Coda Change Airway Innovators 3 - Ketamine in fibre-optic airway management
May 27, 2024
Explore the intriguing use of ketamine in fibre-optic intubation techniques. Patient selection for cooperative, spontaneously breathing individuals is crucial. The discussion delves into key preparation steps like premedication and topical anesthesia. A trauma case is highlighted to showcase the LMA-to-ETT ketamine technique. Insights on dosing protocols and endpoints for ketamine-assisted procedures provide valuable knowledge. The session wraps up with useful resources and expert guidance for airway management.
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Ketamine Works For Spontaneous Fibre‑Optic Airway
- Ketamine can be used as a primary agent for fibre-optic techniques while preserving spontaneous breathing.
- Properly applied, many theoretical risks (reactive airway, secretions, combativeness) were not seen in several hundred cases.
Preempt Secretions With Glycopyrrolate And Topicalisation
- Give IM glycopyrrolate early to reduce upper airway secretions before ketamine procedures.
- Use topical local anaesthesia (10%) and high-flow oxygen to disperse topical spray toward the pharynx.
Trauma Case: LMA To ETT Via Aintree Conduit
- A trauma patient with unstable maxilla and mandible tolerated ketamine-assisted LMA placement while breathing spontaneously.
- The team used an LMA, Aintree/Cook exchange catheter and fibre optic scope to secure a definitive ETT conduit safely.
