The use of neuromuscular blocking agents in the emergency department to facilitate tracheal intubation in the trauma patient: help or hindrance
Information Services, Academic Computing Services; Department of Anesthesiology; Department of Emergency Medicine
Adult; *Emergency Treatment; *Facial Injuries; Female; Humans; *Intubation, Intratracheal; Male; Neuromuscular Depolarizing Agents; Neuromuscular Nondepolarizing Agents; Registries; Respiratory System; Retrospective Studies; Succinylcholine; Vecuronium Bromide
Anesthesiology | Emergency Medicine | Life Sciences | Medicine and Health Sciences
PURPOSE: The purpose of this study is to examine the relationship between the occurrence of a difficult intubation and (1) the use of neuromuscular blocking agents (NMB) and (2) the presence of airway injuries. It is a retrospective analysis of data from a trauma registry.
MATERIALS AND METHODS: Registry records of patients (n = 160) who required emergent endotracheal intubation or establishment of a surgical airway over a 3.5-year period in the emergency department were reviewed. Risk factors for difficult intubations were identified and analyzed using multivariate logistic regression analysis.
RESULTS: NMB were used in 75% of patients requiring intubation. Fifteen percent of the intubations were considered difficult. No association was found between the presence of airway injuries and difficult intubations; however, the use of succinylcholine was associated with a lower risk of difficult intubations compared with intubations where a nondepolarizing NMB was used.
CONCLUSIONS: The use of succinylcholine may result in fewer difficult intubations in the trauma patient than when a nondepolarizing NMB is used. The presence of airway injuries did not appear to predispose to difficult intubations.
J Crit Care. 1998 Mar;13(1):1-6.
Journal of critical care
Vijayakumar E, Bosscher H, Renzi FF, Baker SP, Heard SO. (1998). The use of neuromuscular blocking agents in the emergency department to facilitate tracheal intubation in the trauma patient: help or hindrance. Information Technology Publications. Retrieved from https://escholarship.umassmed.edu/infoservices/55