Surgical Critical Cate

Question 1

Central line placement

Answer 1

Place pt in trendelenberg position, access the vein using ultrasound guidance, pass wire using seldinger technique, remove needle, make a incision, dilate, then pass the flushed catheter. After ensuring cathetger flushes and aspirates secure the line. Get cxr to check position

Question 2

What are the doses for rapid sequence intubation

Answer 2

Etomidate 0.3 mg/kg
Rocuronium 1 mg/kg, if hepatic failure cisatracurium 0.15 mg/kg

Question 3

Intubation

Answer 3

MSMAID:
Machine, suction, monitors, airway, IV, drugs

Have ventilator, suction, ambubag, capnography, 2 working IV
ETT of varying size, direct laryngosope, fiberoptic scope, bougie, LMA
Administer 0.3 mg/kg etomidate, 1 mg/kg rocuronium
Place tube, confirm placement with capno and auscultation then CXR