Transcript Rocuronium - Verde Valley Emergency Medical Services

New drug
authorized to
administer by
DHS.
BUT is limited to
use in a
successfully
intubated patient.
Description:
Neuromuscular blocking (paralyzing)
agent
Mechanism of action:
Half-life:
Produces neuromuscular blockade by
competing with acetylcholine for
cholinergic receptors at the motor
end plate.
Rocuronium has a biphasic distribution.
The rapid distribution half-life is 1 to 2
minutes, and the slower distribution
half-life is 14 to 18 minutes.
Rocuronium has no effect on consciousness or pain threshold.
Therefore, when rocuronium is used, adequate analgesia and
sedation should be administered.
Description:
Neuromuscular blocking (paralyzing)
agent
Mechanism of action:
Half-life:
Produces neuromuscular blockade by
competing with acetylcholine for
cholinergic receptors at the motor
end plate.
Rocuronium has a biphasic distribution.
The rapid distribution half-life is 1 to 2
minutes, and the slower distribution
half-life is 14 to 18 minutes.
Rocuronium has no effect on consciousness or pain threshold.
Therefore, when rocuronium is used, adequate analgesia and
sedation should be administered.
• No effects on HR or BP
• Reliable and controllable duration of action
• Fast onset
• Stable hemodynamics/no histamine release
• Supplied: Solution as 10mg/cc vials of 50mg.
Stable for 60 days at room temperature.





It’s effects may be reversed by administering
an anticholinesterase such as Prostigimine.
Which increases the amount of acetylcholine at
the receptors to compete with rocuronium.
But not in EMS scope of practice in AZ
Reversal of blockade virtually is never indicated
following emergency airway management.
Atropine 0.01mg per kg IV is given to block
excessive muscarinic stimulation (SLUDGE
syndrome)
.


Midalzolam
Morphine
5mg/PRN
Same MS protocol for pain
2 mg initial dose
2-6 mg subsequent doses
max. 20mg
Remember:
None of the previously reviewed medications:
Etomidate, Succinylcholine, Versed, and
Rocuronium are analgesics. Treat your patients
pain!






Short-acting sedative hypnotic
Benzodiazepine
Water-soluble
CNS depressant and causes significant
amnesia following administration
Has some muscle relaxant thus serves to
calm and sedate patients, relax skeletal
muscles, and, in high doses, causes sleep.
Midazolam DOES NOT have analgesic
properties.