Adult Critical Care Specialty (ACCS) Practice Exam

What is a unique side effect of succinylcholine during rapid sequence induction?

1. Hypokalemia

2. Bradycardia

3. Tachycardia

4. Hyperkalemia

The correct answer is: Hypokalemia

Succinylcholine is a depolarizing neuromuscular blocker commonly used during rapid sequence induction due to its rapid onset and short duration of action. One of the unique side effects associated with its use is hyperkalemia, making this particularly important in certain patient populations. When succinylcholine is administered, it causes an initial depolarization of the motor end plate, which can lead to the release of potassium from the intracellular space into the serum. This transient increase in serum potassium, known as hyperkalemia, can be significant, especially in patients with conditions that predispose them to elevated potassium levels, such as severe burns, neuromuscular diseases, or after prolonged immobility. In contrast, the options of hypokalemia, bradycardia, and tachycardia are not recognized as unique or common side effects of succinylcholine in this context. While cardiac responses can occur, especially in certain scenarios or with other agents, it is hyperkalemia that is directly associated with the mechanism of action of succinylcholine and its effects on muscle membranes. Thus, understanding succinylcholine's propensity to cause hyperkalemia is crucial for preventing potential complications during rapid sequence intubation.