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Muscle relaxant in the filed and helicopters

Keith D. Lamb lambrrt at gmail.com
Wed Apr 19 21:20:46 BST 2006

Ketamine isnt a muscle relaxant. succinylcholine is the only depolarizing
muscle relaxant that I know of used in the US, and it is infrequently
approved for pre-hospital use. I have never heard of ketamine being used by
our medics for any reason, and I dont believe that it is used by many
other's either.


On 4/19/06, Michael Ferker <xg2k2 at yahoo.com> wrote:
> Eh sorry, that actually was my fault. I recently looked at an article
> regarding a correlation between sleep apnea and thoracic aorta dissection,
> and somehow managed to invent a new syndrome in my post. When I think of
> muscle relaxants in the pre-hospital setting, I believe Ketamine is one of
> the more commonly used ones, and recent inquiries into prevalence of
> arrythmia along with the apnea can cause certain issues in the ambulance
> that may not be equipped to address. Sorry about the confusion, I'm still
> trying to refine my ability to present arguments in a semi-formal setting.
> :-)
>   -Mike F
> "Lamb, Keith D." <KLamb at Christianacare.org> wrote:
>   What? I didn't understand one thing you just said. Sorry.....maybe it's
> me
> but I don't see how any of this relates to the use of NMB.
> What is thoracic apnea? I like the good old fashioned apnea where the
> patient stops breathing and the passage of an airway is (theoretically)
> easier to accomplish. Apnea is a "desired" result of the use of NMB.
> I also don't understand your "dose" comment.
> I "think" that one of the biggest concerns about the use of muscle
> relaxants
> pre-hospital is what do they do if they cant facilitate an appropriate
> airway after the patient is relaxed. What if they cant maintain a patent
> airway and BVM the patient after the relaxant. Then they (pre-hospital
> personnel) would have to do the same thing that we would do in-hospital,
> and
> put a hole in the patients neck.
> Problem is of course that it is much more difficult to find a surgeon in
> the
> back of an ambulance.
> Keith
> -----Original Message-----
> From: trauma-list-bounces at trauma.org [mailto:
> trauma-list-bounces at trauma.org]
> On Behalf Of Michael Ferker
> Sent: Wednesday, April 19, 2006 14:17
> To: Trauma &, Critical Care mailing list
> Subject: Re: Muscle relaxant in the filed and helicopters
> I think that the high potential for arrythmia, bradycardia, thoracic
> apnea,
> or even straight up larynx spasms make me suspicious of administering
> muscle
> relaxants (atleast in high doses) outside of a hospital.
> -Mike F
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Keith D. Lamb, RRT
Newark, Delaware

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