Rapid Sequence Intubation for Status Asthmaticus.










  • Preoxygenation (as possible) 100% oxygen for 3 min or eight vital capacity breaths, or highest flow oxygen possible
  • Pretreatment—albuterol, 2.5 mg nebulized, or lidocaine, 1.5 mg/kg
  • Paralysis with induction:
    • Ketamine, 1.5 mg/kg
    • Succinylcholine, 1.5 mg/kg
     Ketamine has bronchodilatory properties and may mitigate bronchospasm in patients who are not intubated and in patients who are already intubated and are not improving with mechanical ventilation. Ketamine is also a reasonable induction agent for the emergency intubation of patients with status asthmaticus.

  • Postintubation management:
    • Sedation and analgesia
    • Neuromuscular blocking agent only if required after adequate sedation, analgesia
    •  In-line albuterol nebulization
    • Additional ketamine as indicated

    High-dose, inhaled β-agonists, such as albuterol,

provide maximal protection against reactive bronchospasm
during intubation and are indicated for asthmatics with or
without active bronchospasm.

Popular posts from this blog

Ketamine: The Past, Present, and Potential Future of an Anesthetic Drug

Ketamine is a powerful anesthetic drug that has been used in medical settings for decades. However, its effects on the brain have also led to its use as a recreational drug, leading to controversy surrounding its use. Despite its negative associations, recent research has shown promising potential for the drug in the treatment of mental health conditions such as depression and post-traumatic stress disorder (PTSD).
Read more

Fast track anesthesia approaches

  Fast track anesthesia schemes are multi-modal approaches that aim to reduce the physiological stress response to surgery, enhance recovery, and improve patient outcomes. These schemes typically involve several aspects of perioperative care, including anesthesia management, surgical technique, pain management, fluid management, and early mobilization. Here are some common fast track anesthesia schemes:
Read more