Condition

Intractable bronchospasm

Presentation

↑ Airway pressure; sloping expiratory capnograph trace

Immediate action

100% oxygen; salbutamol 250µg IV/2.5mg neb; aminophylline 250mg slow IV Magnesium sulphate 2g IV has been shown to be effective

Follow-up action

Hydrocortisone 200mg

Investigations

CXR; ABGs

Also consider

Breathing circuit obstruction Kinked ETT/cuff herniation Endobronchial intubation/tube migration Foreign body in airway Anaphylaxis Pneumothorax