Deterioration after intubation: Difference between revisions

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==Diagnosis==
==Diagnosis==
*D - Displaced ETT
*DOPE<ref>EMRA Critical Care Handbook</ref><ref>Monica E. Kleinman et al. Pediatric Advanced Life Support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. AAP. 2010. http://pediatrics.aappublications.org/content/126/5/e1361.full</ref>
*O - Obstructed ETT
**D - Displaced ETT
*P - [[Pneumothorax]]
**O - Obstructed ETT
*E - Equipment failure (ventilator malfunction or disconnect)
**P - [[Pneumothorax]]
**E - Equipment failure (ventilator malfunction or disconnect)


==Management==
==Management==
*When in doubt, disconnect the pt from the ventilator and begin bag ventilation
*When in doubt, disconnect the pt from the ventilator and begin bag ventilation
**Eliminates the vent circuit as source of the problem
**Eliminates the vent ('''E''') circuit as source of the problem
**Helps gauge lung compliance
**Helps gauge lung compliance
*Airway
*Airway
**Is the tube still in? Is it patent?
**Is the tube still in? ('''D''')
**Is it patent? ('''O''')
**Auscultate and/or CXR
*Breathing
*Breathing
**Is the chest rising? Breath sounds equal b/l? Pneumothorax?
**Is the chest rising? Breath sounds equal b/l? ('''P''')
 
==Origin==
*EM Crit Blog Response<ref>http://emcrit.org/blogpost/origins-of-the-dope-mnemonic/</ref>


==References==
==References==
*EMRA Critical Care Handbook
<references/>


==See Also==
==See Also==

Revision as of 23:46, 8 April 2015

Diagnosis

  • DOPE[1][2]
    • D - Displaced ETT
    • O - Obstructed ETT
    • P - Pneumothorax
    • E - Equipment failure (ventilator malfunction or disconnect)

Management

  • When in doubt, disconnect the pt from the ventilator and begin bag ventilation
    • Eliminates the vent (E) circuit as source of the problem
    • Helps gauge lung compliance
  • Airway
    • Is the tube still in? (D)
    • Is it patent? (O)
    • Auscultate and/or CXR
  • Breathing
    • Is the chest rising? Breath sounds equal b/l? (P)

Origin

  • EM Crit Blog Response[3]

References

  1. EMRA Critical Care Handbook
  2. Monica E. Kleinman et al. Pediatric Advanced Life Support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. AAP. 2010. http://pediatrics.aappublications.org/content/126/5/e1361.full
  3. http://emcrit.org/blogpost/origins-of-the-dope-mnemonic/

See Also