SlideShare a Scribd company logo
1 of 9
Download to read offline
Intubation
Made Short &
sweet
by Melissa Yuan-Innes, MD, CCFP-EM
www.melissayuaninnes.com
Prepare
• SOAPME: (Suction, oxygen, airway,
pharmacology, monitoring, equipment), or try
• Suction
• Oxygen
• Airway set-up
• Pharmacology: “What do you want?”
• Mask yourself
• Elevate patient (positioning)
Preoxygenate
• 3 minutes at 100 percent
• 8 deep (vital capacity) breaths
• http://journals.lww.com/em-news/Fulltext/2006/08000/
Preoxygenation,_Critical_in_RSI,_Often_Negates.24.aspx
Premedicate
LOA
• Lidocaine (?“tight head/lungs”)
• Opiates (“tight head/heart”)
• Atropine (tiny infants)
Or think ABC
A: Asthma
B: brains & babies
C: cardiovascular
Pacify the patient
• Etomidate: good for trauma (? not in
sepsis)
• Ketamine: asthma
• Midazolam: seizures
Paralyze
• Succinylcholine (or rocuronium)
• go big or go home
Pass the Tube
• get the epiglottis out of the way to see
the vocal cords
Post-Intubation Check
• CO2 detector
• (visualization, condensation,
auscultation)
• Secure the tube
• Chest X ray
• Sedate patient
Read Up
UpToDate Adults: http://www.uptodate.com/contents/
rapid-sequence-intubation-in-adults?
UpToDate Children: http://www.uptodate.com/contents/rapid-
sequence-intubation-rsi-in-children#H11 [gives error message if not logged in]

More Related Content

Viewers also liked

病房插管小筆記 (Note about Rapid sequence intubation)
病房插管小筆記 (Note about Rapid sequence intubation)病房插管小筆記 (Note about Rapid sequence intubation)
病房插管小筆記 (Note about Rapid sequence intubation)元傑 張
 
Surapong rsi 2009
Surapong rsi 2009Surapong rsi 2009
Surapong rsi 2009taem
 
A I G O Campagna Turismo Tahiti
A I G O  Campagna  Turismo  TahitiA I G O  Campagna  Turismo  Tahiti
A I G O Campagna Turismo TahitiAIPMT
 
Rapid sequence intubationの実践。気管挿管。
Rapid sequence intubationの実践。気管挿管。Rapid sequence intubationの実践。気管挿管。
Rapid sequence intubationの実践。気管挿管。takayuki mawatari
 
Pediatric intubation pharmacology
Pediatric intubation pharmacology Pediatric intubation pharmacology
Pediatric intubation pharmacology tfalgiani
 
Upper airway assessment east iv
Upper airway assessment east ivUpper airway assessment east iv
Upper airway assessment east ivdrnikahmad
 
A blended approach to training Registered Nurses in Nasogastric Tube Insertio...
A blended approach to training Registered Nurses in Nasogastric Tube Insertio...A blended approach to training Registered Nurses in Nasogastric Tube Insertio...
A blended approach to training Registered Nurses in Nasogastric Tube Insertio...Henry Fuller
 
Pediatric intubation
Pediatric intubationPediatric intubation
Pediatric intubationRobert Parker
 
Airway assessment
Airway assessmentAirway assessment
Airway assessmentDeepa Sinha
 
Intravenous cannulation
Intravenous cannulationIntravenous cannulation
Intravenous cannulationSarah Stewart
 
Central neuroaxial blockade
Central neuroaxial blockade Central neuroaxial blockade
Central neuroaxial blockade Pranav Bansal
 

Viewers also liked (20)

病房插管小筆記 (Note about Rapid sequence intubation)
病房插管小筆記 (Note about Rapid sequence intubation)病房插管小筆記 (Note about Rapid sequence intubation)
病房插管小筆記 (Note about Rapid sequence intubation)
 
Surapong rsi 2009
Surapong rsi 2009Surapong rsi 2009
Surapong rsi 2009
 
Thirsty for the Holy Spirit
Thirsty for the Holy SpiritThirsty for the Holy Spirit
Thirsty for the Holy Spirit
 
