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07 / Anaesthesia · Simulation

The wheeze at induction

An asthmatic who missed her inhalers, a tube through a light larynx, and the shark fin on the capnograph: bronchospasm found, treated in order, and the extubation planned so it does not happen twice.

Laparoscopic cholecystectomy31 y female · 65 kg · ASA 2Asthma on an inhaled steroid and a long-acting bronchodilator, a cold last week, and she forgot her inhalers this morning.

Laparoscopic cholecystectomy · min 0 · Pre-induction

HR
84
SpO2
97%
NIBP
124/78
EtCO2
0.0 kPa
RR
16
Temp
36.8°
Anaesthetic recordv systolic · ^ diastolic · ● heart rate
040801201602000102030405060708090minutesv^Salbutamol 5 mg nebulised

Pre-induction

min 0 · step 1/9

In the anaesthetic room she admits she has not taken her preventer for a week and had a cold that has cleared. Her chest is quiet, and her peak flow is 85 percent of her best.

What do you do with an asthmatic who forgot her inhalers?

The case waits for your decision.

Teaching values for the printed patient, not a prescribing reference. The drug cart holds every drug here with its class, concentration and dose logic.