ICU SAQs · Airway management
First Part — the pharmacology of neuromuscular blockade for RSI
A CICM First-Part (basic sciences) SAQ on the two neuromuscular blocking agents used for rapid sequence induction. The candidate explains depolarising versus non-depolarising blockade, onset and duration, the Cochrane evidence that succinylcholine provides superior excellent intubating conditions, and the contraindications (hyperkalaemia, malignant hyperthermia) that swing the choice to rocuronium with sugammadex.
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Prompt
Compare succinylcholine and rocuronium for rapid sequence induction. Include the mechanism of action, onset, duration, the evidence on intubating conditions, and the adverse effects that determine the choice.
Question
Compare succinylcholine and rocuronium for rapid sequence induction. Include the mechanism of action, onset, duration, the evidence on intubating conditions, and the adverse effects that determine the choice. (10 marks)
References3ShowHide
- [1]Tran DT, Newton EK, Mount VA, Lee JS, Wells GA, Perry JJ. Rocuronium Versus Succinylcholine for Rapid Sequence Induction Intubation. Cochrane Database of Systematic Reviews, 2015.PMID 26512948
- [2]Bersten AD, Soni N (eds) Oh's Intensive Care Manual. 8th edition, Elsevier, 2018.
- [3]Marino PL The ICU Book. 4th edition, Lippincott Williams & Wilkins, 2014.