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Avoiding Hypoxemia During Intubation
More than 1.5 million critically ill adults undergo tracheal intubation each year in the United States. Hypoxemia is a common and serious complication during tracheal intubation in critically ill adults, occurring up to 10-20% of intubations in the emergency department (ED) or intensive care unit (ICU). Hypoxemia increases the risk of cardiac arrest and death. The effect of preoxygenation with noninvasive ventilation, as compared with preoxygenation with an oxygen mask, on the incidence of hypoxemia during tracheal intubation is uncertain. In this breakdown of a Journal Club article, Dr de Castro will cover a recent paper comparing NIPPV to oxygen mask only during preoxygenation for intubation.
Grand Rounds Recap 10.30.24
Join us for another great week of Grand Rounds! We started out with a great discussion of the changing workforce and how the differences between generations and leadership styles impacts our interactions with our colleagues. Then we discussed the nuances of managing a dysfunctional tracheostomy with Dr. Adan. We were taken through the pathophysiology and clinical presentation of patients with pneumomediastinum and mediastinitis with Dr. Valles. Finally, Drs. Artiga, Beyde and Vaishnav gave us hands on practice with the different types of nerve blocks that can be used in the ED!
Has Video Finally Killed DL?
More than 1.5 million adults undergo tracheal intubation outside of the operating room each year in the United States. Traditionally, this has been performed with direct laryngoscopy, where a clinician displaces the patient’s tongue and epiglottis with a laryngoscope blade to visualize the vocal cords through the mouth, allowing for direct visualization of the passage of an endotracheal tube. An alternative method for tracheal intubation is video laryngoscopy, where a camera on the distal half of the blade transmits an image to a screen allowing for indirect visualization of the vocal cords and passage of an endotracheal tube without direct line of site.