question about king lt

[Blitzer]

Hello

Im new here, eventually want to go into EM eventually

question about a code I saw the other day.
Older guy who came in by EMS and was intubated by a King LT and had been shocked 3 times prior to arrivng to the ED. His down time was 15 minutes before EMS arrived. When he got to the ED he did not have a pulse and was in asystole. the code lasted 20 minutes, they gave him vasopressin, epinephrine, calcium and cpr .and some other medications but he passed away.

my question is can they call a code with a king LT in? Does the doctor need to put a definitive airway in first? The guy had vomit and blood all over his face, and he was fat and swollen and I could see how he would be a difficult airway. I think the doctor tried to open his mouth but he was closed shut but I heard that they were able to ventilate the patient so he focused on good cpr and medications.

thank you

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[WilcoWorld]

Hello

Im new here, eventually want to go into EM eventually

question about a code I saw the other day.
Older guy who came in by EMS and was intubated by a King LT and had been shocked 3 times prior to arrivng to the ED. His down time was 15 minutes before EMS arrived. When he got to the ED he did not have a pulse and was in asystole. the code lasted 20 minutes, they gave him vasopressin, epinephrine, calcium and cpr .and some other medications but he passed away.

my question is can they call a code with a king LT in? Does the doctor need to put a definitive airway in first? The guy had vomit and blood all over his face, and he was fat and swollen and I could see how he would be a difficult airway. I think the doctor tried to open his mouth but he was closed shut but I heard that they were able to ventilate the patient so he focused on good cpr and medications.

thank you

Yes, you can call a code without an ETT in, especially if the patient has bilateral breath sounds with ventilation. In fact, if I'm not showing signs of improvement after 35 minutes of asystole, please call my code regardless of what kind of airway you have (assuming I'm not a hypothermic arrest).

 

[Birdstrike]

Hello

Im new here, eventually want to go into EM eventually

question about a code I saw the other day.
Older guy who came in by EMS and was intubated by a King LT and had been shocked 3 times prior to arrivng to the ED. His down time was 15 minutes before EMS arrived. When he got to the ED he did not have a pulse and was in asystole. the code lasted 20 minutes, they gave him vasopressin, epinephrine, calcium and cpr .and some other medications but he passed away.

my question is can they call a code with a king LT in? Does the doctor need to put a definitive airway in first? The guy had vomit and blood all over his face, and he was fat and swollen and I could see how he would be a difficult airway. I think the doctor tried to open his mouth but he was closed shut but I heard that they were able to ventilate the patient so he focused on good cpr and medications.

thank you

If a person is hopelessly dead, a person is hopelessly dead. It doesn't matter what they have "in them."

 

[Docinthetrenches]

You can call a code whenever you want - if they are about to arrest or are in arrest (or airway extremis). A King tube is a temporary thing that you put in blindly in cases where you can't intubate or haven't been trained to do so. You can ventilate though it but it does not completely protect the airway so eventually, it must be replaced by an ETT. A Combitube is kind of similar and serves the same purpose. EMS frequently uses these tubes.

 

[Blitzer]

thank you for your replies

THis may be a stupid question because I have limited training (applying to school) but if you can ventilate patient in asystole, should the sats be adequate? I think his etco2 was in 15-20 which shows he had good cpr
If the patient is being ventilated well clinically by stethoscope and bagging, could you tell by the pulse ox? or would that be affected because the guy is in asystole?

thank you again.

 

[WilcoWorld]

thank you for your replies

THis may be a stupid question because I have limited training (applying to school) but if you can ventilate patient in asystole, should the sats be adequate? I think his etco2 was in 15-20 which shows he had good cpr
If the patient is being ventilated well clinically by stethoscope and bagging, could you tell by the pulse ox? or would that be affected because the guy is in asystole?

thank you again.

If you're not getting good peripheral perfusion (which you often won't get even with good CPR), than you won't get a reliable pulse ox. So, the answer to your question is "no".