AI Article Synopsis
- The study analyzed the effects of two neuromuscular blocking agents, succinylcholine and rocuronium, during rapid sequence intubation (RSI) performed by emergency medical services on patients without cardiac arrest.
- Both medications showed similar Cormack-Lehane grades (views during laryngoscopy) and first-attempt success rates, with 84% for succinylcholine and 83% for rocuronium.
- The time from drug administration to the first intubation attempt was shorter for succinylcholine (57 seconds) compared to rocuronium (83 seconds), and peri-intubation hypoxemia rates were comparable for both drugs, around 25% for succinylcholine and
Article Abstract
Objective: Rapid sequence intubation (RSI) is frequently performed by emergency medical services (EMS). We investigated the relationship between succinylcholine and rocuronium use and time until first laryngoscopy attempt, first-pass success, and Cormack-Lehane (CL) grades.
Methods: We included adult patients for whom prehospital RSI was attempted from July 2015 through June 2022 in a retrospective, observational study with pre-post analysis. Timing was verified using recorded defibrillator audio in addition to review of continuous ECG, pulse oximetry, and end-tidal carbon dioxide waveforms. Our primary exposure was neuromuscular blocking agent (NMBA) used, either rocuronium or succinylcholine. Our prespecified primary outcome was the first attempt Cormack-Lehane view. Key secondary outcomes were first laryngoscopy attempt success rate, timing from NMBA administration to first attempt, number of attempts, and hypoxemic events.
Results: Of 5,179 patients in the EMS airway registry, 1,475 adults received an NMBA while not in cardiac arrest. Cormack-Lehane grades for succinylcholine and rocuronium were similar: grade I (64%, 59% [95% CI 0.64-1.09]), grade II (16%, 21%), grade III (18%, 16%), grade IV (3%, 3%). The median interval from NMBA administration to start of the first attempt was 57 s for succinylcholine and 83 s for rocuronium (mean difference 28 [95% CI 20-36] seconds). First attempt success was 84% for succinylcholine and 83% for rocuronium. Hypoxemic events were present in 25% of succinylcholine cases and 23% of rocuronium cases.
Conclusions: Prehospital use of either rocuronium or succinylcholine is associated with similar Cormack-Lehane grades, first-pass success rates, and rates of peri-intubation hypoxemia.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1080/10903127.2023.2285399 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Dantrolene inhibition of ryanodine receptor 1 carrying the severe malignant hyperthermia mutation Y522S visualized by cryo-EM.
Structure
December 2024
Department of Physiology and Biophysics, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298, USA. Electronic address:
Mutations in the skeletal isoform of the ryanodine receptor 1 (RyR1) pose grave risks during anesthesia or treatment with succinylcholine muscle relaxants. These can trigger a potentially lethal malignant hyperthermia (MH) episode via intracellular calcium increase mainly from RyR1 channel leakage. Dantrolene is the only known treatment option to prevent death.
View Article and Find Full Text PDFAnesthetic anaphylactic shock in an emergency cesarean section: a case report.
BMC Anesthesiol
December 2024
Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), West China Second University Hospital, Sichuan University, Chengdu, Sichuan, 610041, P. R. China.
Background: Neuraxial anesthesia is the gold standard for cesarean sections, but general anesthesia is sometimes necessary, especially in emergency cases. Anaphylactic shock due to succinylcholine, a commonly used neuromuscular blocking agent, is rare but life-threatening.
Case Presentation: A 42-year-old woman with severe preeclampsia and a history of intracranial vascular malformations underwent an emergency cesarean section.
Dexmedetomidine and Nitrous Oxide as Anesthetic Agents for Electroconvulsive Therapy: A Case Report.
J ECT
December 2024
Department of Psychiatry, Nowon Eulji Medical Center, Uijeongbu Eulji Medical Center, Eulji University, Seoul, Korea.
Electroconvulsive therapy (ECT) is a therapeutic intervention that induces generalized seizures under general anesthesia. This case report compares the efficacy of dexmedetomidine (DEX) and nitrous oxide (N2O) to that of propofol during ECT procedures. A 33-year-old woman with a 15-year history of schizophrenia and recurrent psychotic episodes underwent ECT.
View Article and Find Full Text PDFNational Survey of Airway Management Practices and Training Among Emergency Medicine Residency Programs in the United States.
Perm J
December 2024
Department of Emergency Medicine, Kaiser Permanente San Diego Medical Center, San Diego, CA, USA.
Article Synopsis
- A study was conducted to analyze airway management training in emergency medicine residency programs across the U.S., highlighting the need for residents to receive extensive training due to evolving practices.
- The study surveyed 258 residency program directors, with 63 responding, primarily from university-based hospitals, revealing that residents typically perform 50-100 intubations, but few pediatric intubations.
- The results indicate a rising use of video laryngoscopy and varied teaching methods to enhance resident exposure to advanced airway management techniques in emergency medicine.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!