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  • Algorithm Lung Massive Hemoptysis

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    Ronald Susanto Budhy
    136 vizualizări1 pagină
    Major airway problem? NO 1. Position of comfort 2. Monitor 3. Nasopharyngeal airway YES NO 1. Coma position 2. Chin lift or jaw thrust 3. Cricothyroidostomy YES Withdraw or remove tube based on volume of blood in lumen. Attempt selective intubation of right lung first 99% chance of success Pass endotracheal tube through cords Advance until only adapter shows out mouth NO YES Tube in less injured side 1. Secure tube in place 2. Auscultate

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    Major airway problem? NO 1. Position of comfort 2. Monitor 3. Nasopharyngeal airway YES NO 1. Coma position 2. Chin lift or jaw thrust 3. Cricothyroidostomy YES Withdraw or remove tube based on volume of blood in lumen. Attempt selective intubation of right lung first 99% chance of success Pass endotracheal tube through cords Advance until only adapter shows out mouth NO YES Tube in less injured side 1. Secure tube in place 2. Auscultate

    Drepturi de autor:

    Attribution Non-Commercial (BY-NC)
    Descărcați ca DOC, PDF, TXT sau citiți online pe Scribd
    Indicator pentru conținut neadecvat
    136 vizualizări1 pagină

    Algorithm Lung Massive Hemoptysis

    Încărcat de

    Ronald Susanto Budhy
    Major airway problem? NO 1. Position of comfort 2. Monitor 3. Nasopharyngeal airway YES NO 1. Coma position 2. Chin lift or jaw thrust 3. Cricothyroidostomy YES Withdraw or remove tube based on volume of blood in lumen. Attempt selective intubation of right lung first 99% chance of success Pass endotracheal tube through cords Advance until only adapter shows out mouth NO YES Tube in less injured side 1. Secure tube in place 2. Auscultate

    Drepturi de autor:

    Attribution Non-Commercial (BY-NC)
    Descărcați ca DOC, PDF, TXT sau citiți online pe Scribd
    Indicator pentru conținut neadecvat
    din 1

    Figure 11: Algorithm for determining from which lung massive hemoptysis is originating and selectively

    intubating the opposite mainstem bronchus. Numbers in boxes indicate order of preference of interventions
    listed.

    Major NO
    1. Position of comfort
    airway 2. Monitor
    problem? 3. Nasopharyngeal airway

    YES

    Massive NO 1. Coma position


    hemoptysis 2. Chin lift or jaw thrust
    ? 3. Cricothyroidostomy

    YES

    Attempt selective More blood Withdraw or


    around than NO remove tube
    intubation of right lung
    through based on
    first
    tube? volume of
    99% chance of success
    blood in lumen
    Pass endotracheal
    tube through cords
    Advance until only YES
    adapter shows out
    mouth
    Tube in less injured side Pass endotracheal
    1. Secure tube in place tube through cords to
    2. Assess need for ventilation normal position
    3. Auscultate for breath sounds

    Attempt selective intubation of left lung


    92% chance of success
    Turn casualty’s head to right side
    Rotate tube 180° so curve of tube
    pointing to casualty’s left side
    YES Advance until only adapter shows out
    mouth
    Tube in more injured side 72% chance of success
    1. Auscultate for breath More blood Do not turn casualty’s head
    sounds to determine which Around Rotate tube 90° counter-clockwise so
    side it is in than curve of tube pointing to casualty’s
    2. Use techniques for through left side
    selective intubation of NO tube? Advance until only adapter shows out
    opposite side mouth
    61% chance of success
    Do not turn casualty’s head
    Rotate tube 180° so bevel opposite
    Advance until only adapter shows out
    mouth

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