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10 Cards in this Set
- Front
- Back
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LOAD |
Lidocaine- for head and lung injuries blunts the cough reflex preventing ICP increase Opiates- blunts the pain response Atropine for infants- prevents reflex bradycardia in infants >1YO |
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7 P's |
Preparation (assure all equipment is accessable) Pre-oxygenate (3-5min at 10-15LPM) Pretreatment (LOAD) Paralysis with induction (neuromuscular blocking agents AND pain control) Protect and position (sniffing position, place a towel under the patients shoulder blades) Placement with proof (tupe passing through vocal chords, capnography, chest x ray ect.) Post intubation management (maintain sedation, oxygenation, ect.) |
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Succinylcholine |
Depolarizing neuromuscular blocking agent Causes fasiculations(muscle twitching) Dose 1-2mg/kg 1-2 min onset 4-6 min duration Can cause hyperkalemia Can cause malignant hyperthermia |
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Signs and symptoms of malignant hyperthermia MH |
Master spasm/trismas(lock jaw) Sustained tietanic muscle contractions Rapid increase in temperature can be as high as 110 Increased ETC02 Tachycardia /hypertension Mixed acidosis |
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How to treat malignant hypertension |
Dantrolene sodium (Dantrium) Dose 3.0 mg/kg DO NOT give CCBs |
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Vecuronium |
Non-depolarizing neuromuscular blocking agent Does NOT cause fasiculations Used after succinylcholine to keep the pt paralyzed (slow onset long acting) Defasciculating doses of a non-depolarizing agent reduces increase in ICP during LOAD slower onset 4-6 min longer duration of action 30-45 min Dose .04 .06mg/kg IVP Maintenance dose .01 - .015 mg/kg |
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Rocuronium |
Non-depolarizing neuromuscular blocking agent Does NOT cause fasiculations Defasciculating doses of a non-depolarizing agent reduces increase in ICP during intubation Used after succinylcholine to keep the pt paralyzed (slow onset, long acting) Onset 4-6 min duration 30-45 min Maintenance dosing .1-.2mg/kg |
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Etomidate |
Sedation induction agent preferred for awake sedation because of fast onset and short Half-Life Dose .3mg/kg 30-60 second onset 3-12 min duration Causes almost no change in BP and cardiac output NO ANALGESIC PROPERTIES Can cause vomiting when it wakes up Contraindications adrenal suppression, Do NOT use in pts in septic shock or Addisons disease |
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Propofol |
Hypnotic with NO ANALGESIC PROPERTIES Milk of amnesia Dose varies based on intended use 1.5 mg/kg 15-45 sec onset, 5-10 min duration Use lowest dose possible DO NOT mix with benzodiazepines Decreases cerebral perfusion pressure and mean arterial pressure DO NOT use in it with a head injury Not a good choice in pts in shock (ketamine is safer choice for induction) |
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Ketamine |
hypnotic (sleep producing) Analgesic, amnesic drug Doses vary depending on intended use 1mg/kg IV 2mg/kg IM 45 - 60 onset 11-17 min duration Used to stop pain impulses (remember NMBs and etomidate DO NOT CONTROL PAIN) potent bronchodilator (use in RSI for asthmatic pts ) Dose NOT dry secretions in airway it can increase them causing laryngospasm! (if this happens give .01 mg/kg IV atropine or .3mg IV Scopolamine SLOWLY) pts can have hallucinations upon waking can also be given IO |
