An 8 year old known asthmatic is in the ED having received continuous albuterol nebs, steroids, and subcutaneous epinephrine. You check on him and find him unresponsive with a RR of 6 and very poor air movement. An RT runs in with a ABG showing pH 6.9, pCO2 190. What medications do you consider for intubation & sedation?
An 8 year old known asthmatic is in the ED having received continuous albuterol nebs, steroids, and subcutaneous epinephrine. You check on him and find him unresponsive with a RR of 6 and very poor air movement. An RT runs in with a ABG showing pH 6.9, pCO2 190. What medications do you consider for intubation & sedation?
A transport team has just arrived to pick up a 4 year old child with severe stridor. On exam she is alert, sitting in Mom’s lap & maintaining her sats, but has severe retractions with every breath and drooling. She appears frightened, and the paramedic asks you to order something to sedate her so that she can be strapped to the gurney. What is your response?
A transport team has just arrived to pick up a 4 year old child with severe stridor. On exam she is alert, sitting in Mom’s lap & maintaining her sats, but has severe retractions with every breath and drooling. She appears frightened, and the paramedic asks you to order something to sedate her so that she can be strapped to the gurney. What is your response?
You consult in the ED on a 7 year old who has presented with sore throat and noisy breathing. He has received 2 gm of chloral hydrate 1/2 hour before for an attempted CT scan of the neck. In the ED you find him in the back room with his mother, with a sat probe on his finger not attached to a monitor. He has retractions and poor air movement with every breath. What happened and what would you do?
You consult in the ED on a 7 year old who has presented with sore throat and noisy breathing. He has received 2 gm of chloral hydrate 1/2 hour before for an attempted CT scan of the neck. In the ED you find him in the back room with his mother, with a sat probe on his finger not attached to a monitor. He has retractions and poor air movement with every breath. What happened and what would you do?
You are taking care of a 9 mo post-op cardiac patient who is intubated and requiring sedation. She initially had issues with heart block and required pacing but is now in a sinus rhythm of 110. She has been difficult to sedate with Fentanyl & Midazolam and the nurses ask you if you can add a 3rd agent. What agents would you want to avoid in this patient and what do you need to consider?
You are taking care of a 9 mo post-op cardiac patient who is intubated and requiring sedation. She initially had issues with heart block and required pacing but is now in a sinus rhythm of 110. She has been difficult to sedate with Fentanyl & Midazolam and the nurses ask you if you can add a 3rd agent. What agents would you want to avoid in this patient and what do you need to consider?
You are called to the ED to see a 6 year old trauma patient who luckily has a normal head CT but unfortunately has a severely displaced tib-fib fracture. The orthopedic surgeons are gathering equipment to reduce and splint the fracture. What drugs do you think about using and what else do you consider?
You are called to the ED to see a 6 year old trauma patient who luckily has a normal head CT but unfortunately has a severely displaced tib-fib fracture. The orthopedic surgeons are gathering equipment to reduce and splint the fracture. What drugs do you think about using and what else do you consider?
