What special preparation are needed for awake intubation?

What special preparation are needed for awake intubation?

Pharmacological preparation of the patient and airway [5] Intravenous (IV) midazolam in a dose of 20 to 40 μg/kg, repeated every 5 min as needed, is used to achieve the desired level of sedation (maximum dose of 100 to 200 μg/kg). Midazolam provides excellent anxiolysis and anterograde amnesia.

How do you perform awake intubation?

E Awake Endotracheal Intubation If a fiberscope is used, the larynx is then sprayed with 2 mL of lignocaine 2% administered through the working channel of the fiberscope, after which the scope is advanced into the trachea. Thereafter, a second spray is applied into the trachea before the ETT is advanced.

Which of the following is a contraindication to elective awake airway management?

Absolute contraindications to awake intubation are limited to patient refusal, despite adequate counselling regarding risks and benefits, and non-compliance. Relative contraindications include operator inexperience, local anaesthetic allergy, and airway bleeding.

Can you Nebulize injectable lidocaine?

A generally accepted safe range of nebulized lidocaine is between 100 and 200 mg per dose. Some research has suggested that higher doses may be tolerable, with one study recommending up to 600 mg of lidocaine in asthma patients undergoing experimental bronchoscopy.

What do you need to prepare for intubation?

IV. Preparation: Details

1. Prepare for Rapid Sequence Intubation.
2. Monitoring Telemetry, Capnography and Pulse Oximetry (Hypoxemia, Bradycardia)
3. Check Laryngoscope for light and blade size (See above)
4. Suction (critical for all patients, especially for children)
5. Select ET size and length (See Endotracheal Tube)

Can you intubate a conscious patient?

The two arms of awake intubation are local anesthesia and systemic sedation. The more cooperative your patient, the more you can rely on local; perfectly cooperative patients can be intubated awake without any sedation at all. More commonly in the ED, patients will require sedation.

Can you intubate an awake patient?

So who can be intubated awake? Any patient except the crash airway can be intubated awake. If you think they are a difficult airway, temporize with NIV while you topically anesthetize and then do the patient awake while they keep breathing.

Can you intubate without sedation?

The two arms of awake intubation are local anesthesia and systemic sedation. The more cooperative your patient, the more you can rely on local; perfectly cooperative patients can be intubated awake without any sedation at all.

Is it safe to take nebulized lidocaine inhalation?

Nebulized solutions varying in concentration from 1% to 4% have been studied and used without major side effects on patients. Studies have found that large doses of lidocaine inhalation up to 575 mg are quite safe.

Which is the best local anesthetic for nasal intubation?

It is also used to topicalize the nasal mucosa to provide the optimal conditions for nasal intubations. Lidocaine is the most commonly used local anesthetic for airway topicalization. The 4% solution and 10% spray are most often used ( Figure 3 ).

How is anesthesia used for Awake endotracheal intubation?

Awake endotracheal intubation can be achieved using a variety of equipment, such as video laryngoscopes, optical stylets, and fiber-optic scopes. Appropriate topical anesthesia of the airway and sedation can enable any of these techniques to be used successfully.

What’s the best way to do awake intubation?

Gargle with viscous lidocaine (4% best, 2% ok). Place a blob (~3 cc) on a tongue depressor, put it in the back of the throat and have the patient gargle and then spit. In Canada, they have 5% paste Spray the epiglottis and the top of the cords with a Mucosal Atomizer Device (MAD).