2016 Trumbull Protocol Book

Succinylcholine (Anectine®)

Succinylcholine (Anectine®)

Action

Onset

Depolarizing Neuromuscular Blocking Agent

1 minute

Indications Rapid Sequence Induction after anesthesia is achieved.

Adult Dose 1mg/kg rapid IV Push

Pediatric Dose Do Not Use

Contraindications Hyperkalemia, allergy, history of malignant hyperthermia, crush injuries, glaucoma, penetrating eye injuries, neuromuscular disease, spinal trauma, abdominal sepsis, CVA, Parkinson’s Disease, Lou Gehrig’s Disease (ALS), presence of burns more than 24 hours old. Side Effects and Adverse Reactions Muscular fasciculation (disorganized muscular contractions), respiratory depression, muscle relaxation, increased ICP, rhabdomyolysis, decrease in heart rate, hyperkalemia, dysrhythmias, excessive salivation, rash. Precautions A proper screening for potential hyperkalemia should be performed prior to succinylcholine administration. Some considerations in potential hyperkalemic patients include tall, peaked T-waves on the ECG, paresthesia and weakness, patients who receive hemodialysis, patients taking potassium supplements (KCl, Klor-Con), patients on certain medications for blood pressure control or heart failure (digitalis, amlodipine, ACE inhibitors). Use caution in patients with closed head injuries. Considerations Ensure a GCS of 3 prior to succinylcholine administration. Your patient should be asleep before you paralyze them. Neuromuscular blocking agents induce paralysis; the patient’s senses are still intact, unless proper anesthesia is achieved.

220

EMR

EMT

AEMT

Paramedic

Extended