Does anyone else carry.....

Phridae

Phridae

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Does anyone else carry succinylcholine? We're seriously thinking of it. A bit costly though, because it has to be kept in a 'fridge. That means we're going to putting refrigerators in our rigs. Or so thats the talk lately. Its not a drug I'll be using but still. We have this awsome medical control. He trusts us so much, and he's willing to help us get what we need.
 
Originally posted by Phridae@Feb 20 2005, 09:56 PM
Does anyone else carry succinylcholine? We're seriously thinking of it. A bit costly though, because it has to be kept in a 'fridge. That means we're going to putting refrigerators in our rigs. Or so thats the talk lately. Its not a drug I'll be using but still. We have this awsome medical control. He trusts us so much, and he's willing to help us get what we need.
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Flight medics areound here have it... next time Medic03 signs he'll probably comment if he sees it.
 
Our fly car medics that respond with the vollies carry etomidate for RSI, the great thing about it is that they have it under standing orders :D
 
We carry Vecuronium for a paralytic under standing orders.
My director prefers a non depolarizing agent instead of succs - he believes there are too many bad side effects associated with it.
 
only ERs and the flight crews carry that business around here. Somehow im happy, the idea of injecting a patient with a medication they put in the coctail that constitutes the lethal injection.
 
Another good one for rsi Diprivan, aka "Milk of Amnesia", works everytime and has a short half life when the infusion is stopped very littel side effects, too bad we dont refridgerator on the buses to keep it cool. Also great for vented transports... :D
 
Originally posted by rescuecpt+Feb 20 2005, 10:36 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (rescuecpt @ Feb 20 2005, 10:36 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-Phridae@Feb 20 2005, 09:56 PM
Does anyone else carry succinylcholine? We're seriously thinking of it. A bit costly though, because it has to be kept in a 'fridge. That means we're going to putting refrigerators in our rigs. Or so thats the talk lately. Its not a drug I'll be using but still. We have this awsome medical control. He trusts us so much, and he's willing to help us get what we need.
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Flight medics areound here have it... next time Medic03 signs he'll probably comment if he sees it. [/b][/quote]
well erika, you're right, I am going to comment. :P
Succinylcholine is a depolarizing neuromuscular blocking drug which means it will compete and bind to receptors for acetylcholine. The problem is that it can lead to fasciculations (muscle twitching) which is uncontrolable by the pt. In some rare cases, the pt can go into a condition called malignant hyperthermia which is when the pt's temp rises above 108, 110........ the pluses are it's quick onset and short lasting life in case you cant get the tube. You can't use it on major trauma, any burn pt's that ocured 24 hours ago and any eye trauma pt's. I don't cary succ with me but we have it at the hospital. I carry etomidate, mivacurium, pancuroniun and narcs for sedation. That's more then enough to keep an elephant down. Really look into the diffrent RSI agents before you commit to succ. It's a great drug, but I feel using etomidate and then mivacurium is a great combo. As for the diprovan, it's wonderful and I love using it. I don't carry it, but if I grab a pt from another hospital and they are on it, I take it with me.
 
Another good one for rsi Diprivan, aka "Milk of Amnesia", works everytime and has a short half life when the infusion is stopped very littel side effects, too bad we dont refridgerator on the buses to keep it cool. Also great for vented transports...
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Nice to see someone else knows that term (yes, it REALLY DOES look like coffee creamer!) what is it's life without refridgeration? the trasport team I used to work with carried it in the drug box in their trucks, not really temp controlled.

well erika, you're right, I am going to comment.
Succinylcholine is a depolarizing neuromuscular blocking drug ... I carry etomidate, mivacurium, pancuroniun and narcs for sedation. That's more then enough to keep an elephant down. Really look into the diffrent RSI agents before you commit to succ. It's a great drug, but I feel using etomidate and then mivacurium is a great combo.
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Also, I've heard that some of the children's hospitals don't like it either, prefer vecuronium, but that is secondhand from some docs at clinical sites.


Around here (PA) Paragods cannot RSI per the state (no RSI drugs on the state list) Flight medics and PHRN's can (some ground-based units have sux and vec for the nurses onboard). Also, I know of two VERY ACTIVE medical directors who carry RSI in their personal "goodie bags."

Flight crews can RSI, and that is actually an excuse to call them - very advanced airway managment (often they will push the drugs and give the local medic first shot at the tube, but not always)


Jon
 
Sevral co's in PA have done RSI as part of Dr. Wang's RSI study, and the results have come back enough to have the state continue to say RSI = EVIL.

Oh, as for narcs as RSI, I know of some medics who have used them as such, and most medical directors will ignore that use / back you up, so long as you GET THE TUBE. If you don't they will probably hang you out to dry to protect themselves, since the state sez : RSI = EVIL

anyway, that is my understanding of pennsyltucky and RSI

Jon
 
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