does not provide sedation.

Sedation for pacing in this setting must use a drug that keeps blood pressure and heart rate as stable as possible while quickly providing unconsciousness. Etomidate fits that need: it acts rapidly, wears off quickly, and has minimal impact on hemodynamics, making it safer for an unstable patient who may require urgent transcutaneous pacing. The other options don’t serve this purpose: Zofran is just an antiemetic, not a sedative; glucagon helps counteract beta-blocker effects by increasing cAMP but does not sedate; and a vasopressor like push-dose epinephrine would support blood pressure but adds cardiovascular stress and does not provide sedation.