Intubation

Terry OConnor talks with ercast about climbing Mt Everest and being an expedition physician<br><br>An experience with delayed sequence intubation<br><br>Rob is interviewed on <a href="http://www.skepreview.com/2010/06/interview-with-dogma-free-americas-dr.html">The Skeptical Review</a> website<br><br>A letter from Dr. Ken Walker about the international emergency medicine and the&nbsp;<a href="http://www.pfid.net/">Partners for International Development</a>  

<p>An interview with ED Critical Care 7th degree</p <p>black belt Scott Weingart, MD.</p>  

<p>Suicide risk assessment in the emergency department.</p <p>An interview with Jeff Young, MD.</p <p>&nbsp;</p <p>Here's the link to the 'famous awake intubation video'</p <p>that will be one of the topics on the next episode</p <p>&nbsp;</p <p><a title="Link to awake intubation video" href="http://blog.emcrit.org/misc/awake-intub-video/" target="_blank">http://blog.emcrit.org/misc/awake-intub-video/</a></p>  

This study was conducted to better define the pathophysiology, risk factors, and therapeutic approach to exercise-associated hyponatremia. Medical records from all participants in the 1998 Suzuki Rock ‘N’ Roll Marathon® who presented to 14 Emergency Departments (EDs) were retrospectively reviewed to identify risk factors for the development of hyponatremia. Hyponatremic patients were compared to other runners with regard to race time and to other marathon participants seen in the ED with regard to gender, clinical signs of dehydration, and use of nonsteroidal anti-inflammatory drugs (NSAIDs). An original treatment algorithm incorporating the early use of hypertonic saline (HTS) was evaluated prospectively in our own ED for participants in the 1999 marathon to evaluate improvements in sodium correction rate and incidence of complications. A total of 26 patients from the 1998 and 1999 marathons were hyponatremic [serum sodium (SNa) ≤135 mEq/L] including 15 with severe hyponatremia (SNa ≤ 125 mEq/L). Three developed seizures and required intubation and admission to an intensive care unit. Hyponatremic patients were more likely to be female, use NSAIDS, and have slower finishing times. Hyponatremic runners reported drinking “as much as possible” during and after the race and were less likely to have clinical signs of dehydration. An inverse relationship between initial SNa and time of presentation was observed, with late presentation predicting lower SNa values. The use of HTS in selected 1999 patients resulted in faster SNa correction times and fewer complications than observed for 1998 patients. It is concluded that the development of exercise-associated hyponatremia is associated with excessive fluid consumption during and after extreme athletic events. Additional risk factors include female gender, slower race times, and NSAID use. The use of HTS in selected patients seems to be safe and efficacious.  

Gastric intubation via the nasal passage (ie, nasogastric route) is a common procedure that provides access to the stomach for diagnostic and therapeutic purposes. A nasogastric (NG) tube is used for the procedure.  

A 57 year old woman presented to the emergency department with swelling of the lips and oropharynx of one hour’s duration. Treatment for anaphylaxis was started but 30 minutes later she was much worse. After intubation, she was taken to the intensive care unit for airway management.  

A 57 year old woman presented to the emergency department with swelling of the lips and oropharynx of one hour’s duration. Treatment for anaphylaxis was started but 30 minutes later she was much worse. After intubation, she was taken to the intensive care unit for airway management.  

Awake Intubation from SMACC 2015  

Get up close on personal with Richard Levitan’s upper airway in this demonstration of fiberoptic intubation. Recorded at SMACCGold 2014.  

Walter Himmel and Scott Weingart discuss the controversial and evolving topic of fluids in sepsis and septic shock & post-intubation sedation and analgesia  

Scott Weingart & Walter Himmel discuss preoxygenation, apneic oxygenation & delayed sequence intubation for the community ED physician on EM Cases  

The DSI study is finally published! Listen to this podcast for a discussion of the paper and the things we have learned since the original DSI podcast.  

1. What is RSI, and why do we use it for most ED intubations? "Rapid Sequence Intubation (RSI) is the administration, after preoxygenation, of a potent induction agent followed immediately by a rapidly acting neuromuscular blocking agent to induce unconsciousness and motor paralysis for tracheal intubation" (Walls and Luten). We use RSI in the ED…  

Rapid sequence intubation, the simultaneous administration of a paralytic and induction agent immediatel  

http://www.youtube.com/watch?v=ThISkClbv7o   This week we have another awesome post from Dr. Eric Shappell!  This is an excerpt on DL from his video on Introduction to Intubation. Check out his YouTube site for more fantastic EM videos!  https://www.youtube.com/user/ericshappell  

A call/response intubation checklist for Emergency Medicine and Critical Care Airway Management  

There is a ton of stuff to do post-intubation besides confirming the tube and giving the team high-fives. Here is the post-intubation package to make it so.  

Pushing some ativan followed by vecuronium is no longer an acceptable strategy to manage post-intubation sedation. A good analgesia and sedation package is essential if you care about your patient's comfort and well-being. We need to move to PAIN-FIRST paradigm. Optimize analgesia and then add in sedative agents as a bonus. In this episode of the EMCrit Podcast, I expand on a previous rant to discuss the optimal way to handle routine post-intubation patients and some special scenarios you may encounter.  

What is this page about? Scott Weingart, MD and Richard Levitan, MD published an article in the Annals of Emergency Medicine entitled Preoxygenation and Pr