A I G O Campagna Turismo Tahiti
A I G O  Campagna  Turismo  TahitiA I G O  Campagna  Turismo  Tahiti
A I G O Campagna Turismo Tahiti
 
Rapid sequence intubationの実践。気管挿管。
Rapid sequence intubationの実践。気管挿管。Rapid sequence intubationの実践。気管挿管。
Rapid sequence intubationの実践。気管挿管。
 
Tracheal Intubation
Tracheal IntubationTracheal Intubation
Tracheal Intubation
 
Rsi
RsiRsi
Rsi
 
Pediatric intubation pharmacology
Pediatric intubation pharmacology Pediatric intubation pharmacology
Pediatric intubation pharmacology
 
Pediatric airway management
Pediatric airway managementPediatric airway management
Pediatric airway management
 
Upper airway assessment east iv
Upper airway assessment east ivUpper airway assessment east iv
Upper airway assessment east iv
 
A blended approach to training Registered Nurses in Nasogastric Tube Insertio...
A blended approach to training Registered Nurses in Nasogastric Tube Insertio...A blended approach to training Registered Nurses in Nasogastric Tube Insertio...
A blended approach to training Registered Nurses in Nasogastric Tube Insertio...
 
ANES 1502 - M6 PPT: Airway Management and Supplies
ANES 1502 - M6 PPT: Airway Management and SuppliesANES 1502 - M6 PPT: Airway Management and Supplies
ANES 1502 - M6 PPT: Airway Management and Supplies
 
Pediatric intubation
Pediatric intubationPediatric intubation
Pediatric intubation
 
Acute epiglottitis
Acute epiglottitisAcute epiglottitis
Acute epiglottitis
 
Airway assessment
Airway assessmentAirway assessment
Airway assessment
 
Airway anatomy
Airway anatomyAirway anatomy
Airway anatomy
 
Caudal anesthesia
Caudal anesthesiaCaudal anesthesia
Caudal anesthesia
 
Intravenous cannulation
Intravenous cannulationIntravenous cannulation
Intravenous cannulation
 
Central neuroaxial blockade
Central neuroaxial blockade Central neuroaxial blockade
Central neuroaxial blockade
 
Nasogastrik tube
Nasogastrik tubeNasogastrik tube
Nasogastrik tube
 

Recently uploaded

รายการตํารับยาแผนไทยแห่งชาติ ฉบับ พ.ศ. 2564.pdf
รายการตํารับยาแผนไทยแห่งชาติ ฉบับ พ.ศ. 2564.pdfรายการตํารับยาแผนไทยแห่งชาติ ฉบับ พ.ศ. 2564.pdf
รายการตํารับยาแผนไทยแห่งชาติ ฉบับ พ.ศ. 2564.pdfVorawut Wongumpornpinit
 
Relationship between vascular system disfunction, neurofluid flow and Alzheim...
Relationship between vascular system disfunction, neurofluid flow and Alzheim...Relationship between vascular system disfunction, neurofluid flow and Alzheim...
Relationship between vascular system disfunction, neurofluid flow and Alzheim...Catherine Liao
 
BMK Glycidic Acid (sodium salt) CAS 5449-12-7 Pharmaceutical intermediates
BMK Glycidic Acid (sodium salt)  CAS 5449-12-7 Pharmaceutical intermediatesBMK Glycidic Acid (sodium salt)  CAS 5449-12-7 Pharmaceutical intermediates
BMK Glycidic Acid (sodium salt) CAS 5449-12-7 Pharmaceutical intermediatesdorademei
 
Denture base resins materials and its mechanism of action
Denture base resins materials and its mechanism of actionDenture base resins materials and its mechanism of action
Denture base resins materials and its mechanism of actionDr.shiva sai vemula
 
CT scan of penetrating abdominopelvic trauma
CT scan of penetrating abdominopelvic traumaCT scan of penetrating abdominopelvic trauma
CT scan of penetrating abdominopelvic traumassuser144901
 
