Regular Sequence Induction

Question 0

PRE-OXYGENATION ***
Open pop off valve (1)
Apply tight mask seal (1)
Assure oxygen flow meter > 5 liters/min (1)
3 forced vital capacities within 30 seconds with 100% O2 (1)
3 minutes of 100% O2 with a goal of >85% end tidal oxygen concentration (1)

Answer 0

Ask supervisor if pre-treating with non-depolarizer (only pre-treat if intubating with succinylcholine) (1)

Question 1

Complete machine check (1)
Complete equipment set-up (laryngoscope, ETT, airway, suction) (1)
Complete medication check (1)

Answer 1

Apply pulse oximeter (1)
Apply ECG leads (1)
Apply NIBP (1)
Obtain baseline vital signs *** (4)

Question 2

ADMINISTRATION OF DRUGS ***
Administer propofol (3)
Monitor for loss of lid reflex or ask patient to open eyes and take a deep breath (2)
Tape eyelids closed after loss of lid reflex (1)

Answer 2

MASK VENTILATE
Volatile agent on (1)
Close pop off valve partially (1)
Provide positive pressure ventilation (1)
Positive end tidal CO2 *** (3)

Question 3

ADMINISTER MUSCLE RELAXANT
Correct relaxant dose *** (1)
Mask ventilate 45 seconds (4)
Adjust pop off valve to prevent sustained positive pressure > 20 cm H2O (1)

Answer 3

INTUBATION
Volatile agent off or fgf off (1)
Intubate (2)
Correct ETT depth (1)
Cuff inflated (1)

Question 4

CONFIRM INTUBATION
Connect to anesthesia machine circuit (1)
Volatile agent on ** (3)
Confirm ETCO2 (3 breaths minimum) ** (1)
Auscultate bilaterally (mid-axillary line & epigastrum) (1)
Tape ETT (1)

Answer 4

VENTILATE PATIENT
Adjust ventilator settings (tidal volume, RR, I:E ratio) (1)
Bag/ventilator switch to ventilator (1)
Turn on ventilator (1)

Question 5

MAINTENANCE OF ANESTHESIA

Adjust fgf, typically 1 liter air and 1 liter O2 (1)

Answer 5

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