SAQ 535 – Anaesthetics – RSI for severe pneumonia with failed view

A 55-year-old woman, 70 kg, presents with severe community-acquired pneumonia and persistent shock despite IV antibiotics and 1 litre of normal saline. You decide urgent intubation is required.

Observation	Result
Heart rate	130/min
BP	90/45 mmHg
SpO2	87% on 15 L Hudson mask
Respiratory rate	50/min
Temperature	37.6 C

List your RSI medication regimen, including dose, and give one justification for the regimen.

(Marked out of 9.0)
</p> <table class="saq-prop-table"> <thead> <tr> <th>Medication</th> <th>Dose</th> <th>Justification</th> </tr> </thead> <tbody> <tr> <td>1.</td> <td></td> <td></td> </tr> <tr> <td>2.</td> <td></td> <td></td> </tr> <tr> <td>3.</td> <td></td> <td></td> </tr> </tbody> </table> <p>

/ 9

On the first attempt you obtain a grade 4 laryngoscopy view. State two (2) actions to optimise the view before attempting intubation.

(Marked out of 2.0)

/ 2

After optimisation the best view is grade 3. State two (2) options to improve the chance of successful intubation on this attempt.

(Marked out of 2.0)

/ 2

After attempted intubation she becomes hypoxic and oesophageal intubation is a concern. State four (4) methods to confirm correct ETT position.

(Marked out of 4.0)

/ 4

Total Score: 0 / 17

Percentage: 0%