Presentation is loading. Please wait.

Presentation is loading. Please wait.

1 Module B: Hour 2 Intubation Difficulties. 2 Think ahead !!!! If you suspect a difficult airway: call for help early What increases the risk of a difficult.

Similar presentations


Presentation on theme: "1 Module B: Hour 2 Intubation Difficulties. 2 Think ahead !!!! If you suspect a difficult airway: call for help early What increases the risk of a difficult."— Presentation transcript:

1 1 Module B: Hour 2 Intubation Difficulties

2 2 Think ahead !!!! If you suspect a difficult airway: call for help early What increases the risk of a difficult airway ?

3 3 Mallampati Is Mallampati a famous curry dish from the south of India ?

4 4

5 5 The 6 “P’s” of RSI Preparation (5 min) Pre-oxygenation (2 min) Paralysis / induction Protection and positioning (30 seconds) Placement (45 seconds) Post-intubation care

6 6 P1 = Preparation What preparations do you make before intubating ? What is “Soap Me” ?

7 7 P2 = Preoxygenate What are the physiological aims of pre-oxygenation ? How are these achieved ?

8 8 P3 = Paralysis/Induction What problems arise with the common induction agents ? Compare the use of these: Suxamethonium vs Rocuronium

9 9 P4 = Protection/Positioning How do you achieve in-line stabilisation if necessary ?

10 10

11 11 P5 = Placement How do you confirm your tube placement ?

12 12 P6 = Post-intubation care SedationParalysisMonitoringHumidification NG tube and IDC

13 13 Mrs AO, 72 years old BIBA from GP’s waiting room Sudden stridor: given adrenaline/ventolin/ phenergan/lasix at GPs for ? anaphylaxis ? APO Sats 95% on R/A on arrival, fairly comfortable. Intermittently complains of SOB, audible soft stridor, two word sentences. Epigastric pain. What is your management ?

14 14 Describe the X-ray

15 15 The patient needs a CT chest. How would you proceed ?

16 16

17 17 Mr DI, 73 years old GCS 7, found on floor by wife (E1 V1 M5) Increased tone /reflexes on right Increased tone /reflexes on right PEARL, but small PMHx IHD, A/F on warfarin Gurgling respirations Sats 89% on R/A, RR 16/min What is your management ?

18 18 You are unable to intubate – this is your view. What grade of laryngoscopy is this ?

19 19 Laryngoscopy What would you do next ?

20 20 Second look STOP, re-oxygenate, rethink BURPIntroducer BOUGIE (if you can see the epiglottis) Different blade

21 21 You remain unable to intubate. What would you do next ?

22 22 End of the line What do you do if you can’t intubate and you can’t ventilate a patient ?

23 23 Reminder: Nobody ever died from a failure to intubate. They died from a failure to ventilate.

24 24 Discussion


Download ppt "1 Module B: Hour 2 Intubation Difficulties. 2 Think ahead !!!! If you suspect a difficult airway: call for help early What increases the risk of a difficult."

Similar presentations


Ads by Google