Ch1 and 2

Question 1

What are the 3 criteria to intubated?

Answer 1

Failure to maintain/protect the airway
Failure of ventilation or oxygenation
Anticipated clinical course and likelihood of deterioration

Question 2

What maneuvers can be used to establish airway?

Answer 2

Reposition
Chin lift
Jaw thrust
Oral/nasal airway

Question 3

What may cause a difficult airway?

Answer 3

LEMON
Look externally
Evaluate w/3-3-2
Mallampati
Obese/obstruct
Neck mobility

Question 4

Describe Mallampati 2

Answer 4

Soft palate, uvula, fauces visible but NOT pillars

Question 5

Describe Mallampati class 3

Answer 5

Soft palate and base of uvula

Mod diff

Question 6

Describe Mallampati 4

Answer 6

Only hard palate visible

Severe diff

Question 7

Causes for difficult BMV?

Answer 7

MOANS
Mask seal
Obese
Aged 
No teeth
Stiffness

Question 8

When is ET CO2 unreliable?

Answer 8

Cardiopulmonary arrest

Question 9

What are the 7 Ps of RSI?

Answer 9

Preparation
Preoxygenation
Pretreatment
Paralysis w/induction
Position
Placement of tube
Postintubation management

Question 10

What do you pretreat with asthma pt?

Cardiovascular pt?

Inc ICP?

Answer 10

Albuterol 2.5 mg

Fentanyl 3 microgram/kg to mitigate sympathetic discharge

Fentanyl again

Question 11

What is sufficient preoxygenation?

Answer 11

100% O2 for 3 minutes allows for 6-8 minutes of apnea before O2 sat below 90%

Question 12

If time insufficient for full 3 minute preO2, what is enough?

Answer 12

8 VC breaths w/high flow O2

Question 13

How long does paralysis take w/succ?

Roc?

Answer 13

45s

60s

Question 14

Versed dosing post intubation?

Fentanyl?
Morphine?

Propofol?

Answer 14

.1-.2 mg/kg

3-5 micrograms/kg
.2-.3 mg/kg

5-50 microgram/kg/min

Question 15

What med and dosing for Delayed sequence intubation?

Answer 15

Ketamine 1.0 mg/kg

Question 16

Describe succinylcholine

Roc?

Answer 16

Depolarizing, non competitive, causes FASICULATIONS

Competitive, Non-depolarizing

Question 17

Dose of Succ?

SE?

Answer 17

1.5 mg/kg using TBW, not IBW

Question 18

What are the contraindications to succinylcholine?

Answer 18

Burns > 10% BSA, Crush injury, denervation, intra-abdominal sepsis > 5 days

Neurom. Diseases: ALS, M.S., DMD

Question 19

Curative drug and dose for malignant hyperthermia?

Answer 19

Dantrolene 1-2.5 mg/kg q 5 minutes, max dose of 10mg/kg

Question 20

Ketamine may be useful in what patients?

Avoided in whom?

Answer 20

Asthma pts - has bronchodilator effects

TBI pts w/elevated BP bc of release of catecholamines and increased BP

Question 21

Induction dose of Propofol??

Avoid in whom?

Answer 21

1.5 mg/kg

anaphylaxis to egg protein

Question 22

How should fentanyl be given? Why?

Answer 22

Over 60s to avoid hypoventilation or apnea

Question 23

What meds should be used in pts w/HoTN and shock?

What dose?

Answer 23

Etomidate and ketamine

50% of regular dose