清醒气管插管.pdfVIP

Awake Orotracheal Intubation 8 Benjamin M. Mahon, Justin Bennett, and Lars K. Beattie 8.1 Indications • Relative – Inability to maintain airway or tolerate secretions • Urgent but not emergent endotracheal intubation is required in a patient who: – Is awake – Is currently protecting his airway 8.3 Materials and Medications – Is not a candidate for a supraglottic airway (LMA) – The patient • Suctioning equipment • Is predicted to have a diffi cult airway • Intravenous access equipment, cardiac monitor, pulse • Has structural abnormalities of the airway oximetry, blood pressure cuff • Will not tolerate a period of apnea • 4 % lidocaine solution • May lose his airway (anaphylaxis, angioedema, • 2 % viscous lidocaine jelly traumatic airway) • Nebulizer • Patients requiring urgent but not emergent intubation in • Mucosal atomization device whom paralytics are contraindicated (i.e., allergies, myas- • 4 × 4 gauze thenic crisis) • Tongue depressor • Glycopyrrolate/atropine • Sedation: ketamine, propofol, Versed, and/or fentanyl 8.2 Contraindications