pediatric rapid sequence intubation drugs

Pediatric rapid sequence intubation drugs mac#

This can be done with a non-rebreather mask on 15L O 2 and 100% O 2 nasal cannula before and during the procedure (termed “apneic” oxygen). The goal in this step is to wash out as much nitrogen in the body to provide an oxygen reserve for the patient while they are apneic.

Neck mobility: Anything that prevents ideal positioning of the neck, such as a c-collar, will make intubation more difficult.

Obstruction: Possible foreign body, epiglottitis, edema, stridor, etc.

Mallampati score: The more of the throat you can see, the easier it will be.

Fitting 2 fingers between the hyoid bone and the notch of the thyroid cartilage.

Fitting 3 fingers between the edge of the chin and the hyoid bone.

Fitting 3 fingers in an open mouth between upper and lower incisors.

Evaluate: 3,3,2 rule for an easier intubation.

Look: Observe for possible complications.

This step also involves stratifying the difficulty level of the patient's airway. This entails gathering and testing the supplies needed (endotracheal tubes, stylet, blades, handles, drugs, alternate airway methods) as well as planning for a surgical airway if orotracheal intubation ultimately fails. Like everything else in medicine, RSI has a list of mnemonics to help us prepare for a successful intubation in stressful situations.

Pediatric rapid sequence intubation drugs mac#

This is meant to prevent insufflation of the stomach and the risk of aspiration from vomiting – especially important in emergency patients who might have just finished their Big Mac before coming in or have conditions predisposing them to aspiration (GERD, traumatic brain injury, pregnancy, etc.). The concept of RSI is that the patient is sedated and paralyzed in order to allow for intubation without the application of artificial breaths via a bag valve mask (BVM). This article will not be a complete or exhaustive resource for this topic, but it can serve as a starting point for medical students. In emergency medicine, rapid sequence intubation (RSI) comes into play when there is neither the time nor the luxury of adequately prepping a patient whose airway and breathing are compromised. We all learn our ABC's as kids, but after a couple years of medical school they take on a different meaning: airway, breathing, and circulation.