title: Out-of-hospital use of neuromuscular-blocking agents in the United States.
abstract: OBJECTIVE
  A national survey was mailed to state EMS directors to assess the current status of use of neuromuscular-blocking agents (NMBAs) by EMS systems across the United States.
  
  
  METHODS
  Initial and second mailings were completed in early 1996 and 1997, respectively.
  
  
  RESULTS
  Replies were received from all 50 (100%) states following the second mailing. Twenty-nine (58%) states use NMBAs. Eleven (22%) of the 29 use paralytic drugs only in aeromedical programs. Of the 18 states that use NMBAs in ground-based EMS systems, 11 (22%) use paramedic ambulance staffing exclusively. Registered nurses (RNs) or RN-paramedic teams comprised the majority of the remaining states' staffing configurations. The first reported date of implementation of use of NMBAs was 1985, and there has been a steady trend of additional states launching paralytic drug use over the last 12 years.
  
  
  CONCLUSIONS
  This trend suggests that use of paralytic drugs by paramedics is becoming standard of care in many out-of-hospital systems.
authors.affiliation: North Carolina Office of Emergency Medical Services, Division of Facility Services, Department of Health and Human Resources, Raleigh 27626-0530, USA.
authors.forename: C C
authors.initials: CC
authors.lastname: McDonald
authors.forename: B
authors.initials: B
authors.lastname: Bailey
mesh_terms: D004632:Emergency Medical Services / Q000706:statistics & numerical data* / Q000639:trends; D004638:Emergency Treatment / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006801:Humans; D007442:Intubation, Intratracheal; D009466:Neuromuscular Blocking Agents / Q000627:therapeutic use*; D011795:Surveys and Questionnaires; D014481:United States
chemical_list: D009466:Neuromuscular Blocking Agents