Rapid Sequence Intubation Summary Questions
Conference July 19th 2012
- 1.Which of the following statements about Rapid Sequence Intubation (RSI) is INCORRECT:
- A.
RSI minimizes the risk of pulmonary aspiration
- B.
RSI increases the chance of successful intubation by inducing paralysis
- C.
RSI minimizes untoward physiologic responses due to direct laryngoscopy
- D.
RSI is the method of choice to secure an airway for a patient in cardiopulmonary arrest
- 2.All of the following are indications for using Atropine as a premedication for RSI EXCEPT:
- A.
12 yo intoxicated patient with GCS 7
- B.
9 mo male with respiratory distress
- C.
2 yo trauma stat patient with closed head injury
- D.
15 yo male requiring a second dose of succinylcholine
- 3.A Trauma Stat is called for a 14 yo male who fell from a ladder with waxing and waning mental status and BP 90/40 with 10 minute ETA. You instruct your med nurse to draw up RSI meds. Your sedative of choice is Etomidate for all the following reasons EXCEPT:
- A.
It is readily available in the code room pyxis
- B.
It causes minimal cardiovascular depression
- C.
It will keep the patient sedated while getting the CT scan and transferred to the PICU
- D.
It decreases Intracranial pressure
- 4.EMS calls with a 10minute ETA for a 2yo male shot to the chest by a stray bullet at a picnic now in respiratory distress. You call a Trauma Stat attending and give an estimated weight and instructions to have the following equipment ready:
- A.
Weight: 12kg; ETT 5.5mm; 11 Fr NG/OG; 18 Fr Chest tube
- B.
Weight: 16 kg; ETT 4.5mm; 8 Fr NG/OG; 16 Fr Chest tube
- C.
Weight: 12kg; ETT 4.5mm ; 9Fr NG/OG; 18 Fr Chest tube
- D.
Weight: 16 kg; ETT 4.5mm; 8 Fr NG/OG; 16 Fr Chest tube
- E.
Weight 14kg; ETT 4.0mm; 11 Fr NG/OG; 20 Fr Chest tube
- 5.A 7yo ill appearing male with a history of renal failure and chronic lung disease presents with vomiting and altered mental status. He is tachycardic, and has deep respirations. His capillary refill is 4-5 seconds and BP of 70/20. Which of the following would be MOST CORRECT regarding your choice of paralytic agent for RSI?
- A.
Succinylcholine is best given its rapid onset, short duration of action and is most readily available in the ED pyxis
- B.
Rocuronium may be used because it has rapid onset and minimal CV side effects which may be best since the patient is hypotensive
- C.
Vecuronium is best because it is readily available and has longer duration of action which may be needed to cover the patient until transfer to the ICU
- D.
Pancuronium is best since there seems to be a drug shortage of everything else and it can be just as effective
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