Airway Flashcards
Failed airway determination
- 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
Failed airway protoccol
- 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
Indication for RSI
- 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
Seven P’s of RSI
- Prepare
- Preoxygenate
- Position
- Pretreat
- Paralyze/Sedate
- Pass tube
- Post-intubation management
Preparation considerations for RSI
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
Induction does of Ketamine
1-2 mg/kg IV
Induction does of Etomidate
0.2-0.4 mg/kg IV
Induction dose of Propofol
1-2.5 mg/kg IV
Paralytic dose of Vecuronium
0.1 mg/kg IV
Paralytic dose of Rocuronium
0.6-1.2 mg/kg IV
Paralytic dose of Succinylcholine
1-1.5 mg/kg IV
Ongoing sedation dose of Ketamine
0.5-2 mg/kg bolus q10-20 min
or
1-3 mg/kg/hr infusion; titrate
levels by 0.25mg/kg/hr
Ongoing sedation dose of Propofol
10-75 mcg/kg/min IV
