Paralytics for field use.

[ffdmedic9504]

Looking for protocols on paralytics in the field. Our Medical Dir. has given the OK to research and write protocols,but would prefer a shorter acting med other than succinylcholine. Any suggestions? Thanks in advance!

[BVFD]

Norcuron?

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Learn all the jobs, at some point you'll have to do them


[This message has been edited by BVFD (edited February 02, 2000).]

[Trauma_Dog]

Hi there, we have been doing rapid sequence intubations in the field for about 4 years now. We have changed a few things since we started and now we feel that our protocol now is the best we have to date. I will include it at the end.

First, succinylcholine is the drug of choice for R.S.I. and to my knowledge there is none with a faster onset. There are some side effects like increased ICP, however those can be abated or blunted by premedication of you pt with other adjunctive medications.
The rapid onset and short half life make it a good choice. If yo are faced with a failed intubation you can bag you pt until it wears off some of the other agents like pavlon or vecuronium have much longer half lifes.

OUR PROTOCOL

You much have enough personell to do the job (at least 2).
Cric kits
all equipment set up and ready to go.

Oh yea, we have to call the supervisor for orders usally not a big deal there all pretty good about it.

Premedication
100 mg. lidocaine - blunts s/e
100 mcg. fentanyl - blunts s/e
20 mg. Etomodate - seditive hypnotic

Paralyzie
200 mg. succinylcholine - depolorizing relaxant.

Mantience
5 mg versed - seditive hypnotic
10 mg nercuron - non-depolorizing relaxant

I have seen (2 times) when using RSI on CHF pt's which have gone into asystole after the admin of the succinylcholine, however both responded well to med therapy and were resusitated. Anymore question or want more detailed copy of our protcol e-mail me.Peace.
The Dog.


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Kent Simon
Paramedic Incharge
MCHD EMS,
Montgomery Co.,TX

[STBURNE]

Not sure that there is a shorter acting med than succinylcholine. It has a pretty rapid onset. This is the drug of choice for our system for RSI.Our protocols are identical to Trauama Dog's minus the fentanyl and norcuron.