Awake intubations
Awake intubations
- In OR and near anesthesia machine
- Aspiration prophylaxis (Bicitra, H2 blocker, Reglan)
- Robinul 0.2-0.4 to dry secretions
- Versed 2-4 mg, Fentanyl 50-100 mcg
- Devilbiss atomizer, 10 ml of 2% lidocaine or 0.45% tetracaine, with high-pressure oxygen source at 8 l/m
- Atomizer at nostrils works best
- Aerosolized lidocaine (4%, 4 ml) can also be used with a standard aerosolizer
- Use lidocaine gel on Q-tips for nose
- Patients can also gargle 4% lidocaine
- Bill Lyman’s technique:
• Versed 4 mg
• Glycopyrrolate
• Nebulize 3 ml of 4% lidocaine
• Put tonsil sponges on tonsils with 5% viscous lidocaine
• Pull tongue out and drop 10 ml of viscous lidocaine on back of tongue
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