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Intubation Essentials with Dr. Alyssa Stoner and Dr. Gina Patel--Part 1 Preparation and Checklists
PedsCrit
English - July 01, 2021 06:00 - 22 minutes - 15.8 MB - ★★★★★ - 35 ratingsEducation picu pedsicu pediatrics critical care emergency medicine peds pccm icu emcrit accrac Homepage Download Apple Podcasts Google Podcasts Overcast Castro Pocket Casts RSS feed
Intubation Essentials-- Part 1 Preparation and Checklists
About our guests:
Dr. Alyssa Stoner is an Assistant Professor of Pediatrics, University of Missouri-Kansas City School of Medicine and practicing pediatric intensivist at Children's Mercy Kansas City.
Dr. Gina Patel is a fellow in pediatric critical care at Children's Mercy Kansas City.
Objectives
When a checklist is elusive a simple mnemonic can be helpful to recall the necessary equipment:
Mnemonic: SOAP ME
Suction Device: Ensure suction is turned on and at appropriate level
Yaunker or large bore suction tube 14 FrenchConsider second suction set up especially if concerned about pulmonary hemorrhage or pulmonary edemaOxygen Delivery system: ensure oxygen sources is connected and functioning appropriately
Nasal Cannula vs. High Flow/ Non-RebreatherConsider non-Invasive if poor oxygenationConsider need for apneic oxygenation depending on clinical situation Self-inflating anesthesia bag with appropriately sized maskAirway Equipment:
Direct Laryngoscope: Blade type and size considerations Video Laryngoscope: CMAC or Glidescope dependent upon access and comfort Endotracheal tube: Correct size + size downBack up airway IE: Laryngeal Mask Airway (LMA)Patient Position: Most of procedural success is based upon the appropriate patient positioning
Consider age of patient and position accordingly to achieve appropriate sniffing position, consider utilizing small shoulder roll (in patients <2years of age) or a small pillow for adolescents/adult sized patients to align all three axis (Oral axis, laryngeal axis and pharyngeal axis) to allow for best viewMedication plan: specific to patient and clinical scenario, there are many combinations that can be utilized and some for specific scenarios.
Analgesic agent: ie: FentanylAmnestic agent: ie: VersedParalytic agent: ie: RocuroniumEquipment: ensure all monitors placed appropriately (BP cuff and pulse ox on separate extremities)
BP monitoring (art line or non-invasive)Pulse oxTelemetry leadsCapnography/End tidal (attached to monitor/ventilator, calorimetry)VentilatorThank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for informational and educational purposes only. It should not be used as a replacement for medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at [email protected]. Check out pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates
Thanks again for listening!