DAANCE: scenarios with Complete
Solutions Latest 2023/2024 airway obstruction - Correct Answer 100% O2 via nasal mask; put patient in Trendellenburg position; retract tongue ( hemostat, suture or tongue forcep); suction oropharynx; if tongue still occludes airway, insert nasopharyngeal/ oral airway- advanced airway if necessary foreign bodies - Correct Answer Digital removal of object ONLY IF WELL VISULAIZED; Chest compressions if no airflow, in supine position; attempt direct laryngoscopy (macgill forceps) for visualization and removal of object; cricothyrotomy may be necessary of obstruction persists Cricothyrotomy - Correct Answer Call 911/ activate EMS; locate crocothyroid membrane by palpitation; utilize cricothyrotomy needle/cannula kit or large gauge needle to enter trachea beneath the vocal chords through the cricothyroid membrane; attach tube of cricothyrotomy device to an O2 source (or Ambu bag) and ventilate with 100% O2 laryngospasm - Correct Answer 100% O2 via nasal hood; establish proper head position/ airway; suction (yankauer); positive pressure, 100% O2 via bag/mask; administer succinylcholine; manually breathe via bag/mask until effects of drug dissipated and strong spontaneous respiration resumes bronchospasm - Correct Answer 100% O2 via bag/mask; Albuterol via inhaler every 20 minutes for up to 4 hours, then every 1-4 hours as needed; ipratropium bromide (Atrovent) 2 puffs stat; repeat every 4 hours; epinephrine injection; intubation, steriod injection (decadron); Benadryl; activate EMS if none of the above resolve issue Emesis with Aspiration - Correct Answer Activate EMS; 100% O2 via bag/mask; turn patient in RIGHT side in Trendellenburg position; suction tonsils/oral cavity/oropharynx (yankaeur); remove foreign bodies with macgill and laryngoscope; intubation Hyperventilation - Correct Answer Stop treatment, remove foreign bodies from mouth and surgical instruments from view; maintain airway; verbally attempt to calm patient; monitor vital signs; DO NOT GIVE OXYGEN; have patient breathe into paper bag to recapture exhaled CO2/ non-sedated: administer IV midazolam, diazepam, propofol etc.monitor breathing and vital signs; activate EMS if condition deteriorates heart attack (myocardial infarction) - Correct Answer Activate EMS; 100% O2; attach AED; asprin 325mg; establish IV access with saline drip; morphine for pain (repeat every 5-10 minutes as needed) ONAM - Correct Answer Rapid identification of interventions necessary to treat acute coronary syndrome. *Oxygen, nitroglycerin, aspirin, and morphine*
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