Prehospital neuromuscular blockade post OHCA: UK's first paramedic-delivered protocol
Mark Durham, Pete Westhead, David Griffiths, Richard Lyon, Margaret Lau-Walker
Saturday, May 2, 2020
Since 2016, critical care paramedics from the South East Coast Ambulance Service have offered neuromuscular blockade to patients for ventilatory/airway control after cardiac arrest.
To examine the first cases of paramedic-delivered neuromuscular blockade, and evaluate the prevalence of its use and safety.
Retrospective service evaluation of patients receiving post-arrest paralysis during the study period from 1 April 2016 until 31 July 2017.
The study included 127 patients. The mean age of administration was 63 years, mean weight was 80 kg (SD: 19 kg), dose was 1 mg/kg and median time from rocuronium administration to hospital was 32 minutes (IQR 20–43 minutes). Three patients (2.3%) experienced a minor adverse incident. There were no major airway complications, nor other significant adverse incidents. Thirty-seven patients (31%) survived to discharge.
From this patient group, paramedic-administered rocuronium in intubated patients who have experienced a cardiac arrest and a return of spontaneous circulation appears to be safe, but further interventional research is required to determine whether this improves patient outcomes.
Subscribe to get full access to the Journal of Paramedic Practice
Thank you for vising the Journal of Paramedic Practice and reading our archive of expert clinical content. If you would like to read more from the only journal dedicated to those working in emergency care, you can start your subscription today for just £48.
Reading the Journal of Paramedic Practice counts towards your professional development
Develop your career
We provide professional information dedicated to paramedics covering training, education and jobs
Get the latest clinical information to ensure you are aware of the latest think and best practice in paramedicne
Already registered? - Sign in here