PT MANAGEMENT OF URINARY INCONTINENCE.pptx
PT MANAGEMENT OF URINARY INCONTINENCE.pptxPT MANAGEMENT OF URINARY INCONTINENCE.pptx
PT MANAGEMENT OF URINARY INCONTINENCE.pptxdrtabassum4
 
MRI Artifacts and Their Remedies/Corrections.pptx
MRI Artifacts and Their Remedies/Corrections.pptxMRI Artifacts and Their Remedies/Corrections.pptx
MRI Artifacts and Their Remedies/Corrections.pptxDr. Dheeraj Kumar
 
Scientificity and feasibility study of non-invasive central arterial pressure...
Scientificity and feasibility study of non-invasive central arterial pressure...Scientificity and feasibility study of non-invasive central arterial pressure...
Scientificity and feasibility study of non-invasive central arterial pressure...Catherine Liao
 
Video capsule endoscopy (VCE ) in children
Video capsule endoscopy (VCE ) in childrenVideo capsule endoscopy (VCE ) in children
Video capsule endoscopy (VCE ) in childrenRaju678948
 
THORACOTOMY . SURGICAL PERSPECTIVES VOL 1
THORACOTOMY . SURGICAL PERSPECTIVES VOL 1THORACOTOMY . SURGICAL PERSPECTIVES VOL 1
THORACOTOMY . SURGICAL PERSPECTIVES VOL 1DR SETH JOTHAM
 
Is Rheumatoid Arthritis a Metabolic Disorder.pptx
Is Rheumatoid Arthritis a Metabolic Disorder.pptxIs Rheumatoid Arthritis a Metabolic Disorder.pptx
Is Rheumatoid Arthritis a Metabolic Disorder.pptxSamar Tharwat
 
SURGICAL ANATOMY OF ORAL IMPLANTOLOGY.pptx
SURGICAL ANATOMY OF ORAL IMPLANTOLOGY.pptxSURGICAL ANATOMY OF ORAL IMPLANTOLOGY.pptx
SURGICAL ANATOMY OF ORAL IMPLANTOLOGY.pptxSuresh Kumar K
 
Cas 28578-16-7 PMK ethyl glycidate ( new PMK powder) best suppler
Cas 28578-16-7 PMK ethyl glycidate ( new PMK powder) best supplerCas 28578-16-7 PMK ethyl glycidate ( new PMK powder) best suppler
Cas 28578-16-7 PMK ethyl glycidate ( new PMK powder) best supplerSherrylee83
 
Cervical screening – taking care of your health flipchart (Vietnamese)
Cervical screening – taking care of your health flipchart (Vietnamese)Cervical screening – taking care of your health flipchart (Vietnamese)
Cervical screening – taking care of your health flipchart (Vietnamese)Cancer Institute NSW
 
DIGITAL RADIOGRAPHY-SABBU KHATOON .pptx
DIGITAL RADIOGRAPHY-SABBU KHATOON  .pptxDIGITAL RADIOGRAPHY-SABBU KHATOON  .pptx
DIGITAL RADIOGRAPHY-SABBU KHATOON .pptxSabbu Khatoon
 
DECIPHERING COMMON ECG FINDINGS IN ED.pptx
DECIPHERING COMMON ECG FINDINGS IN ED.pptxDECIPHERING COMMON ECG FINDINGS IN ED.pptx
DECIPHERING COMMON ECG FINDINGS IN ED.pptxdrwaque
 
Hemodialysis: Chapter 2, Extracorporeal Blood Circuit - Dr.Gawad
Hemodialysis: Chapter 2, Extracorporeal Blood Circuit - Dr.GawadHemodialysis: Chapter 2, Extracorporeal Blood Circuit - Dr.Gawad
Hemodialysis: Chapter 2, Extracorporeal Blood Circuit - Dr.GawadNephroTube - Dr.Gawad
 
