RSI Review Flashcards
RSI is :
A method of intubating patients that have an intact gag reflex who would be otherwise difficult to intubate
Situations that could require RSI:
-Altered LOC
-Burns with airway involvement
CVA/Head injury with posturing
-Respiratory exhaustion
-Facial trauma with poor airway control
-GCS less than 9 with intact gag reflex
Patient must be ____ years old or older
12
Contraindications for RSI
There are no ABSOLUTE contraindications
Relative contraindications for RSI
- Anticipated difficult airway
- Anticipated difficult ventilation
- Beyond the skill of the present crew
Lidocaine
Blunts transient increases in ICP and IOP that result from intubation
What is the RSI dose for lidocaine?
1.5 mg/kg
Atropine can be given as pre-medication to blunt bradycardia. What is the dosage?
0.02 mg/kg
Midazolam is a benzodiazepine with short duration of action. What is the induction dosage?
0.2 mg/kg
Etomidate
- hypnotic agent
- most well tolerated of induction agents
- onset of action 20-30 seconds
What is the induction dose of Etomidate?
0.3 mg / kg
BURP
Backwards
Upwards
Right Pressure
Succinylcholine is a depolarizing paralytic. The depolarization is seen as fasciculations. What is the dosage ?
1.5 mg/kg with a max dose 150 mg
Onset 1 minute
Duration 4-6 minutes
Contraindications to Succinylcholine
- hypersensitivity
- malignant hyperthermia
- 3 days crush injury
- burns over 24 hours old
- known neuromuscular disease
Vecuronium is a _________ agent
Non-depolarizing agent
Lemon Rule
Look externally Evaluate 3-3-2 rule Mallampati scale Obstructions ? Neck mobility
3-3-2 Rule
Three fingers in the mouth opening
Three fingers under the chin
Two fingers floor of mouth to thyroid cartilage
Premedicate….
Etomidate 0.3 mg/kg
And for head injury patients
Lidocaine 1.5 mg/kg
Pre-Oxygenate…….
4-5 minutes with NRM @ 15 lpm
Or
3-5 full deep breaths 100% O2 via BVM
Prophylaxis…..
Atropine 0.02 mg/kg
Bradycardia only
Pressure on Cricoid…..
Sellick Maneuver
Paralyze……
Succinylcholine 1.5 mg/kg
Gold Standard for ET placement
Continuous Waveform Capnography
Patient Comfort…..
Vecuronium 0.1 mg/kg Or Rocuronium 1.0 mg/kg And Versed 2.5 - 5 mg
