Podcast 702: Paralytic Awareness

<p><strong>Contributor: Aaron Lessen, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Known risk factors for being awake and paralyzed in the OR include only receiving IV medications, long-acting paralytics, and no formal monitoring system for being awake</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">The ED-AWARENESS study, a prospective single-center study found 2.6% of patients with induced paralysis during mechanical ventilation were aware</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Rocuronium was a risk factor for developing awareness while paralyzed in this study</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Ensure adequate sedation during paralysis for mechanical ventilation in the ED setting, especially when using rocuronium</span></li> </ul> <p><strong>References</strong></p> <p><span style="font-weight: 400;">Pappal RD, Roberts BW, Mohr NM, et al. The ED-AWARENESS Study: A Prospective, Observational Cohort Study of Awareness With Paralysis in Mechanically Ventilated Patients Admitted From the Emergency Department. Ann Emerg Med. 2021;77(5):532-544. doi:10.1016/j.annemergmed.2020.10.012</span></p> <p><span style="font-weight: 400;">Pappal RD, Roberts BW, Winkler W, Yaegar LH, Stephens RJ, Fuller BM. Awareness With Paralysis in Mechanically Ventilated Patients in the Emergency Department and ICU: A Systematic Review and Meta-Analysis. Crit Care Med. 2021;49(3):e304-e314. doi:10.1097/CCM.0000000000004824</span></p> <p> </p> <p><span style="font-weight: 400;">The Emergency Medical Minute offers</span> <em><span style="font-weight: 400;">AMA PRA Category 1 credits™</span></em> <span style="font-weight: 400;">via online course modules. For more information and to access this content,, visit our website at</span> <a href= "http://www.emergencymedicalminute.org/cme-courses"><span style=