Endotracheal Intubation
Pre Intubation :
01. Arrange the equipment near by.
02. Fluid load : 500cc of crystalloids or 250 cc starch if no cardiogenic pulmonary edema is present.
03. Prepare the sedation for an extended period of time.
04. Pre oxygenation for 3 minutes with non-invasive positive pressure ventilation in case of acute respiratory failure.
During Intubation :
05. Medication :
- Inj : Fentanyl 2 u/kg +
- Inj : Etomidate 0.2-0.3 mg/kg ( avoid in the septic patient )
- Inj : Rocuronium 1.2 mg/kg.
Post Intubation :
06. Immediate confirmation of tube placement with capnography.
07. Norepinephrine or Dopamine if the diastolic blood pressure remains below 35 mmHg.
08. Start long term sedation.
09. Start protective ventilation :
Tidal volume 6-8 ml/kg
plateau pressure 30 cm H20
