The answer, unfortunately, is: there is no answer. It's controversial.
Like most things in medicine, this is unfortunately not an exact science. Some will say its needed and say it depends on the age and what paralytic is given. Others will say its unnecessary or even harmful.
The standard used to be: "Give it"
Now, the pendulum swings in the other direction.
Most things in medicine, and particularly in Emergency Medicine, cannot be verified accurately with a double blind randomized placebo controlled trial. Even one very well done trial does not "prove" anything.
Like I was told on my first day of medical school: "Of all that you learn in the next 4 years, you'll forget half of it, and of the half you remember, one half of that will turn out to be wrong"
If you practice long enough, you see things that were "right" turn out to be "wrong" that eventually become "right" again.
We're not as smart as we think we are.
