Name that difficult AW:

[sebsvenmdc]

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7 - almost looks like Potter facies vs. Trisomy 18.

 

[Noyac]

Would you use IM ketamine to obtain an IV access and then dex sedation for the topicalization of the AW and FI then?

I don't really like the dex for the this but I'd be OK with doing it this way if necessary. I'd probably use propofol very carefully.

 

[Noyac]

👍

You are right, "awake" is probably not the right word here so let's say spontaneously breathing and sedated.
Not necessarily under GA though.
This can be achieved as you know in many ways, Ketamine is just one of them and most of the time Ketamine is all you need to place the tube, or you can just do the FOB with Ketamine and once you see the cords spray lidocaine wait a few seconds then intubate.
You can even use a propofol infusion if you have an IV the trick is just to titrate gradually so you don't lose the airway.
Topical anesthesia and airway blocks are not helpful that much in this population and they cause too much fear and anxiety.

😍

 

[2win]

👍

😍

DO you guys have a peds fellowship?
I have to tell you - I admire you for the knowledge.
I 'm gonna book up a Bahamas "refresher course".👍

 

[ketap]

thx u for this thread..learn so much from this thread 🙂