Severe Bronchospasm

🔑 Key Priorities

  • Maintain oxygenation

  • Deepen anaesthesia and treat bronchospasm

🧠 Team Actions

Role

Task

Team Leader

Guide bronchodilator and steroid therapy

Airway Operator

Confirm ETT position, exclude mechanical issues

Drug Assistant

Prepare bronchodilators and infusions

🧭 Management Algorithm

  1. Call for help

  2. Deepen anaesthesia (switch agent if needed)

  3. Confirm ETT placement

  4. Manually ventilate to feel compliance

  5. Administer salbutamol (MDI 6–12 puffs or IV 250mcg)

  6. Add ipratropium (4–6 puffs)

  7. Administer steroids (e.g. hydrocortisone 200mg)

  8. Consider magnesium, ketamine or aminophylline

  9. Adjust ventilator: ↓tidal volume, ↑expiratory time

  10. If unresponsive → start infusions

🔄 Ideal Crisis Flow

      Suspected Bronchospasm
              ↓
     Deepen Anaesthesia & Confirm ETT
              ↓
       Administer Bronchodilators
              ↓
      Add Steroids & Adjuncts (Mg, Ketamine)
              ↓
     Optimise Ventilator, Start Infusions

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