DIRECT Methodology - Detection
Intervention
Reassessment
Effective Communication
Teamwork
____ is the greatest contribution to diagnosis. - History
____ is the single most important indicator of critical illness. - Tachypnea
Kussmall Breathing (or change in depth of respiration) usually indicates - Metabolic
acidosis
Cheyne-Stokes Respiration (or periodic breathing with apnea or hypopnea usually
indicates - Severe brainstem injury or cardiac dysfunction
Biot Respiration (or ataxic breathing) usually indicates - Severe neuronal damage
____ is one of the most important indicators of critical illness. - Metabolic acidosis
____ is one of the most useful tests in an acutely ill patient. - ABG
An acute deterioration may seem to occur more abruptly in: young or elderly? - Young
What are the two most important predictors of risk in a critically ill patient? - Tachypnea
and Metabolic acidosis
Oropharyngeal airway is not used if ____. - Airway reflexes are intact
Nasopharyngeal airway is contraindicated in patient with ____ and ____. - Suspected
basilar skull fracture or coagulopathy
____ is the most common cause of airway obstruction. - Tongue
SOAP ME (Airway Mneumonic) - Suction
Oxygen
Airways
Position
Monitoring/Medications
Equipment
Airway Evaluation - Neck Mobility
, External Face
Mouth Tongue and Pharynx
Jaw
After tracheal intubation, significant alterations in hemodynamics should be anticipated.
- Hypertension and Tachycardia
Although, you can also have Hypotension and decreased CO due to reduced venous
return associated with positive airway pressure.
Maximum dose of Lidocaine in airway: - 4 mg/kg (Max: 300 mg)
Depolarizing Neuromuscular Blockers - Succinylcholine
Non-depolarizing Neuromuscular Blockers - Vecuronium
Rocuronium
Cisatracurium
Dosage of Succinylcholine - 1-1.5 mg/kg IV bolus
Dosage of Vecuronium - 0.1-0.3 mg/kg IV bolus
Dosage of Rocuronium - 0.6-1 mg/kg IV bolus
Reversal agent of Fentanyl - Naloxone
Reversal agent of Midazolam - Flumazenil
Dose of Etomidate - 0.1-0.3 mg/kg IV bolus
SE of Etomidate - Myoclonus and Trismus
Reversal agent of Etomidate - None
What induction agent may reduce elevation of intracranial pressure during
laryngoscopy? - Lidocaine
Max dose of Lidocaine - Do not excede 4 mg/kg because can cause neurotoxicity
(seizures)
Induction Dose of Ketamine - 1-4 mg/kg IV bolus
Ketamine has no adverse cardiovascular effects except in: - Severe CHF
What induction agent may increase intracranial pressure? - Ketamine