Quote:
Originally Posted by Underwhelmed
While we're on the subject of airway drugs, did you guys hear about the new study that dispeled the intraocular pressure contraindication of succinylcholine?
Increased intraocular pressure was one of the like... 13 contraindications of succinylcholine; one of my buddies [a flight surgeon] found a study that equated the increase in pressure to blinking your eyes 80 times.
I mean, It dosen't really change much, I'm not gonna ask the head trauma patient with a clenched jaw if he has narrow-angle glacouma before we RSI his ass. They used to make us put temp strips on their forehead for malignant hyperthermia, too--- I mean I can see why, and I understand the dangers... but there's no way we can tell most of the time. It's not like they make 'medic alert' bracelets that say "Malignant Hyperthermia".
I guess that's why prehospital medicine makes some providers stroke out, if we followed some of the "relative" contraindications in a good number of life-saving medications we would never get our jobs done.  |
I'd like to see the study if you can get it. Many of the unwanted effects of succinylcholine (Sux), a depolarizing neuro-muscular blocker, can be obtunded with a small dose of non-depolarizer in pre-treatment; 3mg of Currare (DTC) was what I used. Other notable effects include increased intragastric pressure, and generalized muscle pain being the most noted. While there are now rapid acting non-depolarizers on the market, Sux is the most rapidly acting neuro-muscular blocker, for rapid endotracheal intubation. Open globe injuries would probably have me looking at Zemuron, but probably would heavy pretreat and go with sux. The choice is really a huge risk/benefit decision. You say, "it dosen't really change much"; not so if you are leaking vitrious from an eye. The choice is bilndness or death from aspiration pneumonitis.
Malignant Hyprethermia is another issue that is well off topic here. If I had it, or someone in my family had it, I WOULD get a bracelet. I'd also do the same for all genetically linked family members. A temp rise is a late indicator in this dangerous event. I would be glad to begin a thread on Malignant Hyperthermia if SS and other mods think it would be of value.
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