During rapid sequence intubation in a child after taking brief history and clinical examination next step is:
Administer oxygen REF: http://en.wikipedia.org/wiki/Rapid_sequence_induction & others Rapid Sequence Induction (RSI) is an advanced medical procedure, designed for the expeditious induction of sedation and subsequent intubation of the trachea of a patient (endotracheal intubation). RSI is generally used for patients who have an increased risk of aspirating stomach contents into the lungs due to a current disease process. If not performed properly, or if the patient is unable to be intubated very rapidly (2 minutes or less), the patient could suffer extreme morbidity from hypoxia, hypercapnia or acidosis, or even death. Mnemonic: A mnemonic for performing RSI is the Eight- Ps Preparation: prepare all necessary equipment, drugs and patient (basic airway management and Positioning) Preoxygenation: with 100% oxygen, 3 to 5 minutes Premedication: Pediatric: Atropine 0.02 mg/kg IV children < 8 years (minimum 0.1 mg), Adults: Lidocaine 1.5 mg/kg IV (head injury, asthma) Push the sedative: Etomidate, midazolam or ketamine Paralyze: suxamethonium, vecuronium or rocuronium Pass the tube: visualize the tube going through the vocal cords Proof of placement: Use EID, check breath sounds, CO2 detector Post intubation care: secure the tube, ventilate
Administer oxygen
IV anesthetic Diazepam/Ketamine
Preanaesthetic medication with atropine and lignocaine
Analgesic injection with Fentanyl