Pre-Hospital Anesthesia Handbook (eBook)

Foreword 5
Preface 6
Contents 8
Aims and Objectives 12
Introduction 13
1.1 Pre-Hospital Anesthesia (PHA) 13
1.2 Rapid Sequence Intubation 14
1.3 Pre-Hospital Rapid Sequence Intubation ( PRSI) 17
1.4 Confidential Enquiry into Peri-Operative Deaths ( NCEPOD): Trauma – Who Cares? 21
References 22
Summary 22
Indications and Decision Making 24
2.1 Significance of Aspiration 25
2.2 LMA vs. Endotracheal Tube 27
2.3 Summary 28
2.4 Assessment of Need: Risk vs. Benefit 28
Summary 31
References 32
Pre-Hospital Rapid Sequence Intubation 33
3.1 The Six P’s 33
3.2 Preoxygenation 34
3.3 Preparation 36
3.4 Premedication 57
3.5 Paralyze and Sedate 57
3.6 Passage of Tube 59
3.7 Post Intubation 65
References 67
Post-intubation Management 70
4.1 A (and c-Spine) BCDE Approach 71
Equipment and Minimum Monitoring Standards 84
5.1 Monitoring 84
5.2 Equipment 85
5.3 Ventilators 86
References 90
Drugs and Sedation 92
6.1 Pre-Treatment 92
6.2 Induction Agents 94
6.3 Muscle Relaxants 97
6.4 Sedation 100
6.5 Analgesia 105
6.6 Cardiovascular Support 107
References 108
Further Reading 108
Special Circumstances 109
7.1 Hypothermia 109
7.2 Pediatrics 110
7.3 Obstetrics 112
7.4 Head Injury 115
7.5 Transferring Ventilated Patients by Air 117
References 119
Complications and Adverse Events 120
8.1 Complications 120
8.2 Adverse Events 123
References 126
Appendices 127
Index 145