Invasive ventilation in asthma
AMAX4 algorithm
- Adrenaline - 1 mcg/kg IV or cardiac arrest dose
- remember 1:10000 = 10 mcg/ml,
- Muscle relaxant
- Airway - cuffed ETT, expect high pressure ventilation, not LMA
- X...
- Xtreme ventilation,
- Xtra bronchodilators,
- Xtra vasopressors,
- consider pneumothoraX
- 4 minutes to hypoxic brain injury
the hazards
Dynamic hyperinflation + gas trapping
-
manual chest deflation
-
Low PEEP - 60% of autoPEEP?
-
I:E 1:4 - replicate prolonged expiratory phase
- lowers plateau pressure
-
Paralyse