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PedsCrit
Intubation Essentials with Dr. Alyssa Stoner and Dr. Gina Patel, Part 6 Neuromuscular Blockade
Aug 5, 2021
Dr. Alyssa Stoner and Dr. Gina Patel discuss the importance of Su-Gamidex and medication requirements for intubation. They compare Neuromuscular Blockade medications like Vecuronium, Rocuronium, and succinylcholine and emphasize the timing of administration. The podcast also covers the differences between succinylcholine and rocuronium, the use of sugamadex as a reversal agent, sedation strategies, and institutional preferences for NICU rotations.
16:04
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Quick takeaways
- Rockuronium is preferred over Succinylcholine in the ICU due to its shorter duration and availability of sugamadex for reversal.
- Different medication combinations are recommended for intubation based on clinical scenarios, including options for difficult airways and acute pulmonary edema.
Deep dives
Neuromuscular blockade: The choice between Vecuronium and Rockuronium
When deciding on a neuromuscular blockade agent, the podcast highlights the two main choices: Vecuronium and Rockuronium. While succinylcholine is commonly used in operating rooms and emergency departments, it has side effects that make it less favorable in the ICU. Rockuronium is a shorter-acting option compared to Vecuronium, which can last up to 45 minutes to an hour. Both medications take about a minute to be effective. The podcast recommends continuing bag-mask ventilation until the paralytic is truly effective, around the one-minute mark. The availability of sugamadex as a reversal agent for Rockuronium makes it a more preferred option in the ICU.
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