Bronchospasm

Question 1

S/S f bronchospasm

Answer 1

Can’t ventilate
High PIP
Wheezing
Absent breath sounds
Increased exp time
Increased EtCO2
Upsloping EtCO2 waveform
Decreased tidal volumes
Hypotension - air trapping

Question 2

Airway interventions for bronchospasm

Answer 2

100% oxygen
Optimize exhalation:
-change I:E ratio (1:3-1:4)
-minimize PEEP
-avoid hyperinflation

Question 4

S/S of bronchospasm

Answer 4

Inability to ventilate
High PIP
Wheezing
Absent breath sounds if severe
Increased expiratory time
Increased EtCO2
Upsloping EtCO2 waveform
Decreased tidal volume
Hypotension if air trapping

Question 5

Med tx for bronchspasm

Answer 5

Deepen anesthesia
- Bolus propofol
- increase gas
- consider more NMBD

Severe
Epi (5-10mcg IV) or 200 mcg (subQ)

If tachy with stridor
Neb racemic epi
0.5ml of 2.25% in 3mL saline

If you can ventilate — give bronchodilators
Albuterol

Consider
- Ketamine 10-50mg IV
- Magnesium 1-2g
- hydrocortisone 100mg IV