Episode 54: Preoxygenation and Delayed Sequence Intubation

Emergency Medicine Cases

Dr. Anton Helman

Education, Health & Fitness, Courses, Medicine, Science

4.7 • 602 Ratings

🗓️ 25 November 2014

⏱️ 47 minutes

🔗️ Recording | iTunes | RSS

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Summary

Hot on the heels of Dr. Weingart's latest publication in the Annal of EM on Preoxygenation & Delayed Sequence Intubation, we have Dr. Weingart, perhaps the world's most influential critical care educator, and Dr. Walter Himmel, 'The Walking Encyclopedia of EM' discussing how the community ED doc can use preoxygenation, apneic oxygenation and delayed sequence intubation to help improve airway management knowledge and skills. Whether you work in a rural setting or a big urban community hospital, Dr. Himmel and Dr. Weingart explain how these concepts and skills are easily adaptable to your work environment. We introduce the Triple 15 Rule for preoxygenation as a memory aid that will help you the next time you're faced with a critically ill patient who's oxygen saturation isn't good enough on a non-rebreather.

Transcript

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0:00.0	Welcome to the Emergency Medicine Cases podcast.
0:05.8	I'm your host, Dr. Anton Hellman, bringing you Canada's brightest minds in emergency medicine
0:10.5	from EMC studios in Toronto.
0:14.2	The hardest question to answer in critical care is, will my patient benefit for more fluid?
0:19.4	Your only other option is this, a crash intubation.
0:24.7	It'll get you most of the way there for most patients.
0:29.5	15 liters of nasal prongs, 15 liters through the BVM, 15 centimeters of water for the CPAP.
0:37.2	Don't squeeze the bag too many times.
0:40.2	Extremely important to tell yourself that again and again and again.
0:43.5	In the old days, when we used to get 14, 16 liters, then it really mattered which one you chose.
0:48.9	DSI is essentially procedural sedation with the procedure being pre-oxygenation.
0:57.0	Their eyes are goggling back and forth. At this point, you could do whatever you want.
0:58.0	Ketamine is that world all of its on.
1:05.0	I never thought this day would ever become a reality, but alas, here at ASEP 2014 conference in
1:14.0	Chicago, and in this episode on Critical Care Pearls for the community ED doc, we have not only
1:20.0	the world's most influential critical care educator Scott Weingart, but also Canada's walking
1:25.8	encyclopedia of emergency medicine and my personal mentor, Walter Himmel.
1:29.9	Yes, folks, the day has come where I have the pleasure and honor of bringing together truly two of the
1:36.3	brightest minds in emergency medicine to educate you on a topic that because of Dr. Weingart's
1:42.3	amazingly informative EMCrit podcast has become front and center
1:46.9	in emergency medicine education everywhere.
1:50.7	What we'll attempt to accomplish today is to take some of the most important innovations in critical
	...

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