Hi folks. The Airway Twitterati were asked a question about prehospital RSI and avoiding perintubation hypotension and arrest.
Here is my response and todays lesson!
The overview of avoiding the haemodynamic airway clean kill by Scott Weingart
Then my SMACC 2013 talk here
Take home lessons!
- use ketamine at low dose 0.5mg/kg or lower
- give a larger dose of paralytic
- use epinephrine 10-25mcg bolus prior to giving induction/sedative
- Address Breathing and circulatory issues before dealing with Airway – decompress pneumothorax, pelvic binder, fluid bolus
- be gentle, titrate your IV anaesthesia. avoid the slam/bam/thankyou maam approach of RSI
- watch your post intubation ventilation volumes.
Post lesson further reading here: