Extra Airway Stuff Flashcards
What does the OBESE pneumonic stand for? What is the criteria for using it?
O: Obesity (BMI > 30 kg/m2)
B: Beard
E: Edentulous
S: Snorer (OSA)
E: Elderly (Men specifically > 55yrs old)
Criteria for Difficult Mask Ventilation
What does the BOOTS Pneumonic stand for? What does it predict?
B: Beard
O: Obese
O: Older
T: Toothless
S: Sounds (Snoring/Stridor)
Predicts a Difficult Airway and may show an inability to maintain O2 sat > 90% with BMV.
What does the LEMON pneumonic stand for?
L: Look (Abnormal face, Trauma)
E: Evaluate (3-3-2 Rule)
M: Mallampati score
O: Obstruction/Obesity
N: Neck Mobility
This type of intubation may be necessary if the patient has a suspected difficult Airway.
Awake Intubation
What are three very important components to be mindful of when attempting to intubate a difficult airway?
What might you consider if you can’t intubate?
- Optimize O2 throughout
- Limit your attempts
- Call for help if necessary.
Consider awakening the patient.
What does it mean to have a dynamic airway?
What are some examples?
“Changing” airway
Bullets (Trauma), Bites (Angioedema), Burns (Swelling)
When doing an awake intubation, what are the 4 steps for using local anesthesia?
- Dry
- Nebulize
- Atomize
- Topicalize
What are the doses of glycopyrrolate, Atropine, and nebulized lidocaine for awake intubations?
Glyco: 0.2 mg
Atropine: 0.01 mg/kg
Nebulized Lido: Either 4ml of 4% or 8ml of 2%
What are the 5 steps to laryngoscopy as discussed in lecture?
- Set the table
- Find the Epiglottis
- Optimize the head
- Seat the blade
- Optimize the Larynx
If you are not in a good position during laryngoscopy, ___ prior to trying again or use a ___.
Ventilate/ Bougie
The black stripe on the bougie corresponds to what measurement at the lip and what anatomical position in a normal male airway?
25 cm @ the lip
mid-trachea in an adult male
Based on a research article from the powerpoint, ___ is superior to BVM in morbidly obese patients.
LMA
For induction, Ketamine could be beneficial for what patient population?
Asthmatics
What 2 patient populations/physiological issues would we not want to give Etomidate to for induction?
- Sepsis
- Seizure pts
What is the DOA of Roc?
Succs?
Roc: 30-90 mins
Succs: 5-10 mins
What are the 3 “Physiologic Killers” as discussed in lecture?
- Hypotension
- Hypoxemia
- Metabolic Acidosis
True or False: We want to keep our sedatives low and paralytics high in Shock patients?
What two drugs are ideal for induction of shock patients?
True!
Ketamine/Roc (1.6 mg/kg)
Which push-dose pressor is the ideal 1st choice?
Which one do we ALWAYS dilute?
Which one has a great effect in profound shock?
Epi
Neo
Vaso
What is a DSI? Why would we use this technique?
Delayed Sequence Intubation
Uncooperative patients
What does BUHE stand for?
Back - Up Head Elevated
(Patient doesn’t HAVE to be supine to Intubate)
Which intervention for acidosis is “tenuous at best”?
Sodium Bicarb administration
What are the vent settings for VAPOX therapy in acidotic patients?
NC @ 15LPM
Mode: SIM-V/PSV
Vt: 8ml/kg
FiO2: 100%
Pressure Support: 5-10 cmH2O
PEEP: 5 cm H2O
Low Resp Rate
What are some aspiration risks discussed in lecture?
What are the treatments?
Upper GI Bleeds
Bowel Obstructions
Pre-induction vomiting
TX: NGT prior to intubation, intubate in a semi-upright position, bag early.
What is the conversion of “French” to centimeters?
4 French = 1 cm
