Lack of a hyperkalemic response in emergency department patients receiving succinylcholine.
OBJECTIVE
To determine whether serum potassium (K) levels increase significantly following succinylcholine (SCh)-assisted intubation in ED patients.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Section of Emergency Medicine, University of Michigan School of Medicine, Ann Arbor 48109-0303, USA.
B J
BJ
Zink
H S
HS
Snyder
N
N
Raccio-Robak
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D004630:Emergencies; D005260:Female; D006801:Humans; D007008:Hypokalemia / Q000097:blood / Q000139:chemically induced; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D009467:Neuromuscular Depolarizing Agents / Q000008:administration & dosage / Q000009:adverse effects*; D011188:Potassium / Q000097:blood; D011446:Prospective Studies; D013390:Succinylcholine / Q000008:administration & dosage / Q000009:adverse effects*
D009467:Neuromuscular Depolarizing Agents; D013390:Succinylcholine; D011188:Potassium