Integrated Neuromuscular Inhibition Technique (INIT)
Integrated Neuromuscular Inhibition Technique (INIT)Integrated Neuromuscular Inhibition Technique (INIT)
Integrated Neuromuscular Inhibition Technique (INIT)Anjali Parmar
 
hypo and hyper thyroidism final lecture.pptx
hypo and hyper thyroidism  final lecture.pptxhypo and hyper thyroidism  final lecture.pptx
hypo and hyper thyroidism final lecture.pptxdr shahida
 

Recently uploaded (20)

รายการตํารับยาแผนไทยแห่งชาติ ฉบับ พ.ศ. 2564.pdf
รายการตํารับยาแผนไทยแห่งชาติ ฉบับ พ.ศ. 2564.pdfรายการตํารับยาแผนไทยแห่งชาติ ฉบับ พ.ศ. 2564.pdf
รายการตํารับยาแผนไทยแห่งชาติ ฉบับ พ.ศ. 2564.pdf
 
Relationship between vascular system disfunction, neurofluid flow and Alzheim...
Relationship between vascular system disfunction, neurofluid flow and Alzheim...Relationship between vascular system disfunction, neurofluid flow and Alzheim...
Relationship between vascular system disfunction, neurofluid flow and Alzheim...
 
BMK Glycidic Acid (sodium salt) CAS 5449-12-7 Pharmaceutical intermediates
BMK Glycidic Acid (sodium salt)  CAS 5449-12-7 Pharmaceutical intermediatesBMK Glycidic Acid (sodium salt)  CAS 5449-12-7 Pharmaceutical intermediates
BMK Glycidic Acid (sodium salt) CAS 5449-12-7 Pharmaceutical intermediates
 
Denture base resins materials and its mechanism of action
Denture base resins materials and its mechanism of actionDenture base resins materials and its mechanism of action
Denture base resins materials and its mechanism of action
 
CT scan of penetrating abdominopelvic trauma
CT scan of penetrating abdominopelvic traumaCT scan of penetrating abdominopelvic trauma
CT scan of penetrating abdominopelvic trauma
 
PT MANAGEMENT OF URINARY INCONTINENCE.pptx
PT MANAGEMENT OF URINARY INCONTINENCE.pptxPT MANAGEMENT OF URINARY INCONTINENCE.pptx
PT MANAGEMENT OF URINARY INCONTINENCE.pptx
 
MRI Artifacts and Their Remedies/Corrections.pptx
MRI Artifacts and Their Remedies/Corrections.pptxMRI Artifacts and Their Remedies/Corrections.pptx
MRI Artifacts and Their Remedies/Corrections.pptx
 
Scleroderma: Treatment Options and a Look to the Future - Dr. Macklin
Scleroderma: Treatment Options and a Look to the Future - Dr. MacklinScleroderma: Treatment Options and a Look to the Future - Dr. Macklin
Scleroderma: Treatment Options and a Look to the Future - Dr. Macklin
 
Scientificity and feasibility study of non-invasive central arterial pressure...
Scientificity and feasibility study of non-invasive central arterial pressure...Scientificity and feasibility study of non-invasive central arterial pressure...
Scientificity and feasibility study of non-invasive central arterial pressure...
 
Video capsule endoscopy (VCE ) in children
Video capsule endoscopy (VCE ) in childrenVideo capsule endoscopy (VCE ) in children
Video capsule endoscopy (VCE ) in children
 
THORACOTOMY . SURGICAL PERSPECTIVES VOL 1
THORACOTOMY . SURGICAL PERSPECTIVES VOL 1THORACOTOMY . SURGICAL PERSPECTIVES VOL 1
THORACOTOMY . SURGICAL PERSPECTIVES VOL 1
 
Is Rheumatoid Arthritis a Metabolic Disorder.pptx
Is Rheumatoid Arthritis a Metabolic Disorder.pptxIs Rheumatoid Arthritis a Metabolic Disorder.pptx
Is Rheumatoid Arthritis a Metabolic Disorder.pptx
 
