Supraglottic + Croup Flashcards
Supraglotic Airway Medical Directive
What are the INDICATIONS?
Need for ventilatory assistance or airway management
AND
Other airway management is ineffective
Supraglotic Airway Medical Directive
What are the CONDITIONS?
What are the CONTRAINDICATIONS?
Absent gag reflex
Airway obstructed by a foreign object
Known Esophageal dieases (verices)
Trauma to the oropharynx
Caustic ingestion
Supraglotic Airway Medical Directive
What is the TREATMENT plan?
Considering supraglotic airway insertion of 2 attempts max (per patient)
Supraglotic Airway Medical Directive
What are the primary and secondary methods of determining proper placement?
Primary:
ETCO2 (Waveform Capnography)
Secondary:
ETCO2 (Non-waveform device)
Auscultation
Chest Rise
Supraglotic Airway Medical Directive
What is an attempt defined as
If ETCO2 is working is that good enough, if it isn’t working, what do you do?
An attempt is defind as insertion of the supraglotic airway into the mouth.
Yes ETCO2 is good enough
You’d need 2 secondary methods for confirmation
Yes, if not then you have to use 2 secondary methods to confirm
Croup Medical Directive
What are the INDICATIONS?
Current hx of URTI (upper respiratory tract infection)
AND
Barking cough or recent hx of a barking a barking cough
Croup Medical Directive
What are the CONDITIONS for Epinephrine?
What are the CONTRAINDICATIONS?
Pt has to be GREATER/EQUAL to 6 months old and LESS than 8 years old
AND
Pt’s HR has to be LESS than 200bpm
AND
Pt has stridor at rest
Allergy or sensitivty
Croup Medical Directive
What are the CONDITIONS for dextamethasone?
What are the CONTRAINDICATIONS?
Pt has to be GREATER/EQUAL to 6 months old and LESS than 8 years old
AND
Pt’s LOA has to be unaltered
AND
The pt has to have mild, moderate, or severe croup
Allergy or sensitivity
The pt’s received steroids within the last 48 hours
The pt is unable to tolerate oral medications
Croup Medical Directive
What is the TREATMENT plan, CONCENTRATION, AND route for epinephrine a pt weighing LESS than 10kg?
1:1000
NEB
Dose - 2.5mg
Max.single dose - 2.5mg
Dosing Interval - no interval
Max # of doses - 1
Croup Medical Directive
What is the TREATMENT plan, CONCENTRATION, AND route for epinephrine in a pt weighing GREATER/EQUAL than 10kg?
1:1000
NEB
Dose - 5.0mg
Max.single dose - 5.0mg
Dosing Interval - no interval
Max # of doses - 1
Croup Medical Directive
What is the TREATMENT paln AND ROUTE for dexamethasone?
ROUTE - PO ONLY
Dose - 0.5mg/kg
Max.single dose - 8mg
Dosing Interval - no interval
Max # of doses - 1
Croup Medical Directive
What is croup?
A virus that causes an upper (usually) airway infection in children.
Croup Medical Directive
What is stridor, what part of the airway is compromised?
Why is 48 hours an important contraindication for dex?
Why is a HR LESS than 200bpm an improtant condition?
The narrowing of the upper airway more likely near the layrnx, vocal cords, susurroundings
If it’s already in your system additional dose won’t improve (half-life)
Becuase if they’re over 200bpm then it will decrease the hearts ability to perfuse blood (over 200bpm = poor perfusion
Croup Medical Directive
When treating with dexamethasone, the contraindication to steroids applies to?
What is the minial initial volume for NEB?
How do administer epi via NEB
PO AND Parenteral
NOT inhaled or topical
2.5mL
Add saline
Croup Medical Directive
What medication is priority?
What do you give for mild-moderate presentation of croup?
What sould you do when/before NEBing the pt with epinephrine?
Epi
ONLY give dex
Moistening/cool the air if available and the pt’s condition permits
Supraglotic Airway Medical Directive
Capnography to know
Supraglotic Airway Medical Directive
Types of supraglottic airway
