文档介绍：Airway & Ventilation Methods: ALS
Pharmacologic Assisted Intubation (“RSI”)
Neuromuscular Blockade
Contraindications
Most are Specific to the medication
inability to ventilate patient once paralysis is induced
Advantages
enables to provider to intubate patients who otherwise would be difficult or impossible to intubate
minimizes patient resistance to intubation
reduces risk of laryngospasm
整理ppt
Airway & Ventilation Methods: ALS
Pharmacologic Assisted Intubation (“RSI”)
Mechanism of Action for NMB agent
acts at the neuromuscular junction where ACh normally allows nerve impulse transmission
binds to nicotinic receptor sites at skeletal muscle
depolarizes or does not depolarize specific to med
blocks further action by ACh at receptor sites
therefore, blocks further depolarization resulting in muscular paralysis
整理ppt
Airway & Ventilation Methods: ALS
Pharmacologic Assisted Intubation (“RSI”)
Disadvantages & Potential Complications
Does not provide sedation or amnesia
Provider unable to intubate or ventilate after NMB
Aspiration during procedure
Difficult to detect motor seizure activity
Side effects and adverse effects of specific meds
整理ppt
Airway & Ventilation Methods: ALS
Pharmacologic Assisted Intubation (“RSI”)
Common Used NMB Agents
Depolarizing NMB agents
succinylcholine (Anectine®)
Non-depolarizing NMB agents
vecuronium (Norcuron®)
rocuronium (Zemuron®)
pancuronium (Pavulon®)
整理ppt
Airway & Ventilation Methods: ALS
Pharmacologic Assisted Intubation (“RSI”)
Summarized Procedure
Prep all equipment and medications while ventilating patient
Hyperventilate
Administer induction/sedation agents & pretreatment meds (. lidocaine or atropine)
Administer NMB agent
Sellick maneuver
Intubate per usual
Continue NMB and sedation/analgesia prn
整理ppt
Airway & Ventilation Methods: ALS
Examples of
Secondary Tube Placement Confirmation Devices
(From AMLS, NAEMT)
From AMLS, NAEMT
整理ppt
Airway & Ventilation Methods: ALS
Needle Thorac