Lack of a hyperkalemic response in emergency department patients receiving succinylcholine

To determine whether serum potassium (K) levels increase significantly following succinylcholine (SCh)-assisted intubation in ED patients.

A prospective, noncontrolled, consecutive case series design was used to evaluate the change in serum K levels in ED patients who received SCh for emergency intubation. The study was performed at an academic medical center staffed by board-certified emergency physicians. The subjects were 100 consecutive prescreened ED patients with various diagnoses who received SCh for intubation. The eligible subjects had serum K levels determined prior to and 5 minutes after administration of a 1.0-1.5-mg/kg i.v. dose of SCh. Serum K levels were measured by the ion-selective electrode assay method.

The mean change in serum K levels was -0.04 mmol/L (95% CI -0.14 to 0.06). The maximum increase was 1.10 mmol/L. The serum K level rose in 46 cases, decreased in 46 cases, and was unchanged in eight cases. No instance of SCh-induced cardiac arrest was identified.

Changes in serum K levels following SCh administration in prescreened ED patients were minimal. A hyperkalemic response is uncommon in ED patients who undergo SCh-assisted intubation.