Sedation only Intubations are a Beast

>> YOUR LINK HERE: ___ http://youtube.com/watch?v=y3Xi7DhrVFU

When you aren't allowed by your attending by the culture of your ICU, or the EM Attending preference or EMS medical supervisor or by your County, Or City or State to give RSI which includes a Induction agent into a coma, gcs of 3 and paralysis to be given together, the intubation or placement of a SupraGlottic Airway becomes way more trickier. • The patient will react different regardless if the technology that is in your hand or intubation or rescue oxygentation, LMA or Combitube like device. • Higher chance of vocal cord spasm as you try to pass the device into the glottic opening or the back of the proximal esophagus and bumped the glottic opening on your way. • Higher chance of aspiration since the proximal and distal esophageal spincters arent paralyzed and active vomiting/gastric emptying can happen north towards you. Especially if the patient isnt ramped up and remains in the coffin position. You can ramp up the head some even during cardiac arrest. • Tricker to be patient enough to pass the tube when the cords are opening spontaneously and not pump the cords so that they spasm shut. • If you fail, resume oxygenation. • If they vomit, turn the patient and let gravity lead the vomit away from the upper airway then suction with what you have available. • And drive expeditiously and carefully and get help within arms length or reachable by the closest ED. • ##rescueintubation #rsi #rapidsequenceinduction #rapidsequenceairway #sedationonlyintubation #pharmacologyassistedLaryngealMaskplacement • #aspiration #vomiting #laryngealspasm #positioningandpreoxygenation #coffinposition • #intubatiem #resusx #theprotectedairwaycourse • #emergencymedicine #criticalcare #resuscitation #emergencymedicine #theresuscitationist #theresuscitationistiamproudof

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