Respiratory Intubation Emergencies Flashcards Preview

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Flashcards in Respiratory Intubation Emergencies Deck (14):
1

Does airway management mean intubation?

NO
if patient is breathing adequately --> give supplemental oxygen and position to maximize exchange
1. Nasal Cannula
2. Mask
3. CPAP or BiPAP
4. Bag-valve assist (15 L O2)

2

Pearl of epiglotitis presentation

Youngs unimmunized kids --> drooling and sniffing a rose

3

Airway is fine but unprotected

Decreased LOC (GCS <8)
Absence of protective reflexes (gag, cough)
Apnea
Hypoventilation leading to hypercapnia

4

Intubation

ELECTIVE emergency procedure --> make sure you have your shit together before you try --> have a back-up plan --> consider RSI

5

Difficult Intubations

Short necks
Prominent Incisors
Receding Mandible
Limited Jaw Opening
Limited Cervical Spine Mobility

6

Succinylcholine

ultra-short acting muscle relaxant --> acts on cholinergic receptors to produce flaccid paralysis (binds more firmly than ACh)
rapidly broken down by pseudocholinesterase
Takes effect in ~1 min, lasts 8-12 min
S.E. = bradycardia --> tx with atropine, serum K may go up

7

Vecuronium

neuromuscular blocker that competes at motor endplate for cholinergic receptors --> flaccid paralysis
Takes effect in 2-3 min, lasts 25-40 min
DOESN'T CAUSE HYPOTENSION OR TACHYCARDIA

8

Rocuronium

unique non-depolarizing blocker that has onset quicker than succinylcholine but lasts longer (30-60 min)

9

Ideal Sedative

Very rapid onset, short half life, no S.E.

10

Barbiturates

anesthetics with rapid onset of actions
HYPOTENSION risk

11

Ketamine

non-barb sedative
rapid-acting sedative that induces dissociative state (LSD-type trip)
Uses: sedation and analgesia for kids
S.E. = LSD-type trip, HTN, increased intracranial pressure, increase airway secretions

12

Midazolam

benzodiazepine --> short acting CNS depressant --> lack of recall (amnesia)
Acts in 2-3 min
S.E. = slight drop in MAP

13

Propofol

modified phenol --> extremely lipophylic
infiltrates lipid bilayer of nerve cell membrane --> disrupts nerve conduction
Onset --> 10-20 seconds
Offset --> both dose related

14

Etomidate

rapid-acting hypnotic --> sedative with no analgesic or amnestic properties
Onset - 20-30 secs
Offset - 20 minutes
DOESN'T produce any CV effects, ideal for hypovolemic patients
Can cause vomitting