22] found the combination of fentanyl, atropine and suxamethonium
to be the most common, followed by morphine, atropine and suxamethonium
But during more tests on Ward 20, Dr Nial McCarron wrongly used Suxamethonium
instead of Lignocaine, the correct drug for the job.
The SOP included a range of induction agent options (thiopentone, etomidate and ketamine), but specified the use of suxamethonium
I would suggest that in this case when the airway was first lost and the patient "appeared to be splinting his chest", an appropriate dose of suxamethonium
would have either resolved the issue or at least provided adequate relaxation for rescue with a laryngeal mask airway or attempted tracheal intubation (5).
Absolute indications are: replacement of single-factor deficiencies when factor concentrate was not available, immediate reversal of warfarin effect, vitamin K deficiency associated bleeding, acute disseminated intravascular coagulation (DIC), thrombotic thrombocytopenic purpura (TTP), inherited deficiencies in coagulation, and suxamethonium
Dad-of-two Stephen Parkins, 43, from Tile Cross, suffered a fatal heart attack within minutes of being wrongly injected with suxamethonium
at Heartlands in 2006.
Plasma cholinesterase and abnormal reaction to suxamethonium
injection: twenty years' experience with the Danish Cholinesterase Registry.
She rapidly deteriorated, developing cardiogenic shock and acute pulmonary oedema that necessitated intubation of the trachea with a rapid sequence induction technique using propofol 75 mg, fentanyl 100 [micro]g and suxamethonium
In 12 incidents, fentanyl was intended but suxamethonium
was administered instead.
A new expert report into dadof-two Stephen Parkins, aged 43, reveals the Suxamethonium
drug he received is used in torture and on death row prisoners in the US.
In particular, will anaesthetists 'switch' to rocuronium and vecuronium; is suxamethonium
still necessary; and will it improve outcomes for patients?
That one of the most common errors in this study remains the substitution of suxamethonium
for fentanyl, indicates the poor response in South Africa to publications identifying the problem, highlighting causative factors, and suggesting preventive measures.