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Conquer Difficult Airway
Conquer Difficult Airway
E XCESSIVE WEIGHT
D EFORMITY
I NCISORS
C -SPINE
T HYROMENTAL DISTANCE
U VULA
B URNS
E MESIS
S TRIDOR
Conquer Difficult Airways
Succinylcholine Side Effects
Succinylcholine is a depolarizing paralytic and will cause muscles to
contract prior to causing paralysis. Non-depolarizing paralytics such as
vecuronium do not cause muscle contractions and can be given in small
doses prior to administration of succinylcholine to prevent muscle
fasciculations. Non-depolarizing agents have a longer lasting effect than
succinylcholine, and are used to paralyze patients for longer time periods
after the airway has been secured.
Fasciculation: Within 30-60 seconds following administration of
succinylcholine, muscles fasciculate (contract) uncontrollably as muscle
tissue depolarizes. Fasciculation typically lasts for less than 15 seconds.
These involuntary muscle contractions don't usually pose a problem unless
the patient has skeletal fractures that movement could aggravate. You can
administer a decreased dose of a non-depolarizing muscle relaxant, such
as Vecuronium, two minutes prior to succinylcholine administration to
prevent muscle fasciculation.
Elevation of intracranial, intragastric and intraocular pressure:
Succinylcholine transiently increases pressure within the brain, stomach
and eyes. Thus, EMS providers should anticipate vomiting and minimize
the potential for aspiration. Succinylcholine is contraindicated in patients
with penetrating eye injuries and glaucoma. Patients with increased
intracranial pressure (ICP) often require airway protection and controlled
5. Properties of succinylcholine that make its use ideal for RSI include:
A. long lasting effects
B. rapid onset
C. few serious side effect
D. does not cause fasciculations
Your correct answer: B
7. The body responds to the stimulus of a laryngoscope inserted into the airw
A. decreasing blood pressure
B. increasing blood pressure
C. increasing airway secreations
D. decreasing airway secreations
Your correct answer: B
8. Fasiculations:
A. can be fatal
B. usually last less than 15 seconds
C. last for up to two hours
D. may cause hypoxia
Your correct answer: B
12. Which of the following lung sounds indicates upper airway blockage?
A. rales
B. crackles
C. wheezes
D. stridor
Your correct answer: D
15. Succinylcholine can cause elevation in pressure in all of the following EXC
A. eyes
B. lungs
C. brain
D. stomach
Your correct answer: B
18. Which of the following patients would be most likely to develop bradycar
A. pediatric patients
B. patients with cardiovascular disease
C. burn patients
D. hypoxic patients
Your correct answer: A