AFOI topicalisation

1. Glycopyrolate 200-400mcg IV/IM ASAP
2. Sedation EARLY

Topicalise:
Spray co-phenylcaine to nostrils
Gargle 4x5ml of Instilagel
Spray Xylocaine (10% lignocaine) to oropharynx -> distally

+/-
Spray-as-you-go with epidural catheter (2ml 1% lig)
Cricothyroid puncture (2ml 1%lig)

Alternatives/adjuvants:
Instilagel+soft NPA to nostril NB risk of bleeding -> bad view/problems
4% lignocaine squirt to nostril using teat
4% lignocaine squirt to oropharynx
‘nebulised’ lignocaine using cannula + 1% lignocaine

 

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