Treatment for Selected Adverse Respiratory Events

Question 1

Pneumothorax

Answer 1

14-16 g needle 2nd intercostal space mid clavicular line.

Chest tube 5th intercostal space mid axillary line

Question 2

Aspiration Pneumo

Answer 2

Intubation and 100% oxygenation if necessary. Suction airway. PEEP if PaO2/Fi02 <250

Question 3

Venous Air Embolism

Answer 3

Flood surgical field with NS. Surgical site placed lower than heart. D/c NO. Consider fluid bolus and aspiration through central venous catheter if present.

Question 4

Carboxyhemoglobinemia

Answer 4

100% O2. Hyperbaric if possible. Increase MV and add CO2

Question 5

Methemoglobinemia

Answer 5

Methylene Blue 1-2 mg/kg over 5 minutes. May repeat in one hour

Question 6

Bronchospasm

Answer 6

1. 100% O2
2. Albuterol
3. Epinephrine. 10 mcg/kg IV
   Also Ketamine, Lidocaine, Atropine, inhaled gas, Succs, terbutaline

Question 7

Laryngospasm

Answer 7

100%. Suction. Succs 0.5 mg/kg