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 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.


CONCLUSIONS
Paramedics trained to use succinylcholine, to assist the process of endotracheal intubation, can safely intubate a high percentage of patients.
Wayne
M A
MA
Emergency Medical Services, Bellingham/Whatcom County Washington, WA 98225, USA. mwayne@cob.org
Friedland
E
E
D019296:Capnography; D002983:Clinical Competence / Q000592:standards; D017723:Drug Utilization Review; D004634:Emergency Medical Technicians / Q000193:education*; D004638:Emergency Treatment / Q000379:methods / Q000592:standards* / Q000639:trends; D015600:Glasgow Coma Scale; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods / Q000639:trends*; D009467:Neuromuscular Depolarizing Agents / Q000627:therapeutic use*; D018579:Patient Selection; D012189:Retrospective Studies; D013390:Succinylcholine / Q000627:therapeutic use*; D013396:Suction; D016896:Treatment Outcome; D014861:Washington
D009467:Neuromuscular Depolarizing Agents; D013390:Succinylcholine