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Intubation Flashcards

(28 cards)

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1
Q

Pre-Tx RSI | Fentanyl

(MOA)

  • dose
  • onset
  • duration
A

Pre-Tx RSI | Fentanyl

(synthetic opioid)

  • dose: 1-2 mcg/kg, slow push, IV over 1-2 min
  • onset: immediate
  • duration: 30-60 min
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2
Q

Pre-Tx RSI | Fentanyl

advantages:

A

Pre-Tx RSI | Fentanyl

  • advantages:*
  • main pre-tx Rx for SEDATION and ANALGESIA
  • decreases hypertensive response to intubation
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3
Q

Pre-Tx RSI | Fentanyl

cautions:

A

Pre-Tx RSI | Fentanyl

  • cautions*:
  • high doses ( > 15 mcg/kg) → CHEST WALL RIGIDITY
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4
Q

Pre-Tx RSI | Lidocaine/Xylocaine

(MOA)

  • dose
  • onset
  • duration
A

Pre-Tx RSI | Lidocaine/Xylocaine

(type IB antiarrhythmic)

  • dose: 1.5 mg/kg, IV push
  • onset: 1-2 min
  • duration: 10-20 min
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5
Q

Pre-Tx RSI | Lidocaine/Xylocaine

advantages:

A

Pre-Tx RSI | Lidocaine/Xylocaine

  • advantages:*
  • useful in COPD/asthma pts to decrease HTN response to intubation
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6
Q

Pre-Tx RSI | Lidocaine/Xylocaine

cautions:

A

Pre-Tx RSI | Lidocaine/Xylocaine

  • cautions:*
  • hypotension
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7
Q

Pre-Tx RSI | Atropine

(MOA)

  • dose
  • onset
  • duration
A

Pre-Tx RSI | Atropine

(anti-cholinergic for peds < 1 yo)

  • dose: 0.02 mg/kg, IV push
  • onset: 2-4 minutes
  • duration: up to 4 hours
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8
Q

Pre-Tx RSI | Atropine

- advantages

A

Pre-Tx RSI | Atropine

  • advantages*:
  • anti-sialagogue
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9
Q

Pre-Tx RSI | Atropine

- cautions

A

Pre-Tx RSI | Atropine

  • cautions:*
  • tachycardia
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10
Q

Pre-Tx RSI | Vecuronium/Norcuron

(MOA)

- defasciculating dose

A

Pre-Tx RSI | Vecuronium/Norcuron

(NON-depol NM block)

defasciculating dose: 0.01 mg/kg, IV push

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11
Q

Pre-Tx RSI

Vecuronium/Norcuron Rocuronium/Zemuron

advantages

A

Pre-Tx RSI

Vecuronium/Norcuron

Rocuronium/Zemuron

  • advantages:*
  • decreases fasciculations and K+ release from cells
  • good if intending to use succinylcholine
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12
Q

Pre-Tx RSI | Rocuronium/Zemuron

(MOA)

- defasciculating dose

A

Pre-Tx RSI | Rocuronium/Zemuron

(NON-depol NM block)

  • defasciculating dose: 0.06 mg/kg, IV push
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13
Q

RSI Induction | Etomidate

(MOA)

  • dose
  • onset
  • duration
A

RSI Induction | Etomidate

(GABA)

  • dose: 0.3 mg/kg, IV push (~20 mg in avg adult)
  • onset: 30-60 seconds
  • duration: 3-5 min
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14
Q

RSI Induction | Etomidate

- advantages

A

RSI Induction | Etomidate

  • advantages:*
  • no effect on hemodynamics
  • no effect on intracranial pressure
  • no histamine release
  • useful for pts w/ multiple trauma + hypotension
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15
Q

RSI Induction | Etomidate

- cautions

A

RSI Induction | Etomidate

  • cautions:*
  • myoclonus
  • painful on injection
  • adrenal suppression
  • does NOT suppress sympathetic response to DL
  • nausea/vomiting
  • decreases seizure threshold
  • no analgesia
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16
Q

RSI Induction | Propofol/Diprivan

(MOA)

  • dose
  • onset
  • duration
Study These Flashcards
A

RSI Induction | Propofol/Diprivan

(GABA, Na channel blocker)

  • dose: 2-3 mg/kg, IV push
  • *decrease dose if pt unstable*
  • onset: < 1 minute
  • duration: 3-10 minutes
17
Q

