Procedural Sedation — Succinylcholine Stat Bag — Clinical Pathway: Emergency Department

Procedural Sedation Clinical Pathway — Emergency Department

Succinylcholine Stat Bag

In cases of laryngospasm or complete upper airway obstruction not resolved with airway maneuvers, succinylcholine may be required. The succinylcholine stat bag provides the necessary resources to expedite medication administration.

Additional Information on the Treatment of Laryngospasm

Contents of Succinylcholine Stat Bag (Located in ED Pharmacy Refrigerator)

  • 2 x 10 mL vials of succinylcholine
  • Dosing card
  • Syringes
  • Caps
  • Needles

Succinylcholine Stat Bag

Medication and Route Onset Duration Considerations
Succinylcholine IM 3-4 min 10-30 min US Black Box Warning: Use caution in children and adolescents. Acute rhabdomyolysis with hyperkalemia, ventricular arrhythmias and cardiac arrest have been reported (rarely) in children with undiagnosed skeletal muscular myopathy (e.g., Duchenne’s Muscular Dystrophy); occurs soon after administration and requires immediate treatment of hyperkalemia. Prolonged resuscitation may be required. Use in children should be reserved for emergency intubation when immediate airway control is necessary (i.e., Laryngospasm, difficult airway, full stomach).
Succinylcholine IV 30-60 secs 4-6 min

Dosing Card for IV Succinylcholine Dose = 2 mg/kg
(20 mg/mL Concentration)

Patient Weight (kg) IV Dose (mg) IV Dose (mL)
10 20 1
15 30 1.5
20 40 2
25 50 2.5
30 60 3
35 70 3.5
40 80 4
45 90 4.5
50 100 5
55 110 5.5
60 120 6
65 130 6.5
70 140 7
75 150 7.5
80 160 8
85 170 8.5
90 180 9
95 190 9.5
100 200 10

Dosing Card for IM Succinylcholine Dose = 4 mg/kg
(20 mg/mL Concentration)

Patient Weight (kg) IM Dose (mg) IM Dose (mL)
10 40 2
15 60 3
20 80 4
25 100 5
30 120 6
35 140 7
40 150 7.5
45 150 7.5
50 150 7.5
55 150 7.5
60 150 7.5
65 150 7.5
70 150 7.5
75 150 7.5
80 150 7.5
85 150 7.5
90 150 7.5
95 150 7.5
100 150 7.5

Reference

Preparing for Pediatric Emergencies: Drugs to Consider