[Rapid sequence induction in prehospital emergency medicine: is it safe?].
OBJECTIVE
The use of 0,9 mg/kg Rocuronium allows endotracheal intubation within 60 seconds and therefore might be an alternative to succinylcholine for rapid sequence induction. We investigated the use of high-dose Rocuronium for RSI in prehospital emergency medicine.


METHODS
Rocuronium was used in two physician staffed units of emergency medical service for RSI in 79 patients aged 4 - 81 yrs (mean 46 yrs). Anesthesia was induced with etomidate/fentanyl or ketamine and 1 mg/kg of rocuronium. Recorded data were number of intubations, time interval application rocuronium-intubation, rating of intubation conditions and side effects.


RESULTS
In 75 of 79 (94,9 %) patients intubation could be performed at the first attempt. In three (3,8 %) patients a second attempt and in one pt. a third attempt was necessary. In 78 (98,7 %) patients intubation could be performed within 60 seconds, in one patient intubation was completed within three minutes. The intubation conditions were estimated as excellent (n = 69; 87,3 %) or good (n = 10; 12,7 %) in all patients. No specific side effects could be observed.


CONCLUSIONS
The use of muscle relaxants improves the intubation conditions and may help to avoid unnecessary high doses of anesthetics in hemodynamic unstable emergency patients. This study shows that rocuronium might be an alternative to succinylcholine for RSI also in prehospital emergency medicine, if succinylcholine is contraindicated.
Kill
C
C
Klinik für Anästhesie und Intensivtherapie, Philipps-Universität, Marburg. killc@mailer.uni-marburg.de
Wranze
E
E
Wulf
H
H
Geldner
G
G
D000732:Androstanols / Q000008:administration & dosage*; D004630:Emergencies; D004632:Emergency Medical Services; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage*; D000077123:Rocuronium
D000732:Androstanols; D003473:Neuromuscular Nondepolarizing Agents; D000077123:Rocuronium