Sux vs Roc

If you’re a regular subscriber to HEFT EMCAST you will be aware of our recent discussion regarding ED rapid sequence induction. For those you who haven’t listened to the podcast, or simply need a reminder, rapid sequence induction (RSI) is the preferred method of emergency tracheal intubation outside the operating room because it results in a rapid state of unconsciousness (induction) and neuromuscular blockade (paralysis). There’s loads more information about ED RSI on the earlier episode, which you can view here along with the accompanying blog. In today’s episode we will be looking at neuromuscular blockade for the purposes of RSI in the emergency department. Specifically, we are going to look at the two neuromuscular blocking agents (NMBA) suxamethonium and rocuronium. We’ve covered a number of papers including a systematic review so there’s lots of information to digest. This reflects the paucity of data specific to the ED. There are some useful take home messages that are summarised at the end.