Airway

Question 1

Failed airway determination

Answer 1

• Unable to adequately open the airway
• After two failed attempts by the most proficient provider on the scene to place an ETT and at least
  one failed attempt with an SGA under PAI
• Intubation contraindicated due to anatomical abnormalities or major airway trauma
• Continued inability to ventilate patient with mask using a BVM

Question 2

Failed airway protoccol

Answer 2

• If able to ventilate with a BVM, insert NPA or OPA dependent on contraindication and continue ventilating with BVM
• If unable to ventilate, perform an age-appropriate cricothyroidotomy if >10 years of age
• Ventilate patient per age-appropriate respiratory rate to maintain minute ventilation

Question 3

Indication for RSI

Answer 3

• Airway Compromise or Inability to
  Protect Airway
• Respiratory Failure: Hypoxic or Hypercapnic
• > 40% TBSA Burns
• Severe Sepsis
• TBI with AMS
• Patient or Crew Safety
• Combative
• Prolong transfer in
  critically sick

Question 4

Seven P’s of RSI

Answer 4

1. Prepare
2. Preoxygenate
3. Position
4. Pretreat
5. Paralyze/Sedate
6. Pass tube
7. Post-intubation management

Question 5

Preparation considerations for RSI

Answer 5

SOAPMEE

Suction: within reach and switched ON
Oxygen: TWO bottles; one for BVM and one for NC
Airways: ETT, SGA, and Cric
Pharmacology: Induction, paralytic, sedative, and pressor
Monitor: Vitals, EtCO2, ECG
Equipment: Bougie, scope, blade, Cric kit
Evaluaiton: Assess for difficulty, anatomical challenges, and note Cric landmarks

Question 6

Induction does of Ketamine

Answer 6

1-2 mg/kg IV

Question 7

Induction does of Etomidate

Answer 7

0.2-0.4 mg/kg IV

Question 8

Induction dose of Propofol

Answer 8

1-2.5 mg/kg IV

Question 9

Paralytic dose of Vecuronium

Answer 9

0.1 mg/kg IV

Question 10

Paralytic dose of Rocuronium

Answer 10

0.6-1.2 mg/kg IV

Question 11

Paralytic dose of Succinylcholine

Answer 11

1-1.5 mg/kg IV

Question 12

Ongoing sedation dose of Ketamine

Answer 12

0.5-2 mg/kg bolus q10-20 min
or
1-3 mg/kg/hr infusion; titrate
levels by 0.25mg/kg/hr

Question 13

Ongoing sedation dose of Propofol

Answer 13

10-75 mcg/kg/min IV