Bronchospasm - GA -Exam 2

Question 1

Bronchospasm
-Resp S/S

Answer 1

-decreased bag compliance with manual ventilation
-decreased BS, wheezing
-decreased SpO2
-increased PIP
-increased CO2 (hypercarbia)
-hypoxia
-inspiratory limb sloped on EtCO2 (mild to mod)
-decreased or absent EtCO2 +/- BS (SEVERE)

Question 2

Bronchospasm
-Cardiac S/S

Answer 2

-cardiac arrest
-HTN
-arrythmias
-tachycardia

Question 3

Bronchospasm
-Tx Basics

Answer 3

-maintain patent/secure airway
-GIVE FIO2 100%
-manually ventilate
-dx +tx underlying mech or path causes

Question 4

Mild-Mod Bronchospasm
-Tx

Answer 4

-pt can ventilate and O2 sat is acceptable still
tx:
-increase IA concentration
-increase anesthetic depth (propofol or narcs)
-give albuterol via neb or md inhaler

Question 5

Severe Bronchospasm
-Tx basics

Answer 5

basics:
-CALL FOR HELP
-STOP procedure
-tx as indicated (EpiB,EpiI,AminoLD,AminoI,steroid, Terb, Mag)
-maintain airway patency/security
-GIVE 100% FIO2
-MANUAL ventilation
-dx + tx underlying situation

Question 6

Severe Bronchospasm
-Tx Bronchodilators

Answer 6

-Epi IV Bolus - titrated to effect
-Epi IV infusion
-Terbutaline subcut
-Mag Sulfate IV
-Aminophylline IV

Question 7

Severe Bronchospasm
-Tx Corticosteroids

Answer 7

Hydrocortisone IV - or equivalent

Question 8

Severe Bronchospasm
-Tx ventilation

Answer 8

ventilate with high pressure ICU ventilator
-assess tx efficacy with ABG

Question 9

Epi IV bolus for severe bronchospasm dose

Answer 9

1-10 mcg/kg

Question 10

Epi IV infusion for severe bronchospasm

Answer 10

1-4 mcg/MIN

Question 11

Terbutaline subQ dose for severe bronchospasm

Answer 11

0.5 mg

Question 12

Mag Sulfate IV infusion dose for severe bronchospasm

Answer 12

2g over 10 mins

Question 13

Aminophylline IV dose for severe bronchospasm

Answer 13

LOADING dose: 6 mg/kg
INFUSION: 0.5-0.7 mg/kg/hr

Question 14

Hydrocortisone IV dose for severe bronchospasm

Answer 14

0.25 mg -1mg