Albuterol in the intubated patient.

[paraloco]

We have a device called a med-drafter that is specifically for providing a nebulized medication to an intubated patient. I don't know how expensive it is, but it does not take up much room on the shelf. I can find out more if you are interested.

[Kaisu]

We have a device called a med-drafter that is specifically for providing a nebulized medication to an intubated patient. I don't know how expensive it is, but it does not take up much room on the shelf. I can find out more if you are interested.

absolutely... we use nebulized treatment with intubated patients all the time. I was thinking more of your epi and atropine in the arrest patient.

[firedoc5]

I've given several meds down a tube, but I don't think I ever gave Albuterol that way. But I don't think I'd give it for just any code, whether they had asthma or not. But if it believed that they coded due to asthma, that's a different story.

[JakeEMTP]

But if it believed that they coded due to asthma, that's a different story.

Why? Once the heart has stopping beating we have to run it like any other code.

I agree with the majority here (I hate being "Johnny come lately" to these things) and say I can't see a benefit to Albuterol down the tube for the reasons previously discussed.

[firedoc5]

Why? Once the heart has stopping beating we have to run it like any other code.

I agree with the majority here (I hate being "Johnny come lately" to these things) and say I can't see a benefit to Albuterol down the tube for the reasons previously discussed.

If it's the asthma that is causing problems, perhaps it will help improve with ventilations and PaO2. Sort of like addressing the direct cause, underlying condition which brought on the heart stopping. It wouldn't hurt. :wink:

[mobey]

Woulden't the epy take care of that?

[firedoc5]

Woulden't the epy take care of that?

I'd say normally it would. But depends on how persistent the bronchial constriction/ spasms may be.

[BushyFromOz]

I'd say normally it would. But depends on how persistent the bronchial constriction/ spasms may be.

I would think one would be careful not to get suckered into treating a it as a PEA arrest from increased intrathoracic pressure. If its an unconscious astham with a cardiac output we jab em' with .3 of adrenaline IMI. If they lose output and provided they havn't tensioned or just have some mega gas trapping going on, im sure the 1mg of IVI adrenaline will sort out there constriction.

[VentMedic]

The asthmatic that codes is a difficult patient. Even in the hospital with the ability to bag a high dose albuterol neb in with heliox, it is sometimes difficult to bronchodilate enough to relieve the trapping.

I know of a couple of university hospitals that are researching methods to alleviate the air-trapping. As the below article mentions chest compression, the AHA has been kicking this around for several years.

External Chest Compression in the Management of Acute Severe Asthma—

A Technique in Search of Evidence

http://pdm.medicine.wisc.edu/Fischer.pdf

[hertzvanrental]

Do you guys do in line nebulisation? If a patient is in respiratory arrest or close to it, we set up an in line neb using BVM, catheter mount, t-piece and neb acorn. Can be connected up to tube, LMA(para) or face mask(EMT). Back to back nebs and sub cut epi. It works. Obviously no good in cardiac arrest.