AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |
Back to Blog
Rapid sequence intubation case scenarios11/14/2023 ![]() ![]() Consider 500cc to 1L bolus IV of NS consider 4‐point restraints before giving the naloxone to protect the patient and medical staff, as well as one attempt at bag‐valve‐mask ventilation (BVM) to rule out laryngospasm, which could cause negative pressure pulmonary edema if the patient inspires against a closed glottis once the naloxone is given.Transport patient to resuscitation area, notify the whole team (RNs, RTs, etc), and have all the equipment ready (IVs, advanced airways, cardiorespiratory monitors).General approach to patient with respiratory depression Mensour answer questions like: Does Delayed Sequence Intubation have a role in airway management? Which is the best induction agent for patients with head injury? Asthma? What are the pros and cons of Roccuronium vs Succinylcholine? What is the evidence for pre-treatment using lidocaine and fentanyl and head injured patients? Is the new drug Suggamadex useful? Should we be using Video Laryngoscopy (eg: Glidescope) as the primary tool for endotracheal intubation? What is the newest evidence for what constitutes a difficult airway? What are the best methods for confirming Endotracheal Tube placement? How can we best prevent and treat post-intubation hypotension? What is the best positioning for obese patients for intubation? What are the best ventilator settings for patients in status asthmaticus? and many more…. In this episode on Emergency Airway Controversies, Dr. Finally, some key strategies to help manage the morbidly obese patient’s airway effectively are reviewed. ![]() In the last case of a morbidly obese asthmatic they debate the merits of awake intubation vs RSI vs sedation alone in a difficult airway situation and explain the best strategies of ventilation to avoid the dreaded bradysystlolic arrest in the pre-code asthmatic. They review how to identify a difficult airway, how best to confirm tube placement and how to avoid post-intubation hypotension. The new concept of Delayed Sequence Intubation is explained and critiqued. Tips on preparation, pre-oxygenation and positioning are discussed, and some great debates over pre-treatment medications, induction agents and paralytic agents ensues. ![]() The next case, of a patient with severe head injury who presents with a seizure, is the fodder for a detailed discussion of Rapid Sequence Intubation (RSI). This is followed by a discussion of what factors to consider in deciding when to intubate and some of the myths of when to intubate. A case of a patient presenting with decreased level of awareness provides the basis for a review of the importance, indications for, and best technique of bag-valve-mask (BVM) ventilation, as well as a discussion of how best to oxygenate patients. Mark Mensour debate dozens of these controversies surrounding emergency airway management. Finally, some key strategies to help manage the morbidly obese patient’s airway effectively are reviewed.There are so many emergency airway controversies in emergency medicine! Dr. ![]() There are so many emergency airway controversies in emergency medicine! Dr. ![]()
0 Comments
Read More
Leave a Reply. |