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Succinylcholine-assisted intubations in prehospital care
J R Hedges1, S C Dronen, S Feero
1Department of Emergency Medicine, University of Cincinnati, College of Medicine, Ohio 45267-0769.
Annals of Emergency Medicine
|May 1, 1988
Summary
Paramedics safely used succinylcholine (SUX) to improve endotracheal intubation success in critically ill patients. SUX-assisted intubation was linked to better survival rates and fewer complications in prehospital settings.
Area of Science:
- Emergency Medicine
- Critical Care
- Anesthesiology
Background:
- Endotracheal intubation is crucial for critically ill patients but challenging prehospital.
- Short-acting paralytics are rarely used by paramedics for intubation.
- Succinylcholine (SUX) has been used by one EMS system for over a decade.
Purpose of the Study:
- To evaluate the safety and effectiveness of succinylcholine-assisted endotracheal intubation by paramedics.
- To compare outcomes of intubations with and without succinylcholine in a prehospital setting.
Main Methods:
- Retrospective review of prehospital intubations over two years.
- Comparison of patient characteristics and outcomes between succinylcholine and non-succinylcholine groups.
- Analysis of hospital records for complications like aspiration pneumonia and need for mechanical ventilation.
Main Results:
- 95 patients received succinylcholine-assisted intubation; 215 did not.
- SUX group had more women, higher Glasgow Coma Scale scores, fewer cardiac arrest cases, and higher survival rates (58% vs 24%).
- No significant difference in aspiration pneumonia or mechanical ventilation; no emergency cricothyrotomy or esophageal intubation occurred.
Conclusions:
- Succinylcholine-assisted endotracheal intubation can be safely and selectively used by paramedics.
- This practice facilitates airway control and ventilation in patients with difficult intubations.
- SUX use in prehospital settings may improve patient outcomes.