Critical Care Flashcards
(24 cards)
Sizing intubation tube
Age in years/4+4= estimated Tube size
ETT estimated depth
Size of ETT multiplied by 3
Sizing foley, suction, OG tubing
Double ET tube
Indications RSI
Head Injury, significant facial trauma, Vinicius, impending airway compromise, inability to oxygenate, apnea
Atropine
Ideal for infant intubation, helps to prevent vagal bradycardia. Draw it up at bedside wait to administer. 0.01- 0.02mg/kg dosing. at least 0.1mg or they can have worsening bradycardia.
For the pt in cardiac arrest
Just place tube maybe have atropine ready.
For status epilepticus after first line meds like lorazepam and keppra.
Consider fentanyl for pain.
Propofol
Onset 15 seconds last 3-10 mins for single dose.
1-2 mg/kg.
Don’t worry about allergy.
Can cause vasodilation and lower bp.
Great antconvusant
Decreases ICP
Bronchdialaton
Midazolam
Dose: 0.1-0.3mg/kg max of 10mg
Onset for 60-150 seconds
Lasts 30-80 mins
Good for status epilepticus after first
Paralytics
Succinylcholine:
1-2 mg/kg
30-60 seconds
5-10 mins
Muscle spasms can happen with administration
Rocuronium:
Higher the dose the faster it works
0.6-1.2 mg/kg
Rock is typically more common, and higher dose is more common.
Fentanyl
1-3 mcg/kg
Onset 30-60 seconds
Risk of hypotension
Status asthmaticus
Ketamine for bronchodialtor effect and Analgesics,
Ketamine:
Dose 1-4mg/kg
Onset 30-60 seconds
Duration 20-30 mins
Increases blood pressure, bronchodialtor
Etomidate
Pro: doesn’t effect no or heart rate hemodynamically neutral
Decrease ICP
Con:
Don’t redose
Etomidate:
0.3 mg/kg
Onset 15-30 seconds
Duration 5-15 min duration very short acting
Propofol
Do not give long term, the longer you use it. Avoid in infants, it gets metabolized faster, it can cause propofol infusion syndrome for longer than 24 hours.
Norepinephrine
Mainly increases bp with minimal increase on heart rate.
Phenylnephrine
All Alpha- Increases systemic vascular pressure (bp) , no increase in heart rate
Contractility
The biggest driver of poor perfusion, post arrest. Administer EPI drip. Increases Hr and heart beat strength, and increases intravascular resistance.
Vasopressin
Peripherally vasoconstricts, shunts blood to the core.
Milrinone
Decreases blood pressure, and increase contractility. Ideal for pt with poor peripheral perfusion despite hypertension. Given as a drip.
Epi drip mixed 2mg in 250ml
Critical care setting on pump
If infusing med Less than 10ml per hour.
Set up carrier fluid
