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

Durham, Mark, Westhead, Pete, Griffiths, David, Lyon, Richard and Lau-Walker, Margaret (2020) Prehospital neuromuscular blockade post OHCA: UK's first paramedic-delivered protocol Journal of Paramedic Practice, 12 (5). pp. 202-207.

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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.


To examine the first cases of paramedic-delivered neuromuscular blockade, and evaluate the prevalence of its use and safety.


Retrospective service evaluation of patients receiving post-arrest paralysis during the study period from 1 April 2016 until 31 July 2017.


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.


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.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > School of Health Sciences
Authors :
Durham, Mark
Westhead, Pete
Griffiths, David
Date : 2 May 2020
DOI : 10.12968/jpar.2020.12.5.202
Copyright Disclaimer : © 2020 MA Healthcare Ltd
Uncontrolled Keywords : Prehospital; Rocuronium; Out-of-hospital cardiac arrest (OHCA); Return of spontaneous circulation (ROSC); Neuromuscular blockade
Depositing User : Clive Harris
Date Deposited : 03 Jun 2020 13:01
Last Modified : 03 Jun 2020 13:01

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