Both Rocuronium and Succinylcholine Are Appropriate for Emergency Intubations

First-pass success rates and incidence of adverse events were similar for both agents in a large national database study.

The two main paralytics used for U.S. emergency department (ED) intubations are rocuronium and succinylcholine. Succinylcholine has a faster onset, but rocuronium has fewer contraindications. While previous evidence showed that succinylcholine results in better intubating conditions in the controlled environment of the operating room, it is unclear if this difference translates to the ED. This analysis of the National Emergency Airway Registry compared first-pass success rates and adverse effects in all patients older than 14 who received either paralytic as part of rapid sequence intubation in 22 EDs during 2016.

Outcomes of 4075 intubations were included; in 1800 (44%) rocuronium was used. Patients who received rocuronium were older and le…

Reviewing Author

Ali S. Raja, MD, MBA, MPH

Disclosures

Leadership Positions in Professional SocietiesSociety for Academic Emergency Medicine (Board Member); American College of Healthcare Executives – Massachusetts (Board Member)

Ali S. Raja, MD, MBA, MPH

Disclosures

Leadership Positions in Professional SocietiesSociety for Academic Emergency Medicine (Board Member); American College of Healthcare Executives – Massachusetts (Board Member)

Both Rocuronium and Succinylcholine Are Appropriate for Emergency Intubations

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Reviewing Author