Long-acting neuromuscular blocker use during prehospital transport of trauma patients.

INTRODUCTION: The purpose of this study was to determine the rate of long-acting neuromuscular blocker (LA-NMB) use and evaluate the concurrent use of sedatives during prehospital care.

SETTING: Prehospital patients who were brought to a single emergency department in the United States.

METHODS: This was a retrospective cohort study of trauma patients who were intubated in the prehospital setting. The primary outcome measure was to determine the rate of LA-NMB use. The use of postintubation sedatives and the time to the administration of sedative agents was compared between patients who received an LA-NMB and those who did not.

RESULTS: A total of 51 patients were included in the final analyses. Overall, 82% (n = 42) of patients received an LA-NMB during transport. There was no difference in the rate of postintubation sedative use during transport between the LA-NMB and no LA-NMB groups (79% vs. 67%, respectively, P = .42). The LA-NMB group received sedatives less promptly after intubation compared with those who did not receive LA-NMBs (16 vs. 7 minutes, respectively; P = .04).

CONCLUSION: The use of LA-NMB is common during the prehospital transport of trauma patients. Some of these patients may not be given sedatives or may have delays in receiving sedatives after intubation.