Intubation

Oral endotracheal intubation is the preferred technique. At the time of intubation, patients with severe asthma are often tachycardic, tachypneic, hypoxic, hypercarbic, acidotic, hypovolemic, and hypokalemic. Therefore intubation must be performed by experienced medical staff. Unless a difficult intubation is anticipated, intravenous induction with fentanyl, midazolam, propofol, and succinylcholine (suxamethonium), following preoxygenation with 100 per cent oxygen, is satisfactory. Alternatively, for potentially difficult intubations, inhalation induction with isoflurane in oxygen or an awake intubation with topical airway anesthesia (either blind nasal or with fiber optics) should safely secure the airway. The preferred and safest technique is usually the one with which the clinician is most familiar.

Coping with Asthma

Coping with Asthma

If you suffer with asthma, you will no doubt be familiar with the uncomfortable sensations as your bronchial tubes begin to narrow and your muscles around them start to tighten. A sticky mucus known as phlegm begins to produce and increase within your bronchial tubes and you begin to wheeze, cough and struggle to breathe.

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