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. No verbal response. Obeys commands.
Is Intubation Indicated?
69 year old female. Eyes open spontaneously. No verbal response. Obeys commands. Unable to speak or swallow. Tracheal injury. ABG: pO2=71 pCO2=46 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)?
69 year old female. Tracheal injury. With the mouth open at rest, upper half of tonsillar fossa 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 one finger widths. Short neck.
Is Pretreatment Indicated?
69 year old female.
Is Sedative Induction Indicated?
69 year old female. Signs of Dehydration.
Is Paralysis Indicated?
69 year old female. Muscle crush injury 8 days ago.