EM ONE – September Update – Changing SUX to ROC

So this post is not about new data, but a new way of practicing emergency medicine.  Our EMS system will be switching from using Succinylcholine (SUX) to using Rocuronium (ROC) on selected intubated patients next month.

Below is the data behind the decision, which might make you reconsider using ROC preferentially for intubations, but at least should make you more comfortable with others using it.

Here is what is discussed this month and rationale for the change:

  1. SUX will NOT “wear off” to prevent surgical airway

  2. ROC gives you a longer safe apneic time ***

  3. Appropriate ROC dose provides equivalent intubation conditions to SUX

  4. SUX has contraindications, particularly in our patients

  5. SEDATION: ROC removes your cues to sedate a patient**

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