| A | B |
|---|
| Categories of meds used for RSI... | analgesics, sedatives, paralytics |
| Ultimate goal of RSI... | Secure an airway without having the patient vomit or aspirate |
| Indications for RSI... | Impending airway obstruction (facial injuries), excessive work of breathing, shock, GCS <8, persistent hypoxia |
| Name the 6 P's of RSI... | Preparation, Preoxygenation, Pretreatment, Paralysis, Placement of the tube, Post intubation management |
| These are included in Preparation... | Assign roles,Oxygen, suction, ETT, BVM, glidescope, cardiac monitor, pulse ox, ETCO2, Temp probe, difficult airway cart |
| Role responsibilities to assign... | leader, intubationist, cricoid pressure, monitoring, medications, documentation |
| This is how preoxygenation is done... | Using age appropriate devices, 3-5 minutes with 100% oxygen |
| Meds used as pretreatment to weaken normal physiologic and pathophysiological reflex responses to airway manipulation during laryngoscope and insertion of ETT... | Lidocaine, Atropine, Defasiculating agent |
| Uses for Atropine | Treats brady response to giving succs and given in all young children |
| Uses for Lidocaine... | helps decrease ICP associated with intubation |
| Uses for Vecuronium... | keeps muscles from fasiculating (twitching) when using succs |
| How are IV paralytics given? | Rapidly followed by flush |
| Give this BEFORE a paralytic... | anesthetic |
| Give these two things immediately following each other without waiting to see if ventilation can be maintained... | Induction agent followed IMMEDIATELY by the paralytic agent |
| Short-acting sedative hypnotic, dose is 0.3 mg/kg, induction time 5-10 min, myoclonus expected... | Etomidate |
| IM or IV, dissociative anesthesia, dose 1-2 mg/kg IV or 4-10 mg/kg IM, lasts 30 min; watch for agitated recovery, nystagmus, increased BP, HR, N/V, and hypersalivation... | Ketamine |
| Benzodiazepine, sedative, 1-2 mg IV, onset 1.5 min - 2 hours, watch for hypotension | Versed |
| Narcotic analgesic, 50-100 mcg/kg, lasts 30 min, watch for respiratory depression... | Fentanyl |
| Induction agent, standard dose 2 mg/kg, rapid onset, short duration, watch for hypotension and apnea... | Propofol |
| Skeletal muscle relaxer, 0.1 mg/kg IV for paralyzing dose, lasts 25-45 min... | Vecuronium |
| Neuromuscular blocking agent, dose 1 mg/kg, duration 5 min, watch for fasciculations, muscle pain, rhabdo, hyper K, brady, ventricular dysrhythmias and malignant hyperthermia... | Succinylcholine |
| Personal or family history of malignant hyperthermia, significant, verified hyperkalemia, end-stage renal disease or dialysis dependent, unknown potassium levels... | Contraindications for Succinylcholine |
| When ready for placement of tube, this technique may be useful... | Sellick's maneuver ( cricoid pressure) |
| When ready for tube placement, do not bag unless... | O2 is <90% |
| Ways to confirm placement... | ETCO2, bilateral breath sounds, absent epigastric sounds |
| Do this if first tube placement is failed... | BVM |
| Included in post-intubation management... | secure tube, ETCO2, CXR, long acting sedative and/or paralytic, establish vent parameters |
