Adult Airway - Advanced

Question 1

Adult Airway - Advanced - Inadequate air entry with basic airway management?

Answer 1

Refer to foreign body/obstruction protocol

Question 2

Adult Airway - Advanced - Impending airway obstruction? (5)

Answer 2

Preoxygenate
Prepare airway equipment
Assess patient for intervention
Mandatory OLMC
RSIP

Question 3

Adult Airway - Advanced - Ventilation and oxygenation ineffective in conscious patient despite basic interventions?

Answer 3

Preoxygenate
Prepare airway equipment
Assess patient for intervention
Mandatory OLMC
RSIP

Question 4

Adult Airway - Advanced - Preoxygenation consists of?

Answer 4

NRB + NC or BVM and PEEP 5 cm H2O titrate to 10

Question 5

Adult Airway - Advanced - Ventilation and oxygenation ineffective in unconscious patient despite basic interventions?

Answer 5

Preoxygenation

Place King LT

Question 6

Adult Airway - Advanced - ETCO2 not present after airway management attempt?

Answer 6

Return to preoxygenation
Reattempt airway
Consider OLMC

Question 7

Adult Airway - Advanced - ETCO2 present after airway management?

Answer 7

Move to maintenance of sedation/paralysis protocol

Question 8

Adult Airway - Advanced - Failed airway and SpO2 < 85% with altered LOC?

Answer 8

Consider cricothyrotomy

Question 9

Adult Airway - Advanced - RSIP medications?

Answer 9

Ketamine 1.5 mg/kg

Succinylcholine 1.5 mg/kg single max of 150 mg

Question 10

Adult Airway - Advanced - Advanced airway confirmation safety considerations?

Answer 10

Confirm placement with ETCO2 waveform

Loss of ETCO2 waveform, remove device immediately

Question 11

Adult Airway - Advanced - Maximum # of attempts per airway device?

Answer 11

2

Question 12

Adult Airway - Advanced - ETCO2 goals?

Answer 12

35 – 45 mmHg

Question 13

Adult Airway - Advanced - ketamine indications?

Answer 13

Sedation prior to advanced airway management

Question 14

Adult Airway - Advanced - ketamine dose?

Answer 14

1.5 mg/kg SIVP/IO

Question 15

Adult Airway - Advanced - ketamine contraindications?

Answer 15

Hypersensitivity

Relative – conditions where a significant elevation of blood pressure is hazardous

Question 16

Adult Airway - Advanced - ketamine precautions?

Answer 16

Can induce hypersalivation and tracheobronchial secretions

Must be given slow IV push as it can induce apnea

Question 17

Adult Airway - Advanced - succinylcholine indications?

Answer 17

Paralysis to facilitate intubation

Question 18

Adult Airway - Advanced - succinylcholine dose?

Answer 18

1.5 mg/kg IV/IO to a single max of 150 mg

Question 19

Adult Airway - Advanced - succinylcholine contraindications?

Answer 19

Hypersensitivity
Known or suspected hyperkalemia
Family history of malignant hyperthermia
Myopathies associated with elevated CK

Question 20

Adult Airway - Advanced - succinylcholine precautions?

Answer 20

Should not be administered prior to sedatives or analgesics
Takes 60 – 90 seconds to take effect
An acute airway burn is not a cause for hyperkalemia