For those few cases where the airway fails, all physicians should have a menu of rescue devices on hand at the bedside. Just having the devices at the ready isn’t enough, said Dr. Gibbs. Practice, practice, practice.
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ACEP16 Monday Daily NewsTo reduce the risk of post-intubation hypotension, Dr. Gibbs said physicians must be on the lookout for shock. A Shock Index of greater than 0.8 is the most important predictor of a poor outcome, he noted. He also recommended slowing ventilation for resuscitated patients. “Bag the patient slowly,” he said.
For Dr. Gibbs, the take home essentials include meticulous preparation, acknowledgement that all ED intubations are high risk and a thorough assessment of anatomy and physiology. “In my view, physiology carries the day,” he said. Dr. Gibbs also emphasized becoming an expert at pre-oxygenation.
Teresa McCallion is a freelance medical writer based in Washington State.
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