Thu18November0317AM 6

Is it true that the following are recommendations for tracheal intubation in a brain-injured patient prior to transfer as outlined by the Association of Anaesthetists of Great Britain and Ireland (AAGBI)?

True / False

It is recommended that a rapid sequence induction technique is employed Correct

Intubation should be considered if the GCS falls by two points in any domain Correct

Aggressive hyperventilation is justified (but carbon dioxide not below 4 kPa) if there are signs of raised intracranial hypertension Incorrect answer selected

If a patient's GCS falls by 1 point in motor scoring they should be intubated Correct

All patients with a Glasgow coma scale (GCS) less than 10 prior to transfer should be intubated Correct

Explanation

The Association of Anaesthetists of Great Britain and Ireland (AAGBI) guidance states that all patients with a GCS less than 8 prior to transfer require intubation. Also, whatever the baseline GCS, intubation should be considered if the GCS has fallen by 2 or more points. Intubation is essential if there is a fall of 2 or more points in the motor score.

Rapid sequence induction with in-line cervical-spine stabilisation is the recommended technique for intubation unless a contraindication exists.

Aggressive hyperventilation is justified if evidence of raised intracranial hypertension exists, otherwise you should aim for a PaCO2 of 4.5-5 kPa.

Reference:

Association of Anaesthetists of Great Britain and Ireland (AAGBI). Interhospital Transfer.

Answer Statistics

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Average score: 72.64%

Times answered: 326