Repeat Dose for Anectine

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What is the repeat dose for Anectine? Is there a repeat dose?

Last shift we RSI'd a 14 yo. While responding to the hospital, my medic repeated the Versed and the Anectine twice, for a total of 6mg Versed (lets try not to get into her initial dose being the wrong amount) and 120mg Anectine.

The ER Dr was pretty upset about the repeated doses of the Anectine. I was to pi$$ed and my medic for so many other things, I didn't stand there and listen to what he was saying to her and I just tuned out her incessant talking in the truck on the way to meet with our shift CPT.

I checked our protocols and my ALS field guide and cannot find anything on giving repeat doses or not giving repeat doses.

Thanks.....and only 6 more Mondays until I finish medic school!!

In our service, Sux is only used for intubation (one dose).

We use Vecuronium for all intubated patients (i.e. after we intubate them, or transporting pre-intubated patients).

Malignant hyperthermia is a risk with Sux... and that only goes up with repeated doses.

I guess if you work in a system with short transport times, there may not have been much need to include a long acting paralytic to your RSI protocols.

We actually use a low (defasciculating) dose of Vec along with Sux (during the initial intubation) in patients with severe burns, crush injuries, and severe head injuries.