Читать книгу Emergency Medical Services - Группа авторов - Страница 493

The EMS clinician performing rapid sequence intubation (RSI) should avoid depolarizing neuromuscular blocking agents (NMBA) such as succinylcholine in patients who are at risk for being hyperkalemic. Along with the renal failure population, those patients with muscular dystrophy, stroke > 72 hours, crush injury > 72 hours, and burns > 72 hours old are at increased risk of severe hyperkalemia with the use of depolarizing NMBAs due to an upregulation of acetylcholine receptors. Fatal arrhythmias can develop within minutes and the EMS clinician must recognize and appropriately initiate treatment as discussed above. It is recommended that nondepolarizing NMBAs such as rocuronium be used instead for this patient population should RSI be required [39].