RSI Induction | Propofol/Diprivan

- advantages

Study These Flashcards
A

RSI Induction | Propofol/Diprivan

  • advantages:*
  • use in sympathomimetic drug-induced delirium and seizures!
  • rapid onset, brief duration
  • possibly cerebroprotective by decreasing ICP
  • amnestic
18
Q

RSI Induction | Propofol/Diprivan

- cautions

Study These Flashcards
A

RSI Induction | Propofol/Diprivan

  • cautions:*
  • cardiovascular depression + hypotension
  • no analgesia
  • respiratory depression is dose-dependent
  • decreases pharyngeal and laryngeal mm tone
19
Q

RSI Induction | Ketamine/Ketalar

(MOA)

  • dose
  • onset
  • duration
Study These Flashcards
A

RSI Induction | Ketamine/Ketalar

(NMDA-R block, PCP derivative)

  • dose: 1-2 mg/kg, slow IV push
  • onset: 30-60 sec
  • duration: 5-10 minutes
20
Q

RSI Induction | Ketamine/Ketalar

- advantages

Study These Flashcards
A

RSI Induction | Ketamine/Ketalar

  • advantages:*
  • only induction Rx that is also an ANALGESIC
  • amnesic
  • bronchodilatory, give to asthma pts
  • increases sympathetic tone, give to hypotensives
21
Q

RSI Induction | Ketamine/Ketalar

- cautions

Study These Flashcards
A

RSI Induction | Ketamine/Ketalar

  • cautions:*
  • hallucinations
  • increases sympathetic tone, do NOT give to aortic dissection pts
  • potent cerebral vasodilation
  • CV stimulation, do NOT give to MI/CAD pts
22
Q

RSI Paralysis

Rocuronium/Zemuron

(MOA)

  • dose
  • onset
  • duration
Study These Flashcards
A

RSI Paralysis

Rocuronium/Zemuron

(NON-depol NM bloc)

  • dose: 0.6-1 mg/kg, IV push
  • onset: < 1 min
  • duration: 30-60 minutes
  • *longer duration in hepatic impairment*
23
Q

RSI Paralysis

Rocuronium/Zemuron

- advantages

Study These Flashcards
A

RSI Paralysis Rocuronium/Zemuron

advantages: - minimal effect on hemodynamics

24
Q

RSI Paralysis

Rocuronium/Zemuron

- cautions

Study These Flashcards
A

RSI Paralysis

Rocuronium/Zemuron

  • cautions:*
  • longer duration in hepatic impairment

* use cis-atricurium: metabolism is independent

of both the kidney and liver

* if MSOF or ICU pt, give cis-atricurium

25
RSI Paralysis **Succinylcholine/Anectine** (MOA) - dose - onset - duration
RSI Paralysis **Succinylcholine/Anectine** (depol NM block) - dose: **0.3-2 mg/kg** (avg 1.5 mg/kg) - onset: 1 min - duration: 4-6 min \*prolonged w/ cocaine toxicity
26
RSI Paralysis **Succinylcholine/Anectine** *- advantages*
RSI Paralysis **Succinylcholine/Anectine** * advantages:* - drug of choice d/t onset + duration
27
RSI Paralysis **Succinylcholine/Anectine** *- cautions*
RSI Paralysis **Succinylcholine/Anectine** * cautions:* - avoid **hyperK+** crush injury, large burns, spinal cord injury, mm necrosis, MS, ALS, undx'd/dx'd myopathies (**peds**) - large strokes or spinal cord injuries 1 wk old → healed - **Absolute CI:** pseudocholinesterase deficiency - *masseter mm spasm* (1% **peds** pts), give NON-depolarizing agent, watch for MALIGNANT HYPERTHERMIA - *bradydysrrhythmias,* ASYSTOLE (**peds** \> adults), esp if repeat dosing
28
RSI Preparation Mnemonic *(you want to* WASH YOUR HANDS *first, right?)* :-)
**S O A P M E** ## Footnote S: suction O: oxygen (connect BVM to O2 @ 15L, fill resevoir, squeeze) A: airway (OPA, NPA, combitube, check ETT cuff, place stylet) P: position (ear in line w/ sternum), pre-oxygenate M: monitor equipment, medications E: end-tidal CO2

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