Anaesthesia
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Following the return of spontaneous circulation after out-of-hospital cardiac arrest, neurological dysfunction, airway or ventilatory compromise can impede transport to early percutaneous coronary intervention, necessitating pre-hospital or emergency department anaesthesia to facilitate this procedure. There are no published reports of the ideal induction agents in these patients. We sought to describe haemodynamic changes associated with induction of anaesthesia using a midazolam (0.1 mg.kg-1 ), fentanyl (2 μg.kg-1 ) and rocuronium (1 mg.kg-1 ) regimen developed using expert opinion, and adherence to the protocol by our pre-hospital teams. ⋯ Adherence to recommended fentanyl and rocuronium doses was high. Overall, systolic blood pressure was reduced following induction of anaesthesia, and systolic pressures < 90 mmHg occurred more often at measurements made later (up to 9 min) after induction. Changes in heart rate, and new hypertension were uncommon.