When intubation fails…

We should never allow more than 3 intubation attempts, and sometimes clinical conditions will dictate fewer tries. Examples that come to mind are severe brain injury patients (hypoxia is bad) and patients who do not recover from oxygen desaturation when they are bagged. Don’t lose track of time and the number of attempts!

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 […]

Emergency Ventilation

BMV is always a 2 person procedure (regardless of technique used) – Skilled person holds the mask and anyone else can provide the breaths + Consider the 2 thumbs down technique for BMV instead of the CE clamp. And Believe it or Not – Learning BMV is more important than mastering Laryngoscopy !!

Emergency Medicine Kenya Foundation