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 to speech. No verbal response. Obeys commands.
Is Intubation Indicated?
25 year old male. Eyes open to speech. No verbal response. Obeys commands. Persistent and profuse upper airway bleeding. Inhalation burn. ABG: pO2=30 pCO2=57 on room air.
Evaluate neck proportions
Which of these criteria imply a more difficult airway?
Name that Mallampati Class
With the mouth open at rest, upper half of tonsillar fossa is visible.
Why is this a Difficult Airway (LEMON)?
25 year old male. Inhalation burn. With the mouth open at rest, upper half of tonsillar fossa is visible. Mouth opens to a width of one 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. Long mandible.
Is Pretreatment Indicated?
25 year old male.
Is Sedative Induction Indicated?
25 year old male. Signs of Dehydration.
Is Paralysis Indicated?
25 year old male. Spinal cord injury 6 days ago.