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    Prehospital neuromuscular blockade post OHCA: UK's first paramedic-delivered protocol

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    Author
    Durham, Mark
    Westhead, Pete
    Griffiths, David
    Lyon, Richard cc
    Lau-Walker, Margaret
    Keyword
    Emergency Medical Services
    Pre-hospital Care
    Out-of-Hospital Cardiac Arrest (OHCA)
    Return of Spontaneous Circulation (ROSC)
    Neuromuscular Blockade
    Journal title
    Journal of Paramedic Practice
    
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    URI
    http://hdl.handle.net/20.500.12417/841
    DOI
    10.12968/jpar.2020.12.5.202
    Abstract
    Background: 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. Aims: To examine the first cases of paramedic-delivered neuromuscular blockade, and evaluate the prevalence of its use and safety. Methods: Retrospective service evaluation of patients receiving post-arrest paralysis during the study period from 1 April 2016 until 31 July 2017. Findings: 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. Conclusion: 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. Abstract published with permission.
    ae974a485f413a2113503eed53cd6c53
    10.12968/jpar.2020.12.5.202
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    Publications - South East Coast Ambulance Service

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