RESUS PROCEDURES

Question 1

3 CONDITIONS WHICH IS AGGRAVATED BY LARYNGOSCOPY, DUE TO ITS SYMPATHETIC RESPONSE

Answer 1

INCREASED ICP, CARDIAC ISCHEMIA, AORTIC DISSECTION

Question 2

RESPIRATORY EFFECT OF LARYNGEAL STIMULATION

Answer 2

LARYNGOSPASM, COUGH, BRONCHOSPASM

Question 3

HOW LONG SHOULD YOU WAIT TO START RSI, AFTER GIVING PRETREATMENT

Answer 3

3-5 MINUTES

Question 4

THIS PRETREATMENT DRUG IS FOR SYMPTOMATIC BRADYCARDIA INCHILDREN

Answer 4

ATROPINE

Question 5

INDICATIONS OF LIDOCAINE -3
DOSAGE
PRECAUTIONS

Answer 5

ELEVATED ICP, BRONCHOSPASM, ASTHMA
1.5 MG/KG IV OR TOPICAL
PRECAUTIONS-

Question 6

INDICATIONS FOR FENTANYL
PRECAUTIONS
DOSAGE

Answer 6

INDIC- INCR ICP, CARDIAC ISCHEMIA, AORTIC DISSECTION
PREC-RESPIRATORY DEPRESSION, HYPOTENSION, CHEST WALL RIGIDITY
DOSAGE- 3MICROGRAM/KG

Question 7

INDICATIONS FOR ATROPINE

DOSAGE

Answer 7

KIDS <5 WITH BRADYCARDIA, KIDS<10 ON SUX AND WITH BRADYCARDIA

Question 8

BENEFITS OF ETOMIDATE
CAVEATS 
DOSAGE 
ONSET 
DURATION

Answer 8

PROTECTS FROM MYOCARDIAL AND CEREBRAL ISCHEMIA
HAS MINIMAL HISTAMINE RELEASE, LITTLE HEMODYNAMIC DEPRESSION
CAVEATS- MYOCLONUS, SEIZURES AND VOMITING
DOSAGE =0.3-0.5MG/KG
ONSET <1 MIN
DURATION OF 10-20MIN

Question 9

BENEFITS OF PROPOFOL
CAVEATS
DOSAGE
ONSET 
DURATION

Answer 9

ANTICONVULSANT, ANTI-EMETIC AND DECR ICP, DOESN’T TRIGGER HISTAMINE RELEASE

DOSAGE 0.5-1.5MG/KG
ONSET - 20-40SEC
DURATION - 8-15 MIN
CAVEATS- APNEA, HYPOTENSION, NOT AN ANALGESIC

Question 10

INDUCTION MEDICATION THAT IS CI IN TRAUMA WITH HYPOTENSION OR HYPOVOLEMIA

Answer 10

PROPOFOL

Question 11

KETAMINE BENEFITS, CAVEATS, DOSAGE AND DURATION

Answer 11

BRONCHODILATOR, ANALGESIC, PRESERVES RESPIRATORY DRIVE
CAVEATS: INCREASE BP, INCREASE SECRETIONS, PRESERVES RESPIRATORY DRIVE AND EMERGENCE PHENOMENON, HAS CEREBROPROTECTIVE EFFECT,
DOSAGE 1-2 MG/KG
ONSET - 1 MIN
DURATION - 10-20 MIN

Question 12

RSI MEDS FOR STATUS ASTHMATICUS WHICH IS REFRACTORY

Answer 12

KETAMINE

Question 13

RSI MED FOR HEAD TRAUMA

Answer 13

KETAMINE

Question 14

RSI MED NOT FOR ELDERLY OR WITH CARDIAC ISCHEMIA. WHY?

Answer 14

KETAMINE, BECAUSE OF THE ASSOCIATED TACHYCARDIA AND HYPERTENSION

Question 15

3 benefits of neuromuscular blockade

Answer 15

Facilitate tracheal intubation, improve mechanical ventilation, help control intracranial hypertension

Question 16

How does paralysing a patient improve intubation -2 and in what conditions does it benefit

Answer 16

Improves oxygenation and decreases peak airway pressures

For refractory pulmonary edema and respiratory distress syndrome

Question 17

Downside of neuromuscular blockade

Answer 17

Limits neurological assessments,

Long term use - increases critical illness polyneuropathy and ptsd

Question 18

Are neuromuscular blockers analgesic?

Answer 18

Nope, neither it is anxiolytic too

Question 19

What are depolarizing agents?

Answer 19

High affinity for cholinergic receptors of motor end plate and resistant to acetylcholinesterase, not antagonized and enhanced by anticholinesterase agensts

Question 20

What are nondepolarizing agents?

Answer 20

Compete with acetycholine for cholinergic receptors and can be antagonized by anticholinesterase agents

Question 21

Preferred choice for intubation

Answer 21

Succinylcholine

Question 22

Hydrolyzed succinylcholine

Answer 22

Plasma cholinesterase

Question 23

Onset, duration and dosage of succinylcholine

Answer 23

45-60sec onset, duration of 5-9 min, dosage of 1.5mg/kg

Question 24

In the event of failed intubation, BVM is required for how long, before the return of spontaneous ventilation

Answer 24

12 minutes

Question 25

Transient rise of potassium in depolarizing neuromuscular blockade

Why the exaggerated hyperkalemic response

Answer 25

0.5 mEq/L

Due to ACh receptor upregulation at MNJ

Question 26

3 clinical conditions that are contraindicated for admin of sux

Answer 26

Myopathies (MG), renal failure

Question 27

Rare adverse effect of Sux, occuring in patients with genetic predisposition, and its antidote

Answer 27

Malignant Hyperthermia - dantrolene

Question 28

Clinical findings in malignant hyperthermia

Answer 28

Unexplained rapid fever with muscle rigidity, acidosis or hyperkalemia

Question 29

Drug that is metabolized by plasma choinesterase, which reduces amount of enzyme available for sux metabolism

Answer 29

Cocaine

Question 30

If patient has know plasma cholinesterase deficiency, what NMJ drug should be used?

Answer 30

Rocuronium

Question 31

Conditions at risk for hyperkalemia

What RSI drug should be contraindicated?

Answer 31

Succinylcholine CI: more than 5 days old of burns, denervation injury, crush injury, severe infection, preexisitng myopathies, preexisting hyperkalemia

Question 32

Complications of succinylcholine

Answer 32

Fasciculations, transient increase in intragastric, intraocular, and icp, masseter spasm alone or with malignant hyperthermia, bradycardia, and prolonged apnea with pseudocholinesterase deficiency or MG

Question 33

Excellent alternative for Sux

Answer 33

Rocuronium

Question 34

Onset, duration and dosage of rocuronium

Answer 34

Onset of 1-3 min, duration of 30-45 min, dosage of 1mg/kg

Question 35

Paralyzing agent that is biliary excreted

Dosage, onset and duration

Answer 35

Vecuronium

Dosage- 0.08 - 0.15 mg/kg, duration of 25-40 minutes, onset of 2-4 minutes

Question 36

MOI of SUgammadex

Answer 36

Reversal agent that encapsulates the molecules of nondepolarizing agent that are circulating in plasma;

Reverses blockade from roc or vec

Question 37

BVM adverse effect and when should it be deferred?

Answer 37

Gastric distention and deferred when oxygenation is optimal