Succinylcholine vs Rocuronium for Prehospital Emergency Intubation

Study Overview
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Brief Summary
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All adult patients with spontaneous cardiac activity and requiring tracheal intubation in the pre hospital emergency context will be included in order to compare the use of succinylcholine vs Rocuronium for prehospital emergency intubation.

Detailed Description
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All adult patients with spontaneous cardiac activity and requiring tracheal intubation in the pre hospital emergency context will be included. All intubation will be performed by an emergency physician or a nurse specialized in anesthesia. For patients with spontaneous cardiac activity, rapid sequence intubation will be performed to allow intubation. Comparisons studied will be : Intubation success rate at the first laryngoscopy, glottis exposure assessed by Cormack and Lehane classification, difficult intubation rate assessed by the Intubation Difficult Score (IDS), the conditions of intubation assessed by the Copenhagen score, the need for alternative airway techniques and the immediate post intubation complications rate as vomiting, dental trauma, pulmonary inhalation, arterial desaturation , hypotension episodes and cardiac arrest occurrence.

Official Title
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Succinylcholine vs Rocuronium for Prehospital Emergency Intubation : a Randomized Trial

Conditions
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Coma, Major Trauma, Respiratory Distress, Shock

Intervention / Treatment
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* Drug: Succinylcholine : 1mg/kg
* Drug: Rocuronium : 1.2 mg/kg


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All adult patients with spontaneous cardiac activity and requiring tracheal intubation in the pre hospital emergency context Exclusion Criteria: Patients in cardiac arrest; Patients under-18s; Patients under guardianship ; Pregnancy known; Patients with cons to one of the following three drugs: rocuronium, succinylcholine, sugammadex; Patients not affiliated to a social security scheme (beneficiary or legal).

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Administration of Succinylcholine<br>Intubation after IV administration of Succinylcholine 1mg/kg | Drug: Succinylcholine : 1mg/kg<br> <br> * Other names: SUXAMETHONIUM BIOCODEX 50 mg/ml, solution injectable;|
| Experimental: Administration of Rocuronium<br>Intubation after IV administration of Rocuronium 1.2 mg/kg | Drug: Rocuronium : 1.2 mg/kg<br> <br> * Other names: ESMERON®;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| First-pass intubation success rate | Measured by the proportion of successful intubation in the first laryngoscopy. | between 1 hour to 3 hours after inclusion | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of difficult intubation | measured by the Intubation Difficulty Scale | between 1 hour to 3 hours after inclusion | 
| Intubation conditions assessment | using the Copenhagen score | between 1 hour to 3 hours after inclusion | 
| Need for alternate airway devices |  | between 1 hour to 3 hours after inclusion | 
| early intubation-related complications | complications : esophageal intubation, mainstem intubation, vomiting, pulmonary aspiration, dental trauma, bronchospasm or laryngospasm, ventricular tachycardia, arterial desaturation, hypotension, or cardiac arrest | between 1 hour to 3 hours after inclusion | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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tracheal intubation, pre hospital emergency