Intubation

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34 year old male with PMHx quadriplegia 2/2 GSW 8 years prior, with elective tracheostomy after his early disease course was complicated by frequent intubations for sepsis, presents to ED from NH with fever x1 day.  

A key component in the planning of intubation is pre-oxygenation. Recently apnoeic oxygenation during laryngoscopy has been adopted too. These are just two components of an overall oxygenation strategy to consider when intubating the critically ill. Some patients will require proactive preparation of the components of successful post-intubation oxygenation, especially those with severe lung pathology like ARDS.  

Introduction 0 Noninvasive ventilation (i.e. BiPAP) is arguably the most powerful approach to optimize oxygenation and ventilation before intubation, given