NBME Cancels Step 2 CS, medical students rejoice. 
The Do-Nothing Break 
Episode 22- Dr. Jessica Molokie 
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Today’s shorty discusses which paralytic is preferable to use for RSI? The debate has been going on in emergency medicine and anesthesia for quite some time, and the conclusion tends to boil down to provider preference. Today’s article is “Update: Does Rocuronium Create Better Intubating Conditions Than succinylcholine for Rapid Sequence Intubation?” from the May 2017 Annals of Emergency Medicine by Julie Welch and Rawle Seupaul.
The researchers did a literature review and searched Cochrane, EMBASE, and MEDLINE for RSI studies. They did not include language restrictions. All randomized control trials and controlled clinical trials were involved in the analysis. Studies involved in the data set included studies that analyzed rocuronium administration of equal to or greater than 0.6 mg/kg or succinylcholine greater than or equal to 1 mg/kg. There were no age restrictions that were explored.
Of the 66 studies that were found, 50 met the inclusion criteria. These 50 studies comprised 4,151 patients. These patients fit groups that are described as having “excellent intubating conditions” or “clinically acceptable conditions (excellent or good).”
The analysis found no appreciable difference between the two drugs, however determined that succinylcholine was a superior induction agent to rocuronium. The authors describe the benefit of succinylcholine’s short time of onset and short duration as advantageous in RSI. However, the authors note that rocuronium is an acceptable substitute.
Do not leave SCH!
Especially in emergency!
Please.