Oxygen Bubble Bottles or Bacteria Swimming Pools?

Humidified oxygen is widely administered in hospitals and EMS vehicles and this is presumed to alleviate nasal and oral discomfort in the non-intubated patient. Humidification of supplemental oxygen is commonly delivered by bubbling oxygen through either cold or warm sterile water before it reaches the patient. However, the effect on patient comfort is negligible. Bubble humidifiers may, however, represent an infection hazard and should not be used.


Apneic Preoxygenation

Use of ApOx during RSI in adult patients in the ED, is low cost, low complexity, and not proven to cause harm while also reducing incidence of hypoxemia and increasing first pass attempt intubation. It is time for a RCT evaluating this modality.

Apneic preoxygenation

Apneic oxygenation without nasal prongs – the “Hungarian Air Ambulance method”. a The intubator preoxygenates the patient with a non-rebreathing mask (15 lpm). Upper airway patency is maximized by two naso- and one oropharyngeal airway. b The intubator cuts the tubing of the mask after the onset of apnea. c The intubator removes the mask and inserts the free end of the tubing approximately 3–5 cm deep into the nasopharyngeal airway. d The laryngoscopy is performed with the “tube in the tube”