Bronchoconstriction - Respiratory

Question 1

What are the 7 medications used for bronchoconstriction as per the MDSO, and what are the patch requirements?

Answer 1

Salbutamol (MDI and nebulized) - no patch
Ipratropium Bromide (MDI and neb) - no patch
Epinephrine IM (severe cases) - initiate then patch
Methylprednisolone OR Dexamethasone - mandatory patch
Mag sulfate - mandatory patch
Near death: Epinephrine IV/IO - mandatory patch

Question 2

In mechanical ventilation of pts with bronchoconstriction or asthma exacerbation what is the pH target for permissive hypercapnea?

Answer 2

> 7.25

Question 3

What is the protocol when mechanically ventilating asthmatics in cardiac arrest or with severe auto-PEEP with hypotension, hypoxemia and very high PIPs?

Answer 3

1. Disconnect the ventilator
2. Stop ventilating
3. Manually compress the chest
4. Bilat needle decompression if required
5. Restart ventilation slowly (6 breaths/min)
6. Patch as soon as possible