This post might become a regular under the banner “What I learned from Scott Weingart this week!” Scott runs the EMCrit blog and if you haven’t seen it – do yourself a favour and download his podcasts from Itunes – he is a great teacher, and pitches his education in a practical / pragmatic fashion that is well suited to rural GP Anaesthetic / ED types.
I got in contact with Scott a few weeks back to give my 5 cents on “pre-oxygenation”, basically I (and a lot of Anaesthetists) was taught to think of it as “denitrogenation” of the lungs – aiming to get the ET O2 up to 80 – 90% prior to RSI. This is true, however as Scott has pointed out in his video response – this is missing a few crucial steps. You cannot directly translate what we do in OT back to the crashing ED patient.
Check out Scott’s video and demonstration of pre-oxygenation on himself.
Then check out Scott’s “DSI: delayed sequence intubation” concept – this is basically how to preoxygenate a sick patient, and hopefully avoid them crashing on induction. The link then links to another video demonstrating the technique.
This is me learning a better way, it does break a few of the “Anaesthetic Commandments”.
Would love to hear your comments