Rapid Sequence Intubation
On the next page, a patient will present to you. Do they need an advanced airway? Are they a difficult airway? What to use for induction and paralysis? You decide the Rapid Sequence Intubation.
You can find an advanced airway cheat sheet on fpnotebook.com.
The LEMON mnemonic and specific induction and paralytic agent indications are derived from the Difficult Airway Course.
Assign a Glasgow Coma Scale (GCS)
Eyes open spontaneously. Confused. Obeys commands.
Is Intubation Indicated?
60 year old female. Eyes open spontaneously. Confused. Obeys commands. Hoarse Voice. Severe maxillofacial injury. ABG: pO2=62 pCO2=51 on non-rebreather mask.
Evaluate neck proportions
Which of these criteria imply a more difficult airway?
Name that Mallampati Class
With the mouth open at rest, only hard palate is visible.
Why is this a Difficult Airway (LEMON)?
60 year old female. Severe maxillofacial injury. With the mouth open at rest, only hard palate is visible. Mouth opens to a width of three finger(s). The distance between the mentum (chin) and hyoid bone is three finger width(s). The distance from the hyoid bone to the thyroid notch is two finger widths.
Is Pretreatment Indicated?
60 year old female. CHF.
Is Sedative Induction Indicated?
60 year old female. CHF. Signs of Dehydration.
Is Paralysis Indicated?
60 year old female. CHF. Burn injury last week.