RSI question

[Just Plain Ruff]

I have a question that I can't seem to get answered so here goes

you administer the paralytic medication to a patient you are going to want to intubate.

The question I have is is that patient able to see? Can they see or focus on anything?

I had a colleague ask me this after they ran a call the other night. He was wondering if once he gave the Sux was the patient able to see?

Theories are acceptable here too.

But fact would be better.

[tom5706]

That is a good one.. I would think yes. You can still see when a dentist fills you with novacaine. IMHO

[FireMedic65]

That is a good one.. I would think yes. You can still see when a dentist fills you with novcaine. IMHO

Doesn't Novocaine only numb the area where it's being injected into? Paralytics such as Sux, paralyze the body by blocking the neuromuscular actions. They work differently.

[spenac]

I say yes and that is why you must administer a drug to sedate and hopefully block the memory prior to using sucs or other.

[chbare]

Neuromuscular blockade occurs at the site of the neuro-muscular junction. This does not include the optic nerve, optic chiasma, optic tract, or associated CNS structures. The retinal conversion of photons, impulse transmission, and nervous integration of visual stimuli is not effected. Obviously, eyelid movement can be effected; however, the underlying visual physiology is not involved.

Take care,

chbare.

[Just Plain Ruff]

ChBare, that answer corresponds with another answer I got via PM. I would think that the patient could still see but I wasn't sure.

[chbare]

That is a good one.. I would think yes. You can still see when a dentist fills you with novacaine. IMHO

As stated, we are talking about different physiology. Blocking sodium channels versus noncompetitive or competitively acting on ACh receptor sites.

In addition, Novocaine (Procaine) is known as an ester. Unfortunately, serious problems such as anaphylaxis, toxicity, and prolonged duration of Procaine related to atypical plasma pseudocholinesterase in about 1 in every few thousand people. For these reasons, Procaine has fallen out of favor and Xylocaine an amide, is commonly used as a local anesthetic for dental procedures.

Take care,

chbare.

[fireflymedic]

Yes, they can still see, however, every patient I have seen given a paralytic (even those who were not sedated prior due to medic ignorance - see previous post) close their eyes - it seems to be a reflex. That is why the comment has been made that the patient appears to be asleep, but actually is not and is fully aware of what is happening. They can feel pain, process fear, etc. If their eyes were opened, they would be very much able to see.

[chbare]

it seems to be a reflex.

Actually, somewhat opposite of a reflex. Lack of reflex activity.

Take care,

chbare.

[spenac]

Yes, they can still see, however, every patient I have seen given a paralytic (even those who were not sedated prior due to medic ignorance - see previous post) close their eyes - it seems to be a reflex. That is why the comment has been made that the patient appears to be asleep, but actually is not and is fully aware of what is happening. They can feel pain, process fear, etc. If their eyes were opened, they would be very much able to see.

Have you ever seen the look of terror when a doctor pushes sucs w/o versed or other? I have. They are aware of what is happening but unable to do anything.