Prehospital use of succinylcholine: A 20-year review

Objective. To determine the safety and efficacy of succinylcholine, as an adjunct to endotracheal intubation, administered by paramedics trained in its use. Methods. Retrospective review of 1,657 consecutive patients, aged 16 years or older, receiving prehospital succinylcholine administered by para...

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Bibliographic Details
Published in:Prehospital emergency care 1999, Vol.3 (2), p.107-109
Main Authors: Wayne, Marvin A., Friedland, Eric
Format: Article
Language:English
Subjects:
adults
Capnography
Clinical Competence - standards
Drug Utilization Review
Emergency Medical Technicians - education
Emergency Treatment - methods
Emergency Treatment - standards
Emergency Treatment - trends
Glasgow Coma Scale
Humans
intubation
Intubation, Intratracheal - methods
Intubation, Intratracheal - trends
Neuromuscular Depolarizing Agents - therapeutic use
paralytic
paramedic
Patient Selection
prehospital
Retrospective Studies
succinylcholine
Succinylcholine - therapeutic use
Suction
Treatment Outcome
Washington
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Summary:Objective. To determine the safety and efficacy of succinylcholine, as an adjunct to endotracheal intubation, administered by paramedics trained in its use. Methods. Retrospective review of 1,657 consecutive patients, aged 16 years or older, receiving prehospital succinylcholine administered by paramedics. In this community of 175,000 people, trained paramedics intubated both medical and trauma patients with the assistance of succinylcholine. Main outcomes measured were success of intubations, complications of the procedure and/or the drug, and use of alternative methods of airway management. Results. Paramedics successfully intubated 95.5% (1,582) of all patients receiving succinylcholine, 94% (1,045) of trauma patients, and 98% (538) of medical patients. They were unable to intubate 4.5% (74) of the patients. All of these were successfully managed by alternative methods. Unrecognized esophageal intubation occurred in six (0.3%) patients. The addition of capnography and a tube aspiration device, in 1990, decreased the incidence of esophageal intubations. Conclusion. Paramedics trained to use succinylcholine, to assist the process of endotracheal intubation, can safely intubate a high percentage of patients.
ISSN:1090-3127
1545-0066
DOI:10.1080/10903129908958916