Algorithm Lung Massive Hemoptysis
2
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 airway problem? Massive hemoptys is? 1. Coma position 2. Chin lift or jaw thrust 3. Cricothyroidostomy 1. Position of comfort 2. Monitor 3. Nasopharyngeal airway More blood around than through tube? Attempt selective intubation of right lung first 99% chance of success Pass endotracheal tube through cords Advance until only adapter shows out mouth Tube in less injured side 1. Secure tube in place 2. Assess need for ventilation 3. Auscultate for breath sounds Withdraw or remove tube based on volume of blood in lumen Pass endotracheal tube through cords to normal position 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 Advance until only adapter shows out mouth 72% chance of success Do not turn casualty’s head Rotate tube 90 counter- clockwise so curve of tube pointing to casualty’s left side Advance until only adapter shows out mouth 61% chance of success More blood Around than through tube? Tube in more injured side 1. Auscultate for breath sounds to determine which side it is in 2. Use techniques for selective intubation of opposite side NO NO YES YES NO YES NO YES
-
Upload
ronald-susanto-budhy -
Category
Documents
-
view
108 -
download
2
Transcript of Algorithm Lung Massive Hemoptysis
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 airway
problem?
Massivehemoptysis
?
1. Coma position2. Chin lift or jaw thrust3. Cricothyroidostomy
1. Position of comfort2. Monitor3. Nasopharyngeal airway
More blood around than
through tube?
Attempt selective intubation of right lung first99% chance of success Pass endotracheal tube through cords Advance until only adapter shows out mouth
Tube in less injured side1. Secure tube in place 2. Assess need for ventilation3. Auscultate for breath sounds
Withdraw or remove tube
based on volume of
blood in lumen
Pass endotracheal tube through cords to
normal position
Attempt selective intubation of left lung92% chance of success Turn casualty’s head to right side Rotate tube 180 so curve of tube pointing to casualty’s left side Advance until only adapter shows out mouth72% chance of success Do not turn casualty’s head Rotate tube 90 counter-clockwise so curve of tube pointing to casualty’s left side Advance until only adapter shows out mouth61% chance of success Do not turn casualty’s head Rotate tube 180 so bevel opposite Advance until only adapter shows out mouth
More bloodAround
than through tube?
Tube in more injured side1. Auscultate for breath sounds to determine which side it is in2. Use techniques for selective intubation of opposite side
NO
NO
YES
YES
NO
YES
NO
YES
