Just Wait to Pre-oxygenate!

I believe sometimes we are in rush for no reason. Patient with hypoxia and no reserve requires some oxygen to prevent hypoxia during intubation, DSI vs RSI. I am fan of DSI to buy some time to see how we could assist with oxygenation before definitive airway intervention.

Scott Weingart, et al. published in April 2015 in Annals of EM their study regarding DSI, recommending an algorithm to improve preoxygenation before intubation. in this method, the procedure starts with selcecting patient, use Ketamine to sedate patient with nasal cannula and NRB mask to preoxygenate also recommending NIPPV in AMS! then paralytic and proceed with intubation.

 

Link to article