Keyword
Full stomach child intubation, pediatric rapid sequence induction
Induction
Treated the same as for an adult with a full stomach ; rapid sequence intubation
- Oxygen consumption is much greater (어릴수록 Hb desaturation 빠름) 소아에서 협조 잘 안됨-> high flow oxygen enrich the environment
- Two suction catheter (하나 막혔을경우 대비)
- Two sized laryngoscope blades (Machintosh 2, Miller 2) with two handles (if the bulb, contact or battery fail..)
- Cricoid pressure gently
- Head up position
- Oxygenation 시 atropine 0.02mg/kg ; reflex or succinylcholine-induced bradycardia 대비
- thiopental 5-6mg/kg or propofol 3mg/kg → Succinylcholine 1-2mg/kg
- Hypovolemic child 에서 ketamine 2mg/kg (gag reflex 주의)
- Hemodynamic instability (cardiomyopathy) - etomidate 0.2-0.3mg/kg 사용
- Succinylcholine 못쓰면 rocuronium 1.2mg/kg
- Succinylcholine : rhabdomyolysis, hyperkalemia, muscle dystrophy, masseter muscle spasm, malignant hyperthermia 때문에 소아 금기
Reference