Kicking off the April Episode and continued from last month Darren and Richard return in Airway Corner to continue this very informative and clinically important conversation. Breathe easier after hearing this segment.
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Mel, thanks for organising and recording this great interview between Darren and Richard. I really enjoy and learn from EMRAP because you dont shy away from controversy and allow debate to be heard on areas of clinical practice that are not clear cut. The rants are often very insightful and cut through a lot of bullshit but still present two sides of the story. Your narrative is always amusing and a good summary to the dialogue. I am obsessed with all things airway in emergency medicine and this segment gives me my monthly fix! Congratulations from a happy customer
the big caveat is the tachypneic, sepsis patient where there is pre-existing acidosis (with respiratory compensation) and rising CO2 and acidosis may just kill them. Having said that, I've tried it and LOVE this technique. Awesome to hear it from the Master.
thankyou Brendan. rising CO2 and acidosis may kill them. Enemy Hypoxia will kill everyone if left unchecked. check out this old report. http://lib.bioinfo.pl/paper:10373738 ok they used an intra tracheal catheter at ten litres oxygen per minute. for four hours..I suspect with RSI and nasal cannula apnoeic oxygenation, the few minutes it takes to secure the airway is not going to worsen CO2 and acidosis too much.
This passive oxygenation technique adds more evidence to the fact we shouldn't be rushing to get that tube in for the cardiac arrest patient. By just compressing the chest wall you are already causing a degree of ventilation and if high flow oxygen is on, the oxygenation part is already taken care of. Any thoughts on in???
When are you coming to play on our island? Prince Edward Island would love to have you come visit. You can even bring Stuart if he is allowed back in Canada.
Mel, Don't tell my staff, but with passive oxygenation, you once again proved what I don't know. They have been for years slipping the nasal cannula underneath the non-rebreather, only to have me trip over it and angrily pull it off. Now I will still trip over it on the way to the head of the bed, but I will leave it on!
Episode 127Full episode audio for MD edition239:21 min - 100 MB - M4AC3 Project Written Summary: Diarrhea150 KB - PDFEM:RAP April 2012 Written Summmary1 MB - PDF
Minh L., Dr - April 4, 2012 1:37 PM
Mel, thanks for organising and recording this great interview between Darren and Richard. I really enjoy and learn from EMRAP because you dont shy away from controversy and allow debate to be heard on areas of clinical practice that are not clear cut. The rants are often very insightful and cut through a lot of bullshit but still present two sides of the story. Your narrative is always amusing and a good summary to the dialogue. I am obsessed with all things airway in emergency medicine and this segment gives me my monthly fix! Congratulations from a happy customer
Mel H. - April 7, 2012 8:26 AM
Darren Braude is doing a great job - lots more coming...thanks
brendan c. - April 9, 2012 9:11 AM
the big caveat is the tachypneic, sepsis patient where there is pre-existing acidosis (with respiratory compensation) and rising CO2 and acidosis may just kill them. Having said that, I've tried it and LOVE this technique. Awesome to hear it from the Master.
Minh L., Dr - April 13, 2012 4:22 AM
thankyou Brendan. rising CO2 and acidosis may kill them. Enemy Hypoxia will kill everyone if left unchecked. check out this old report.
http://lib.bioinfo.pl/paper:10373738
ok they used an intra tracheal catheter at ten litres oxygen per minute. for four hours..I suspect with RSI and nasal cannula apnoeic oxygenation, the few minutes it takes to secure the airway is not going to worsen CO2 and acidosis too much.
jairo u. - April 17, 2012 11:55 AM
This passive oxygenation technique adds more evidence to the fact we shouldn't be rushing to get that tube in for the cardiac arrest patient. By just compressing the chest wall you are already causing a degree of ventilation and if high flow oxygen is on, the oxygenation part is already taken care of. Any thoughts on in???
Trevor J. - April 23, 2012 7:54 AM
Hey Mel,
When are you coming to play on our island? Prince Edward Island would love to have you come visit. You can even bring Stuart if he is allowed back in Canada.
Cheers!
Trevor
Kevin M. - April 25, 2012 7:23 PM
Mel,
Don't tell my staff, but with passive oxygenation, you once again proved what I don't know. They have been for years slipping the nasal cannula underneath the non-rebreather, only to have me trip over it and angrily pull it off. Now I will still trip over it on the way to the head of the bed, but I will leave it on!
David F. - August 8, 2012 6:29 AM
I really enjoyed the information in thie lecture. Thank you, Darren and Richard.
Jeff - October 7, 2012 4:22 PM
I've used this approach with good success. I recently implemented it as a required technique for all of my paramedic's RSIs. Thanks!