RSI in children....sux or not to sux

[joncmarkley]

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Question.....When are you guys using sux in children for RSI? At my facility it is avoided and roc is used for RSI in kids. Obviously the concern of using roc in RSI is the rare event where the child is a difficult mask you would be up the creek. On the other hand we all know sux can have its share of sequale.

Ex. 2 wk old w NEC
Pyloromotomy in 6 mo old
5 yr old appy
7 yr old trauma

what do you all do?

Thanks😉

 

[IceDoc]

Ex. 2 wk old w NEC Panc or Nothing(awake)
Pyloromotomy in 6 mo old propofol +/- Roc
5 yr old appy Roc
7 yr old trauma Roc (unless D.A. suspected ie ENT Trauma, then a spont vent method)

 

[Noyac]

I'm not a fan of sux in kids at all. But if I remember right the really risk of trouble with sux comes after they are 1 yo or older. I am also not a fan of the awake intubation is kids ie: pyloric stenosis. I mostly use roc or just propofol and intubate.

 

[deleted126335]

.

 

[CremeSickle]

Assuming a true RSI was needed I would go with Suxx on all of them but for the NEC.

 

[Planktonmd]

Question.....When are you guys using sux in children for RSI? At my facility it is avoided and roc is used for RSI in kids. Obviously the concern of using roc in RSI is the rare event where the child is a difficult mask you would be up the creek. On the other hand we all know sux can have its share of sequale.

Ex. 2 wk old w NEC
Pyloromotomy in 6 mo old
5 yr old appy
7 yr old trauma

what do you all do?

Thanks😉

You don't need muscle relaxants to intubate kids.
So, you give Propofol and intubate, then if you need muscle relaxants for the surgery (rare) you give whatever you want!

 

[amyl]

why don't you need a muscle relaxant to intubate kids?

 

[Planktonmd]

why don't you need a muscle relaxant to intubate kids?

You actually don't need muscle relaxants to intubate anybody, but kids are particularly easy and Propofol will give you enough muscle relaxation to do it.