FOI 26-184 Rocuronium use in SAS

Freedom of Information Request

Reference
FOI 26-184 Rocuronium use in SAS
Request Date
10 Apr 2026
Response Date
15 Apr 2026
Information Requested

I am currently formulating a case for change within NWAS in relation to post cardiac arrest management and as such, I'm submitting FOI requests to each UK ambulance service to gauge current practice for specialist/advanced paramedics in critical care in relation to post-ROSC care. This is being undertaken to hopefully improve cardiac arrest survival across the North West. With this in mind, please could this email be forwarded onto the relevant team and the following questions be answered:  

  1. Is rocuronium carried by your specialist/advanced paramedics in critical care?  
  1. What are the indications and dosing if so?  
  1. How many patients have received rocuronium post-ROSC in 2025?  
  1. What governance framework is in place for rocuronium administration in terms of training and ensuring competency?  
  1. What sedation agents are used and what are their indications and dosing strategies?  
  1. Is there a standardised practice guideline/clinical management plan for post-ROSC care for your specialist/advanced paramedics in critical care?  
  1. If so, can this please be shared?  
  1. Is there a difference in survival to hospital, survival to 30 days and survival to discharge when a specialist/advanced paramedic in critical care attends cardiac arrests when compared to non-specialist crews?  
Response

Q1 – No, Rocuronium is not carried by specialist or advanced paramedics in critical care within the Scottish Ambulance Service 

 

Q2 - Not applicable.  As rocuronium is not carried or administered by the Scottish Ambulance Service, no indications or dosing information is held. 

 

Q3 - Not applicable.  As rocuronium is not carried or administered by the Scottish Ambulance Service, no patients have received this medication under our care. 

 

Q4 - Not applicable.  As rocuronium is not carried or administered by the Scottish Ambulance Service, no governance framework, training arrangements or competency assessments are in place for its use. 

 

Q5 - All paramedics within the Scottish Ambulance Service have access to midazolam for post‑ROSC sedation via a Patient Group Direction (PGD). 

  • Indication: 
    Adults aged 18 years and over who are combative or agitated where this impedes the safe assessment or management of the patient following return of spontaneous circulation (ROSC). 
  • Dosing: 
  • 0.5–1 mg administered intravenously and titrated slowly 
  • Maximum dose:  
  • 7.5 mg for patients aged 18–59 years 
  • 3.5 mg for patients aged 60 years and over 

Q6 - At present, documentation relating to post‑ROSC care for specialist or advanced paramedics in critical care forms part of a wider review of clinical guidelines. 

As this work is ongoing, the requested guideline or clinical management plan is not currently available. 

Accordingly, in line with section 17(1) of FOISA, the information requested is not held in a finalised or disclosable form. 

Q7 - The Scottish Ambulance Service does not routinely measure or hold recorded information comparing survival outcomes on this basis. 

The Freedom of Information Scotland Act 2002 applies only to information that is held at the time of the request. Public authorities are not required to create new information, undertake new analysis, or provide commentary or interpretation. 

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