Airway Skills & RSI Flashcards
High 5 Difficult Airway Indicators
Upper Airway Hemorrhage, Mandibular Fracture, Decreased Thyromental Distance, Direct Laryngeal Trauma, Expanding Neck Hematoma
Which neuromuscular diseases are contraindications for Succinylcholine?
Guillian-Barre, ALS, Myasthenia Gravis, Muscular Dystrophy
Succinylcholine contraindications?
Burns greater than 24 hours, spinal cord injury, neuromuscular disorders, dialysis, malignant hyperthermia
ET Tube Confirmations
Visualize Tube through cords, chest rise and fall, negative epigastric sounds, bilateral breath sounds, tube depth, pilot cuff tension, fog in the tube, sp02, etc02
Indications for RSI without Consult
GCS less than or equal to 8 with RR= 8 or >/= 35
OR
GCS less than or equal to 8 with SpO2 = 90 on NRB
Lidocaine Dose for Adult RSI Pre-medication
1 mg/kg
Adult Induction dose of Etomidate for RSI normotensive patient
0.3 mg/kg
Adult Induction dose of Etomidate for hypotensive RSI patient
0.15 mg/kg
Adult Induction dose of Versed for RSI
0.1 mg/kg
Adult Induction dose of Ketamine for RSI
2 mg/kg
Adult dose of Succinylcholine in RSI
1.5 mg/kg (Max 200mg)
If Succinylcholine contraindicated, what is the Vecuronium dose for induction?
0.1 mg/kg
Atropine dose pre-RSI for < than 8 y/o or less than 6.0 ETT?
0.02 mg/kg
What ETCO2 would you try and target in a head-injured patient?
30 mmHg
VDP Dose of Etomidate - Doses?
0.3 mg/kg for the first dose, and 2 further doses of 0.15 mg/kg
VDP Dose of Ketamine - Doses?
2 mg/kg for the first dose, and 2 further doses of 1 mg/kg
VDP Dose of Versed - Doses?
0.1 mg/kg to a max of 5 mg, but cannot be repeated without consult
VDP - If significant resistance to ventilation continues despite adequate sedation AND ANALGESIA, the paramedic may administer what medication?
Vecuronium 0.05 mg/kg to a max dose of 10 mg.
During VDP, can you treat the patient with Fentanyl in addition to the sedative you use?
Yes!! As long as the blood pressure is stable and there is no risk of hypotension, Fentanyl is a great medication to use in conjunction to your sedative of choice in order to ensure adequate post-intubation management.
Under what age is a surgical cricothyroidotomy contraindicated in a pediatric patient?
8
The “D” in DOPES stands for?
Displaced tube
The “O” in DOPES stands for?
Obstruction
The “P” in DOPES stands for?
Pneumothorax
The “E” in DOPES stands for?
Equipment Malfunction
The “S” in DOPES stands for?
Stacking Breaths
If the EtCO2 is greater than 45, how would you change your vent settings?
Increase respiratory rate in increments of 2.
If the EtCO2 is less than 35, how would you change your vent settings?
Decrease respiratory rate in increments of 2.
In standard ventilator settings, how many mL/kg do we start ventilating the patient with?
8 ml/kg IBW
At what age can you place a pediatric patient on CPAP?
13 or older
What are contraindications for a Nasal Intubation?
Patients on blood thinners, Patient with upper airway hemorrhage or significant facial trauma, patient with evidence of a basilar skull fracture.
What site would you decompress with a needle thoracostomy on an adult patient over the age of 15?
5th intercostal space anterior axillary line
If unable to perform a needle thoracostomy at the 5th intercostal space, which site would you use?
2nd intercostal space at the mid-clavicular line
What site would you perform a needle thoracostomy on a child under the age of 15?
2nd intercostal space at the mid-clavicular line
What is the formula for ETT size in pediatric patients?
16 + the child’s age divided by 4
What is the normal ETT Tube depth for a male adult patient?
21-23 cm
What is the normal ETT Tube depth for a female adult patient?
20-22cm
What is the normal Nasal Tube depth for an adult patient?
25-28cm
