Airway

Question 1

9Ps of RSI

Answer 1

1.Plan
2. Preparation
3. Protect C spine
4. Preoxygenated
5. Pretreatment
6. Paralysis
7. Position
8. Placement
9. Post intubation management

Question 2

Difficult airway Ax
LEMON and 4Ds

Question 3

ET size
Adult
Child

Answer 3

Male 7.5-8.5
Female 7-8

Cuff = (age/4)+ 3.5

Question 4

Induction agent dosages

Answer 4

Etomidate 0.2-0.3
Midazolam 0.2-0.4
Propofol 2
Ketamine 1-2

Question 5

Pros and cons
Etomidate

Answer 5

👍🏼Cardiovascular stable

👎🏼Myoclonus therefore not epilepsy
👎🏼Adrenal suppression

Question 6

Pros and cons
Propofol

Answer 6

👍🏼 30 seconds
👍🏼 good anticonvulsant effects - status epilepticus

👎🏼 decrease BP
👎🏼pain on injection
👎🏼 egg or soybean allergy

Question 7

Pros and cons
Ketamine

Answer 7

👍🏼Increase BP and HR
👍🏼Bronchodilator effects

👎🏼Increase IOP
👎🏼Increase ICP
👎🏼Hallucinogenic

Question 8

Paralytic agent dosages

Answer 8

Sux 1-2mg
Roc 0.6-1.12mg

Question 9

Antidote for Rocuronium or vecuronium?

Answer 9

Sugammadex

Question 10

NB effects of suxamethonium

Answer 10

1. Hyperkalaemia by 0.5mmol/L
   - burns >72hrs
   - crush
   - denervation neuromuscular disorders >72hrs
2. Malignant hyperthermia
   - dantrolene Rx
3. Scoline apnoea

Question 11

ETCo2 graphs

Question 12

Extubation criteria

Answer 12

Indication for intubation resolved
Peep <6
Fi02 < 40%
Sats >92 %
GCS- Lift head off bed and follow commands
RSBI - <105

Then Spontaneous breathing trial 30-90mins
-RR <30
-TV >325
If no distress then extubate

Question 13

Complications of extubation?

Answer 13

Stridor
Laryngospasm

Question 14

Awake intubation?

Answer 14

1. Head up
2. Atropine/glycopyrulate - antisialogue
3. Antiemetic
4. Lignocaine gel & spray
5. Ketamine
6. Laryngoscope and bougie
7. Then only fully sedate and paralyze

Question 15

Lignocaine toxicity

Answer 15

With epi 7mg/kg
Without epi 5mg/kg

Sx: perioral numbness , neuro, cardio
Mx: intralipid 20%

Question 16

Cormack-Lehane classification