optimal succinylcholine dose for intubating emergency patients: retrospective comparative study

Succinylcholine remains the drug of choice for satisfactory rapid-sequence tracheal intubation. It is not clear from the literature why the 1 mg/kg dose of succinylcholine has been traditionally used. The effective dose [ED95] of succinylcholine is less than 0.3 mg/kg. The dose of 1 mg/kg represents 3.5 to 4 times the ED95. To compare the effect of the traditionally used 1 mg/kg of succinylcholine with lower doses of 0.6 mg/kg and 0.45 mg/kg on intubation condition regarding the onset time, duration of action, duration of abdominal fasciculation, and the intubation grading. This retrospective comparative study was carried into three groups of ASA III and IV [American Society of Anesthesiologist's Physical Status III and IV] non-prepared emergency patients who were intubated at emergency department of Hamad General Hospital, Doha, Qatar during January 1st 2007 to August 31, 2010. The Institutional Research Board [IRB] approval was obtained. This study was limited to 88 patients who received fentanyl 1 micro g/kg followed by etomidate 0.3 mg/kg intravenously as induction agents and succinylcholine as a muscle relaxant agent in doses of 0.45 mg/kg, 0.6 mg/kg, or 1 mg/kg. Increasing the succinylcholine dosage shortened the onset time, prolonged the duration of action, and prolonged the duration of abdominal fasciculation significantly [P<.001]. Tracheal intubation was 100% successful in the three groups of patients. Succinylcholine dose of 0.45 mg/kg provides an optimal intubation condition in ASA III and IV emergency non-prepared patients. Duration of action of succinylcholine is dose dependent; reducing the dose allows a more rapid return of spontaneous respiration and airway reflexes

Open globe injuries in the pediatric population in Qatar

To determine and describe the epidemiological characteristics of open globe injuries in children less than, and equal to, 14 years of age at Hamad Medical Corporation [HMC], Doha, Qatar. One hundred and three patients with open globe injuries were treated at HMC between September 1992 and June 2004. Data was collected retrospectively on: age in years; gender; nationality; hospital stay in days; cause of injury; type and severity of injury; site. Presence and type of intra ocular foreign body; visual acuity at initial presentation to the hospital, post surgical repair, and last best corrected vision. We used the Auto chart projector to check visual acuity and Topcon slitlamp for eye examination. Male to female ratio was 4:1. Injuries were more common in the age range 3-10 years. Sixty-four percent of injuries affected the right eye. Eighty-six percent of injuries were penetration type. The most common object, which caused injury, was glass, followed by knives, pencils, and stones. The cornea was the most common entry site [73%]. One patient presented with a metallic intra-ocular foreign body. Fifty-nine [57.3%] of patients had final visual acuity of 6/18 or better. Although advances in the repair and treatment of open globe trauma have improved visual prognosis, prevention of injury through health education and creating awareness remains the first line of defence