Sedation with Dewesh Flashcards
RSI - for anesthesiologist
inducing sedation prior to intubation
RSI for EM
sedating and intubating
True RSI
Awake patient that is intubated without PPV ( not normally done in PEM
Indications for RSI
inadequate, fatigue, obstruction
C/I for RSI
Cardiopulm arrest, deeply comatose, anatomic features
major facial trauma
suspected airway obstruction in awake spontaneously breathing patient
Difficult airway
Snoring OSA, Craniofacial anomalies - large tongue or manibular hypoplasia floppy airway - Hunter/ Hurler Limited jaw and neck flexibility loose teeth, facial airway trauma Malampati score
How do you work out NG/OG tube size
x2 size ETT
ETT depth
x3 size ETT
Chest tube size
X4 size ETT
Weigth estimate
Age x 2 + 8 ( kids ages 1-10 years)
Sellick man oeuvre - indications
prevention of vomiting
How long do you have until you intubate after pre-oxygenation
Increases with ages and weight
Indication for atropine as a premedication
should be used under age of 1 Infants< 1 Kids under 5 gettign succs Older children needing 2nd dose of succs Ketamine
Trauma protocols for intubation
Etomidate and succs
Dose of atropine
0.02mg/kg ( minimum 0.1 mg max 1mg) - minimal evidence to support this
IV given 1-2 minutes prior to intubation
Lidocaine premedication
Optional for kids undergoing RSI who may have increased ICP
1-2 mg/kg given 2-3 mins prior
Defasciculation
Give 1/10 usual dose of nondepolarzing muscle blocker 1-3 minutes prior -
Not done in kids as they have little muscle mass
Priming - what is this
Anecdotal used for pancuronium becauseof how long it took to act
