DAANCE: scenarios

DAANCE: scenarios airway obstruction - ANSWER 100% O2 via nasal mask; put patient in Trendellenburg position; retract tongue ( hemostat, suture or tongue forcep); suction oropharynx; if tongue still occludes airway, insert nasopharyngeal/ oral airway- advanced airway if necessary foreign bodies - ANSWER Digital removal of object ONLY IF WELL VISULAIZED; Chest compressions if no airflow, in supine position; attempt direct laryngoscopy (macgill forceps) for visualization and removal of object; cricothyrotomy may be necessary of obstruction persists Cricothyrotomy - ANSWER Call 911/ activate EMS; locate crocothyroid membrane by palpitation; utilize cricothyrotomy needle/cannula kit or large gauge needle to enter trachea beneath the vocal chords through the cricothyroid membrane; attach tube of cricothyrotomy device to an O2 source (or Ambu bag) and ventilate with 100% O2 laryngospasm - ANSWER 100% O2 via nasal hood; establish proper head position/ airway; suction (yankauer); positive pressure, 100% O2 via bag/mask; administer succinylcholine; manually breathe via bag/mask until effects of drug dissipated and strong spontaneous respiration resumes bronchospasm - ANSWER 100% O2 via bag/mask; Albuterol via inhaler every 20 minutes for up to 4 hours, then every 1-4 hours as needed; ipratropium bromide (Atrovent) 2 puffs stat; repeat every 4 hours; epinephrine injection; intubation, steriod injection (decadron); Benadryl; activate EMS if none of the above resolve issue Emesis with Aspiration - ANSWER Activate EMS; 100% O2 via bag/mask; turn patient in RIGHT side in Trendellenburg position; suction tonsils/oral cavity/oropharynx (yankaeur); remove foreign bodies with macgill and laryngoscope; intubation