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da orientation > 6- Standard vs RSI > Flashcards

6- Standard vs RSI Flashcards

1
Q

What are the patient factors contributing to aspiration risk factors ?

A

Increased gastric content

Lower esophageal sphincter incompetence

Decreased laryngeal reflexes

Gender

Age

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2
Q

What are examples of increased gastric content?

A

Intestinal obstruction

Non- fasted

Drugs (Ozempic)

Delayed gastric emptying

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3
Q

What are examples of lower esophageal sphincter incompetence?

A

Hiatus Hernia

Gastro-sephageal reflux

Pregnancy

Morbid obesity

Neuro Muscular disease (NMD)

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4
Q

What are examples of Decreased laryngeal reflexes?

A

Head injury

Bulbar palsy

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5
Q

Gender

A

Male

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6
Q

Age

A

Elder

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7
Q

What are the Operation factors contributing to aspiration risk factors ?

A

Procedure

Position

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8
Q

What are examples of procedure?

A

Emergency

Laparoscopic

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9
Q

What are examples of position?

A

Lithotomy

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10
Q

What are the Anesthetic factors contributing to aspiration risk factors ?

A

Airway

Maintenance

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11
Q

What are examples of Airway?

A

Difficult intubation

Gas insufflation

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12
Q

What are examples of maintenance?

A

inadequate depth

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13
Q

What are the 3 main Aspiration risk factors?

A

1- Patient factors

2- Operation factors

3- Anesthetic factors

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14
Q

Define Standard Induction?

A

Assumes the patient is NPO/ not a “full stomach” and not aspiration risk

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15
Q

What are the Airway steps of a standard induction before medication induction?

A

Position and pre-oxygenate the patient, “Nitrogen washout” with 100% O2 and a tight fitting mask

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16
Q

What are the induction medications for a standard induction?

A

Midazolam

Fentanyl

Lidocaine

Propofol/ Etomidate

17
Q

Prior to giving a paralytic what is be checked?

A

“bag” mask the patient, establish that we can actually oxygenate/ ventilate the patient

18
Q

What is the SI for paralytic ?

A

Rocuronium- 0.6 mg/kg

Succinylcholine 1-1.5 mg/kg

19
Q

What step is always taken into consideration before and after giving a paralytic in a Standard induction?

A

“bag” mask the patient, establish that we can actually oxygenate/ ventilate the patient

20
Q

Once paralytic is given during an SI, what step follows?

A

proceed with laryngoscopy/ ETT placement or LMA placement

21
Q

What steps are done after ETT placement or LMA?

A

Inflate cuff, close APL, give a few breaths (squeeze bag), look for misting, bilateral chest rise and breath sounds

22
Q

What is the last step to an SI?

A

Begin manual/ machine ventilation, secure ETT

23
Q

Define Rapid sequence induction?

A

Minimize the time when the patient’s airway is unprotected (time between in induction and intubation)

24
Q

RSI induction indications?

A

Full stomach/ NPO status is questionable, aspiration risk (uncontrolled GERD, inability to protect airway).

25
Q

What are some contraindication to RSI?

A

Known or presumed difficult airway

26
Q

During an RSI what is important to check?

A

ensure and check suction

27
Q

True or False:

During an RSI you still position and pre oxygenate the patient, “nitrogen washout” with 100% O2 with a tight fitting mask

A

True

28
Q

What is a TRUE RSI? and what is the induction meds?

A

When the stomach is full or bleeding is noticed

Propofol/ Etomidate + paralytic ( Roc 1.2mg/kg, Suc 1-1.2 mg/kg)

29
Q

What meds could be used for patient comfort/ reduce sympathetic surg from laryngoscopy?

A

Benzodiazepines, Lidocaine, and Opioids

30
Q

What is a huge NO while masking the pt with RSI?

A

DO not manually mask ventilate- passive oxygenation ONLY!

31
Q

What sign are we waiting for before we intubate laryngoscopy and after a paralytic (Succinylcholine)?

A

Fasciculations

32
Q

Once Fasciculations are seen, what is the nest step?

A

1- Intubate, inflate cuff, close APL, give a few breaths (squeez bag), look for misting, bilateral chest rise and breath sounds

2- begin manual/ machine ventilation/ secure ETT

33
Q

What are the NPO guidelines for Clear fluids?

A

2 hours

34
Q

What are the NPO guidelines for breast milk?

A

4 hours

35
Q

What are the NPO guidelines for nonhuman milk?

A

6 hours

36
Q

What are the NPO guidelines for light mean?

A

6 hours

37
Q

What are the NPO guidelines for regular meal?

A

8 hours

da orientation (6 decks)

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