Lists

Question 1

RSI

Answer 1

RSI 7Ps:

1. Preparation: Equipment, medications, personnel readiness.
2. Preoxygenation: 100% oxygen delivery to maximize oxygen stores.
3. Pretreatment: Medications to mitigate adverse effects of intubation.
4. Paralysis with Induction: Rapid-onset sedative and neuromuscular blocking agent administration.
5. Protection and Positioning: Cervical spine stabilization, patient positioning optimization.
6. Placement with Proof: Endotracheal tube placement, confirmation with capnography, auscultation.
7. Post-intubation Management: Tube securing, mechanical ventilation initiation, sedation, continuous monitoring.

Question 2

Breaking bad news

Answer 2

SPIKES: Breaking Bad News

1. Setting Up: Privacy, involve others, sit down, avoid interruptions.
2. Perception: Assess patient’s understanding.
3. Invitation: Ask patient’s preference for information.
4. Knowledge: Give information clearly, avoid jargon.
5. Emotions: Identify and acknowledge patient’s emotions.
6. Strategy and Summary: Offer a plan, summarize the discussion.

Question 3

The lethal triad

Answer 3

• Hypothermia
• Coagulopathy
• Acidosis

Question 4

Breaking bad news (brain death)

Answer 4

SPIKES

• Set up: Ensure a quiet, private environment without distractions.
• Perception: Gather information on what the family already knows about the patient’s condition.
• Invitation: Provide information in small, understandable segments, clearly stating the patient’s death without using euphemisms.
• Knowledge: Confirm the family’s understanding of the information provided.
• Emotions: Acknowledge and empathize with the family’s emotions, allowing them space to express their feelings.
• Strategy and Summary: Offer continued support, inviting any further questions or clarifications, and respond compassionately without reacting negatively to their emotions.