Emergency Medical Care: Rapid Sequence Intubation - Pharmacology

These flashcards cover key vocabulary and concepts related to Emergency Medical Care, specifically focusing on Rapid Sequence Intubation and its pharmacology.

Rapid Sequence Intubation (RSI)

A medical procedure used to secure an airway quickly in an unconscious patient.

Premedications

Medications given prior to a procedure to reduce anxiety and physiological responses.

Atropine

A premedication used to blunt bradycardia caused by vagal response during intubation.

Midazolam

A short-acting GABA agonist used as an anxiolytic and sedative in RSI.

Fentanyl

An opioid used to blunt the sympathetic surge during intubation.

Lignocaine

A local anesthetic that can blunt the sympathetic response to intubation.

Induction Agents

Drugs used to induce anesthesia rapidly before intubation.

Etomidate

An induction agent that mimics GABA effects and causes minimal cardiovascular change.

Ketamine

A dissociative anesthetic that acts as an NMDA antagonist.

Propofol

A highly lipid-soluble GABA agonist used for induction with rapid onset.

Neuromuscular Blockers (NMBs)

Drugs that induce muscle paralysis by blocking transmission at the neuromuscular junction.

Suxamethonium

A depolarizing neuromuscular blocker that causes a Phase I and Phase II block.

Rocuronium

A non-depolarizing neuromuscular blocker used for its rapid action.

Vecuronium

A non-depolarizing neuromuscular blocker used for longer-term paralysis.

General Considerations for NMBs

Adverse cardiovascular effects can occur, including bradycardia and tachycardia.

Adrenal suppression

A potential side effect of etomidate associated with decreased cortisol production.

Phase I block

Initial fasciculation phase caused by depolarizing neuromuscular blockers.

Phase II block

A prolonged block where the membrane becomes refractory to stimulation.

Dantrolene Sodium

A reversal agent used to treat malignant hyperthermia and to relax muscles.

Neostigmine

An anticholinesterase agent that increases acetylcholine levels to reverse non-depolarizing NMB.

Sugammadex

A drug that encapsulates rocuronium/vecuronium to rapidly reverse neuromuscular blockade.

Emergence phenomenon

Disorienting hallucinations or other psychodysleptic effects after ketamine use.

Neuroprotective effects of ketamine

Ketamine is thought to protect the brain during traumatic brain injury.

Induction Agent's onset of action

The time taken for the drug effects to begin following administration.

Duration of action

The length of time the drug remains effective after administration.

Cardiovascular stability during intubation

Maintaining patient heart rate and blood pressure within safe ranges during RSI.

Intracranial pressure (ICP)

Pressure within the skull that may be affected by certain anesthetics.

Sympathetic response

The body’s involuntary response to stress which can complicate intubation.

Hemodynamic stability

The consistent maintenance of blood pressure and heart rate during procedures.

Cerebral blood flow (CBF)

Blood flow within the brain, important for maintaining neurological function.

RSC (Rapid Sequence Consciousness)

The practice of preparing a patient quickly for intubation while minimizing consciousness.

Neuromuscular junction (NMJ)

The synapse between a motor neuron and skeletal muscle where NMBs act.

Skeletal muscle paralysis

Loss of voluntary muscle movement induced by neuromuscular blockers.

Physiological responses

Body's involuntary reactions to stimuli, important to control during intubation.

Induction agent side effects

Adverse effects that may occur as a result of using anesthesia induction agents.

Hypotension

Abnormally low blood pressure, which can complicate anesthesia.

Bradycardia

Abnormally slow heart rate, sometimes a response to certain medications.

Catecholamine response

Release of hormones that can affect heart rate and blood pressure in stress.

End tidal carbon dioxide (ETCO2)

The concentration of carbon dioxide in exhaled breath, an indicator of ventilation.

Bronchodilation

The relaxation of bronchial muscles leading to better airflow, important in respiratory care.

Anxiolytic

A drug that reduces anxiety.

Laryngoscopy

The procedure of examining the larynx, often performed before intubation.

Intravenous (IV) anesthetics

Anesthetics administered through a vein for rapid onset.

Acid-base balance

The equilibrium between acids and bases in the body, affecting patient stability.

Patient comfort

Ensuring the patient feels as comfortable as possible during medical procedures.

Anaesthesia induction

The process of administering drugs to achieve unconsciousness for surgery.

Muscle rigidity

Stiffness in muscles that can be associated with high doses of certain medications.

Respiratory drive

The neuronal mechanisms that control breathing, often spared by ketamine.

Analgesia

Pain relief, an important consideration during intubation.

Urinary retention

Inability to empty the bladder, which can be a side effect of certain medications.

Histamine release

The release of histamines during drug administration, can cause allergic reactions.

Cerebral vasodilation

Widening of blood vessels in the brain, potentially affecting ICP.

Hemodynamic response

Dynamic changes in blood circulation as a response to medication.

GABA receptor

A neurotransmitter receptor that is involved in inhibitory neurotransmission.

Crosses blood-brain barrier

Refers to a substance's ability to penetrate the central nervous system.

Non-depolarizing agents

Neuromuscular blockers that compete with acetylcholine without causing depolarization.

Malignant hyperthermia (MH)

A severe reaction to certain anesthetics, causing hypermetabolism and rigidity.

Ketamine pharmacodynamics

The study of how ketamine affects the body.

Ketamine pharmacokinetics

The study of how the body affects ketamine over time.

Enhancement of GABA function

A mechanism of action for certain anesthetics where they increase the inhibitory effect.

Compartment syndrome

A harmful condition caused by increased pressure within a muscle compartment.

Neuroinhibition

Suppression of neuronal activity, often beneficial in surgical settings.

Volume of distribution

A pharmacokinetic measure of the extent of drug distribution throughout body fluids.

Hydrophilic

Having an affinity for water, affecting drug solubility and absorption.

Anxiolytic dosages

The recommended amounts of anxiolytics for effective sedation.

Clinical recovery

The process of returning to normal function after the effects of anesthesia wear off.

Opioid receptor sites

Specific binding locations for opioid medications that affect pain perception.

Psychodysleptic effects

Altered perceptual experiences resulting from certain medications.

Hyponatremia

Low sodium levels in the blood, which can complicate patient stability.

Emergency intubation

A rapid airway management procedure performed in critical situations.

Physiological stability

Condition in which vital signs remain within normal limitations.

Patient selection criteria

Guidelines determining which patients are appropriate candidates for specific procedures.

Acute care setting

Immediate medical care provided to gent in need of urgent treatment.

Controlled environment

A situation where conditions are managed to ensure patient safety.