Painkillers and sedatives nearing ‘critical shortage’: emergency physicians’ group

TORONTO — As governments attempt to address the dwindling stock of masks, tests and ventilators needed during the COVID-19 pandemic, a national group of physicians is warning of another supply threat.

Painkillers and sedatives are potentially weeks away from a “critical shortage,” the Canadian Association of Emergency Physicians (CAEP) said in a news release Tuesday.

“This would have significant clinical impact and therefore requires immediate investigation and action,” the group said. 

xWhile the issue of ventilator access has been particularly dire, the group said, some attention needs to be paid to the supply of the medications required to operate the ventilators. A shortage could have devastating consequences for patients who can’t control their breathing, some of whom may even develop delirium on top of the painful, anxiety-inducing process of ventilation.

“All these patients require specific medications to provide sedation, pain control and, in some cases, paralysis,” the CAEP release said.

The drugs in question include sedatives (propofol), benzos (midazolam), painkillers (fentanyl and morphine) and paralytic agents (succinylcholine and rocuronium). Not only may an increasing number of coronavirus-infected patients require these drugs, but they’ll likely need more of them, said the CAEP.

“COVID patients appear to require the support of a ventilator for longer times than other ICU patients and, as such, require more of these essential drugs,” the release said.

The CAEP is calling on authorities to develop processes as the local level to inform physicians of stock levels and possible drug alternatives, including older medications. The group wants a “national review” of the supply, distribution and management of the drugs across provinces, as well as “national management” of procurement, production and distribution of the drugs.

At the clinical level, emergency physicians should use alternative techniques and painkiller options if appropriate and reduce drug waste, the group continued.

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