EBQ:Comparison of Succinylcholine and Rocuronium for RSI: Difference between revisions

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==Clinical Question==
==Clinical Question==
How do succinylcholine and rocuronium compare for use is rapid-sequence intubation in the emergency department?


==Conclusion==
==Conclusion==
Both succinylcholine and rocuronium produce fast and reliable paralysis for RSI in the ED.


==Major Points==  
==Major Points==  
 
{| class="wikitable"
|-
! Result !! Succinylcholine !! Rocuronium
|-
| Time of Onset (± SD) || 39 (± 13) seconds || 44 (± 20) seconds
|-
| Mean Dosage || 1.7 mg/kg || 1.0 mg/kg
|-
| Satisfaction 0-10 (± SD) || 9.4 (± 1.3) || 8.8 (± 2.0)
|}
==Study Design==
==Study Design==
*Data form completed by intubator immediately after intubation with following info
**Patient's name, age, gender, paralytic used, reason for use, time from administration to paralysis, serum K at time of intubation, need for BVM ventilations, pulse ox readings during intubation, any complications
==Population==
==Population==
===Patient Demographics===
===Patient Demographics===
*Mean age: 46 years old
**Range: days old-96 years old
*Male: 63%
===Inclusion Criteria===
===Inclusion Criteria===
*Every patient intubated in the ED from January 1, 1998 to December 31, 1998 was eligible for enrollment


===Exclusion Criteria===
===Exclusion Criteria===


==Interventions==  
==Interventions==  
Prospective observational study of paralytic use in ED
   
   
==Outcomes==
==Outcomes==
N= 521 patients who received RSI in the ED
*382 (73%) received succinylcholine
*138 (26%) received rocuronium


===Primary Outcome===
Indications for
{| class="wikitable"
|-
! Common Indications for Rocuronium Use
! Number of Patients
|-
| Suspected hyperkalemia
| 53
|-
|     Chronic renal failure
| 28
|-
|     Rhabdomyolysis
| 6
|-
| Lack of medical history
| 43
|-
| Known hyperkalemia
| 11
|-
| Neuromuscular disease
| 11
|}


===Secondary Outcomes===


===Subgroup analysis===
   
   
   
   

Revision as of 15:43, 16 September 2015

Under Review Journal Club Article
Laurin EG, et al. "A Comparison of Succinylcholine and Rocuronium for Rapid-sequence Intubation of Emergency Department Patients". Academic Emergency Medicine. 2000. 7(12):1362-9.
PubMed PDF

Clinical Question

How do succinylcholine and rocuronium compare for use is rapid-sequence intubation in the emergency department?

Conclusion

Both succinylcholine and rocuronium produce fast and reliable paralysis for RSI in the ED.

Major Points

Result Succinylcholine Rocuronium
Time of Onset (± SD) 39 (± 13) seconds 44 (± 20) seconds
Mean Dosage 1.7 mg/kg 1.0 mg/kg
Satisfaction 0-10 (± SD) 9.4 (± 1.3) 8.8 (± 2.0)

Study Design

  • Data form completed by intubator immediately after intubation with following info
    • Patient's name, age, gender, paralytic used, reason for use, time from administration to paralysis, serum K at time of intubation, need for BVM ventilations, pulse ox readings during intubation, any complications

Population

Patient Demographics

  • Mean age: 46 years old
    • Range: days old-96 years old
  • Male: 63%

Inclusion Criteria

  • Every patient intubated in the ED from January 1, 1998 to December 31, 1998 was eligible for enrollment

Exclusion Criteria

Interventions

Prospective observational study of paralytic use in ED

Outcomes

N= 521 patients who received RSI in the ED

  • 382 (73%) received succinylcholine
  • 138 (26%) received rocuronium

Indications for

Common Indications for Rocuronium Use Number of Patients
Suspected hyperkalemia 53
    Chronic renal failure 28
    Rhabdomyolysis 6
Lack of medical history 43
Known hyperkalemia 11
Neuromuscular disease 11



Criticisms & Further Discussion

External Links

Funding

References

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