Survival following intentional succinylcholine injection for self-harm

Area of Science:

• Anesthesiology
• Emergency Medicine
• Toxicology

Background:

• Succinylcholine is a rapid-acting depolarizing neuromuscular blocking agent.
• Anesthetic drug misuse is a potential cause of sudden deterioration in emergency department patients.

Observation:

• A 28-year-old female healthcare worker presented with respiratory arrest, altered mental status, hypoxia, bradycardia, and hypotension.
• An empty succinylcholine ampoule was found, leading to suspicion of intentional intravenous injection.

Findings:

• The patient received immediate resuscitation, mechanical ventilation, and targeted temperature management.
• She survived without neurological deficits and was discharged after 4 days.

Implications:

• This case highlights the critical need for emergency departments to consider anesthetic drug misuse in patients with unexplained critical illness.
• It is the first reported survival following intentional succinylcholine self-harm injection.