RSI/Difficult Airway

Question 1

PALS pneumonic

Answer 1

Preoxygenate, Atropine, Layout, Sedation/Succinylcholine/Sellicks

Question 2

Preoxygenate

Answer 2

NRB 1-3 min and NC 5 LPM

Question 3

Atropine

Answer 3

<8 y.o. = Atropine 0.02 mg/kg

Question 4

Layout

Answer 4

Blade with handle to LEFT
Tube with Stylet on CHEST
Suction on RIGHT
BVM on RIGHT

HAVE AVAILABLE:
Frova
King
Cric-Kit

Question 5

RSI Meds

Answer 5

Etomidate 0.3 mg/kg IVP
Succicynlcholine 2 mg/kg IVP

If Succicynylcholine is contraindicated:
Rocuronium 1 mg/kg IVP

• *All in Rapid Succession
• *BURP/Sellick’s Maneuver
• *NC to Flush when unconsious

Question 6

Etomidate Dose

Answer 6

0.3 mg/kg IVP

Question 7

Succicnylcholine Dose

Answer 7

2 mg/kg IVP

Question 8

Rocuronium

Answer 8

1 mg/kg IVP

Question 9

BVM if:

Answer 9

Sa02 < 98% with 100% O2 flow

Question 10

Premedications To Consider

Answer 10

Lidocaine: 1.5 mg/kg IVP for Actual or potential Head Injury
Fentanyl: 3-5 mcg/kg IVP for Actual or potential Head Injury
Atropine: 0.02 mg/kg IVP for <8 y.o. pt
Rocuronium: 0.1 mg/kg for Fasiculations

Question 11

Fentanyl Premedication:

Answer 11

3-5 mcg/kg IVP

Question 12

Lidocaine Premedication:

Answer 12

1.5 mg/kg IVP

Question 13

Atropine Premedication:

Answer 13

0.02 mg/kg IVP for <8 y.o.

Question 14

Etomidate Unavailable:

Answer 14

Propofol 2 mg/kg (NON-Hypotensive)

Ketamine 2 mg/kg (Hypotensive)

Question 15

Contraindications to Succicynlcholine:

Answer 15

Malignant Hyperthermia

Hyperkalemia >5.5 mEq/L

Burn/Crush Injury > 5 days ago

Spinal Cord Injuries > 5 days ago

Myopathies

Question 16

Airway Assessment:

Answer 16

LEMON:
Look
Evaluate 3-3-2
Mallampati
Obstruction
Neck Mobility