LOADING AWESOME
EMERGENCY INTUBATION CHECKLIST
O2 + POSITION
- PRE-OXYGENATE FACEMASK 15L/min
- NASAL-OXYGENATION (APNOX) 15L/min
- POSITION (EAR IN LINE WITH STERNAL NOTCH)
- RAMP THE PATIENT IF THEY ARE OBESE
- NASAL-OXYGENATION (APNOX) 15L/min
- POSITION (EAR IN LINE WITH STERNAL NOTCH)
- RAMP THE PATIENT IF THEY ARE OBESE
- SUCTION, OXYGEN, GUEDEL
- MAPLESON C CIRCUIT
- AMBUBAG
- FRONT-OF-NECK ACCESS KIT
- BOUGIE/STYLET
- 2 x WORKING LARYNGOSCOPES (DL + VIDEO)
- 2 x ET TUBES & RIBBON
- MAPLESON C CIRCUIT
- AMBUBAG
- FRONT-OF-NECK ACCESS KIT
- BOUGIE/STYLET
- 2 x WORKING LARYNGOSCOPES (DL + VIDEO)
- 2 x ET TUBES & RIBBON
- 2 x SUPRAGLOTIC AIRWAY DEVICES (iGel)
- CAPNOGRAPHY
HARDWARE
DRUGS
- IV FLUIDS & CANNULA SITED
- VASOPRESSORS - EPHEDRINE/PHENYLEPHRINE/ADRENALINE (+ATROPINE)
- MIDAZOLAM/FENTANYL/ALFENTANIL
- VASOPRESSORS - EPHEDRINE/PHENYLEPHRINE/ADRENALINE (+ATROPINE)
- MIDAZOLAM/FENTANYL/ALFENTANIL
- INDUCTION AGENT + SPARE
- NEUROMUSCULAR BLOCKER (eg: ROCURONIUM) + SPARE
- ANAESTHETIC AGENT (MAINTENANCE INFUSION - ENSURE ENOUGH)
- NEUROMUSCULAR BLOCKER (eg: ROCURONIUM) + SPARE
- ANAESTHETIC AGENT (MAINTENANCE INFUSION - ENSURE ENOUGH)
- CHECKED that all of the above is completed?
- Any anticipated problems?
- Informed your most senior doctor that you are doing this?
- Optimal pre-ox? Do they need NIV/have you time for this?
- Patient is optimally positioned?
- Knowledge of an allergy or non-esclatation policy with this patient?
- Have you the right team around you?
- Everyone clear of their roles?
- Ventilator for the patient to be transferred on to?
- If I cannot place this tube, is there a 2nd intubator?
- Place for the patient to be transferred to?
- Is there a direct post-intubation plan? (Surgery/Scan etc.)
- Have you enough drugs to maintain anaesthesia/paralysis?
- Is there a clear plan A, B, C and D for intubation (DAS guidelines of DL --> SAD --> BVM --> CRIC)
TEAM
-Team leader
-Airway doctor (+2nd?)
-ODP/Airway Nurse
-Drug Giver
-ICU Doctor?
-Cricoid (if used)
-Runner
- Ensure Senior Help Available
"EVERYONE LISTEN-THIS IS PLAN ABCD FOR INTUBATION"
FINAL CHECK
This is an emergency and the decision has been made to intubate the patient
ECG, SATS, NIBP/IAP, ETCO2
ARE ON THE PATIENT AND WORKING
Pre-ox for 3 minutes if possible or 8 maximal inspirations /expirations
Nasal specs on & flowing
"Does everyone know how we contact help if we need it?"
www.propofology.com
ED
ICU
THEATRES
Dr. David Lyness / @Gas_Craic