What is a defasciculating drug in RSI ?

Question

Paramedic Drug used in RSI,

Answer 1

First off, please forgive me if I'm off in my answer. I last studied this about 1 1/2 years ago, and RSI is not part of the skill set in Alabama, so it's been awhile since I've had to think about it.

As you probably know, succinlycholine (the most common RSI drug due to it's rapid onset and short duration) causes fasiculations (muscle tremors, essentially). These can be quite painful for the patient (especially, after they wake up and wonder why they are so sore!) I faintly recall that these fasiculations have been strong enough to break bones in some people, although that may not be accurate. To facilitate RSI, a defasiculating dose of a paralytic is given. It's a small dose, not enough to cause paralysis in itself, but it's enough to depolarize the muscles, so when you give the entire dose of succinycloline, there are no fasiculations. Note: Succinlycholine is the only depolarizing paralytic used in EMS. The rest (rocuronium, vecuronium) operate in a different fashion. I'd recommend that you check a paramedic text or check online to verify what I said; I couldn't look up online due to a slow internet connection.
Hope this helps!

Answer 2

Defasciculating

Answer 3

Great question, I had to dig up my paramedic text book to find the answer. This is a quote from my text:

"Frequently 0.5 mg of atropine is administered prior to to succinylcholine to halt the fasciculations and reduce secretions."

Thanks for the question, this one made me think!

Answer 4

Initially - for using my lap-top so much ! Secondary for using my right-hand in place of a woman - IF you get my drift LOL !