SURGICAL ANATOMY OF ORAL IMPLANTOLOGY.pptx
SURGICAL ANATOMY OF ORAL IMPLANTOLOGY.pptxSURGICAL ANATOMY OF ORAL IMPLANTOLOGY.pptx
SURGICAL ANATOMY OF ORAL IMPLANTOLOGY.pptx
 
Cas 28578-16-7 PMK ethyl glycidate ( new PMK powder) best suppler
Cas 28578-16-7 PMK ethyl glycidate ( new PMK powder) best supplerCas 28578-16-7 PMK ethyl glycidate ( new PMK powder) best suppler
Cas 28578-16-7 PMK ethyl glycidate ( new PMK powder) best suppler
 
Cervical screening – taking care of your health flipchart (Vietnamese)
Cervical screening – taking care of your health flipchart (Vietnamese)Cervical screening – taking care of your health flipchart (Vietnamese)
Cervical screening – taking care of your health flipchart (Vietnamese)
 
DIGITAL RADIOGRAPHY-SABBU KHATOON .pptx
DIGITAL RADIOGRAPHY-SABBU KHATOON  .pptxDIGITAL RADIOGRAPHY-SABBU KHATOON  .pptx
DIGITAL RADIOGRAPHY-SABBU KHATOON .pptx
 
DECIPHERING COMMON ECG FINDINGS IN ED.pptx
DECIPHERING COMMON ECG FINDINGS IN ED.pptxDECIPHERING COMMON ECG FINDINGS IN ED.pptx
DECIPHERING COMMON ECG FINDINGS IN ED.pptx
 
Hemodialysis: Chapter 2, Extracorporeal Blood Circuit - Dr.Gawad
Hemodialysis: Chapter 2, Extracorporeal Blood Circuit - Dr.GawadHemodialysis: Chapter 2, Extracorporeal Blood Circuit - Dr.Gawad
Hemodialysis: Chapter 2, Extracorporeal Blood Circuit - Dr.Gawad
 
Integrated Neuromuscular Inhibition Technique (INIT)
Integrated Neuromuscular Inhibition Technique (INIT)Integrated Neuromuscular Inhibition Technique (INIT)
Integrated Neuromuscular Inhibition Technique (INIT)
 
hypo and hyper thyroidism final lecture.pptx
hypo and hyper thyroidism  final lecture.pptxhypo and hyper thyroidism  final lecture.pptx
hypo and hyper thyroidism final lecture.pptx
 

Rapid Sequence Intubation Made Short and Sweet

  • 1. Intubation Made Short & sweet by Melissa Yuan-Innes, MD, CCFP-EM www.melissayuaninnes.com
  • 2. Prepare • SOAPME: (Suction, oxygen, airway, pharmacology, monitoring, equipment), or try • Suction • Oxygen • Airway set-up • Pharmacology: “What do you want?” • Mask yourself • Elevate patient (positioning)
  • 3. Preoxygenate • 3 minutes at 100 percent • 8 deep (vital capacity) breaths • http://journals.lww.com/em-news/Fulltext/2006/08000/ Preoxygenation,_Critical_in_RSI,_Often_Negates.24.aspx
  • 4. Premedicate LOA • Lidocaine (?“tight head/lungs”) • Opiates (“tight head/heart”) • Atropine (tiny infants) Or think ABC A: Asthma B: brains & babies C: cardiovascular
  • 5. Pacify the patient • Etomidate: good for trauma (? not in sepsis) • Ketamine: asthma • Midazolam: seizures
  • 6. Paralyze • Succinylcholine (or rocuronium) • go big or go home
  • 7. Pass the Tube • get the epiglottis out of the way to see the vocal cords
  • 8. Post-Intubation Check • CO2 detector • (visualization, condensation, auscultation) • Secure the tube • Chest X ray • Sedate patient
  • 9. Read Up UpToDate Adults: http://www.uptodate.com/contents/ rapid-sequence-intubation-in-adults? UpToDate Children: http://www.uptodate.com/contents/rapid- sequence-intubation-rsi-in-children#H11 [gives error message if not logged in]