Cite this post as:
Scott Weingart, MD FCCM. PEMED’s Resus Kit. EMCrit Blog. Published on June 8, 2014. Accessed on February 13th 2025. Available at [https://emcrit.org/emcrit/pemeds-resus-kit/ ].
Financial Disclosures:
The course director, Dr. Scott D. Weingart MD FCCM, reports no relevant financial relationships with ineligible companies. This episode’s speaker(s) report no relevant financial relationships with ineligible companies unless listed above.
CME Review
Original Release: June 8, 2014
Date of Most Recent Review: Jul 1, 2024
Termination Date: Jul 1, 2027
You finished the 'cast,
Now Join EMCrit!
As a member, you can...
- Get CME hours
- Get the On Deeper Reflection Podcast
- Support the show
- Write it off on your taxes or get reimbursed by your department
.
Get the EMCrit Newsletter
If you enjoyed this post, you will almost certainly enjoy our others. Subscribe to our email list to keep informed on all of the Resuscitation and Critical Care goodness.
This Post was by the EMCrit Crew, published 11 years ago. We never spam; we hate spammers! Spammers probably work for the Joint Commission.
Personally, I don’t think this is crazy at all. If you have the capability and ability to perform interventions immediately, why not take advantage of that?
Agree superglue is one of the most useful items, I always carry for simple wound repair on remote kayaking trips, securing lines etc
With regard to drugs…what are you carrying? And is thermal lability a worry for neuromuscular blockade? Or no paralytic in kit?
Im a fan of celox haemostatic dressings in austere pack. Thoughts?
Two things spring to mind… 1: Why succinylcholine – it will be out of the fridge and (hopefully) be used infrequently and have a short shelf life so likely wastage – perhaps for such a rare use item something like Vecuronium might be more cost-effective? (DOI: I carry Roc, and Sux but my car is also used for voluntary responding for the ambulance service on a regular basis) 2: Is the plan to super-glue the wound in the field and let the casualty go home with no further intervention? I would have thought that proper wound toilet would be required… Read more »
That will very, if the wound is obviously clean and just bleeding, say it was a little scrape while riding a bike, I would just have them wash it out with tapwater as I believe that “dilution is the solution to pollution.” You don’t really need to add anything but water under pressure to get the wound clean. Then I’d glue it and send then on their way. If the wound is obviously contaminated but profusely bleeding, I would use the SuperGlue to try and stop the bleeding Then I’d send them on to hospital for definitive managent. The caveat… Read more »
I too carry roc…as well as fentanyl, ketamine, propofol, morphine, adrenaline etc etc
But interested in the thermal lability of rocuronium. Anyone got data?
The SPC for Rocuronium states it can be left in temperatures up to 30 degrees Celsius for up to 12 weeks.
My understanding is that all paralytics are unstable in heat, but succinylcholine has a longer shelf life than Roc. If vecurronium is the most stable then I should probably reconsider putting that in my kit. Admittedly, I’m taking a chance by having any paralytic in my hot car, but I plan to change it out every six months and would more than likely be giving a big IM/IV dose to increase the chances it would work. Ideally, I guess I should invest in a car fridge.
I’m not sure about the United States but in Germany, Suxamethonium is available as a powder for reconstitution with saline (brand name: Lysthenon siccum). No issues with temperature and a massive 5 years shelf life. Having to reconstitute is obviously a disadvantage in an emergency but considering frequency of use and not needing a fridge is a pro. We use it in our volunteer ambulance service.
…scope for a research project there.
Hey Scott and Andrew what a great discussion! Scott you asked about comments, so I am going to liberally give mine. I mean all this is the name of good discussion so take it all with a grain of salt, and I hope I articulate my thought in a non-offensive manner. This is my first post on EMCrit, but Scott I have been following you from day 1, and have totally swallowed the cool aid! Thanks for all you do. I believe that if most knew what it takes to put together what you do, they would think you even… Read more »
Anthony, Im late to the party but just wanted to say great comments. In putting together a similar bag for myself, I went the conservative route and stuck with a king airway over an ET setup. My reasons were lack of suction and speed of placement when I am working alone. I have used a King a few times at work as a paramedic and have never had trouble with it. The two 1,000mL bags are a good idea, even though they add alot of weight. Ive had a few patients where 1,000mL just wasnt enough to correct their BP.… Read more »
Great comments, Will
At the risk of simply echoing Anthony’s excellent comments above, I am extremely skeptical of the idea of performing RSI in the austere setting. If a patient is clearly apneic, you do not need RSI to intubate the trachea. If a patient is in a state that you would normally intubate them in your ED, but would like RSI to accomplish this, I think the field is the wrong environment. In order to perform RSI you first have to start an IV, then give medications. Then you have to intubate them with no backup method if DL fails, because you… Read more »