Depolarizing Neuromuscular Blockade

DEPOLARIZING NEUROMUSCULAR BLOCKADE

A 33-year-old man in the medical intensive care unit with 30% body surface area third-degree burns to the neck and trunk develops dyspnea over 6 days as a result of adult respiratory distress syndrome. On 100% oxygen, his satu-ration is 91%. He is given ketamine 1 mg/kg and succinyl-choline 1 mg/kg intravenously. He is easily intubated and ventilation is controlled. Within 1 minute, the patient became pulseless and a cardiac arrest is apparent on the electrocardiogram.