Hello, med students. My name is Zach Olson, and thank you for downloading this week's episode of the E.M. Clerkship Podcast. This week, we are talking finally about the tube. So airway phase one, right, was suction and move the tongue. And then phase two was how to oxygenate with a bag valve mask. And when you have trouble, the tricks that you have up your sleeve, the nasal pharyngeal, oropharyngeal, LMA, king, combative. You got to master that. But we've now arrived at this week.

How to intubate.

It's called rapid sequence intubation, RSI.

Once you got that patient oxygenated, once you got their blood pressure somewhat stable, and you've suction and you've moved the tongue you've used that bag valve

mask or any adjuncts if necessary obviously you don't use them if they're not necessary but you want

to get them oxygenated now you can start thinking about intubation i'm not going to teach this how

the book teaches it the The peas, right?

You prep and then you pre-oxygenate and you position and you pre-treat and then you paralyze

and then you pray and then you pass the tube and then post-treatment or whatever.

Like there's like a million peas, right?

Because I can't really remember it.

I think it's dumb.

The most important part of intubation is that you need to pre-oxygenate the moment you start going down this pathway,

you want to have the patient have a non-or breather on or a bipap. You want to basically just

flood them with oxygen. This is really the only time where you want to do that, but you

want to flood them with oxygen. This buys you time to do the RSI procedure without their

oxygen level dropping really, really dangerously low. And so the more oxygen, you can kind of

pre-oxygenate into their lungs up front, and the more nitrogen you can wash out

the longer you can attempt and re-attempt without your attending, ending your attempt, and taking

the blade away because the monitor's beeping and the patient's desaturated.

It buys you time. You want to pre-oxygenate

the shit out of your patient. That is the main thing to know. But after that, today, the procedure,

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