Triple Scope (EGD, Bronch, ENT)
- Access
- PIV x1
- Airway
- Unsecured. However, have backup LMA and ETT ready to intervene. Proceduralists will be visualizing the vocal cords and airway.
- Induction
- Mask or IV
- Maintenance
- TIVA (propofol/remifentanil/phenylephrine)
- Emergence
- Awake
- Antibiotics
- None
- Position
- Standard
Notes
A tricky case because the goal is to be amnestic, but not apneic. Different attendings will have different recipes. Some use dexmedetomidine and ketamine, propofol and dexmedetomidine, etc. A common approach is propofol/remifentanil: propofol for amnesia, remifentanil to help with coughing and bucking, and both are forgiving agents.