Initial management of laryngospasm includes
a. intubating the patient and providing manual ventilation with 100% oxygen.
b. hyperextending the patient's head and administering positive-pressure ventilations on 100% oxygen.
c. administering 10 mg of succinylcholine.
d. administering nebulized racemic epinephrine.
B
Management is initiated by removing the stimulus along with any irritants such as secretions, blood, or an artificial airway that is too long. The patient's head must be hyperextended and positive-pressure mask ventilation instituted on 100% oxygen. The anesthesiologist is notified immediately. If complete obstruction is unrelieved by positive-pressure ventilations, a small dose of succinylcholine (10–20 mg) may be needed to relax the vocal cords to allow for ventilation. Positive-pressure mask ventilation is continued until full muscle function has resumed. Endotracheal intubation is required if the laryngospasm persists or if refractory hypoxemia develops even though it may cause further irritation of the airways. Medications that may be used in the treatment of laryngospasm include lidocaine, steroids, and atropine.
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