Rapid Sequence Awake Intubation

00:00
20:06

Playback Speed

No me gusta!

The flash player was unable to start. If you have a flash blocker then try unblocking the flash content - it should be visible below.

Nurses Edition Commentary

Mizuho Spangler, DO, Lisa Chavez, RN, and Kathy Garvin, RN
00:00
01:04

Playback Speed

No me gusta!

The flash player was unable to start. If you have a flash blocker then try unblocking the flash content - it should be visible below.

Todd H. -

good morning...

great case...

Was the intubation done thru nasal fiberoptic or oral... if oral... was the patient supine??? if oral was a bite bloc used to prevent the teeth from clamping on the tube??

Jess Mason -

The Intubatuon was oral, sitting upright, no bite block.

Todd H. -

so essentialy, you loaded the 6.5 ETT with a fiberoptic scope...hooked the scope to the screen so you could do video fiberoptic... put the pre-loaded ETT witht he scope past the oropharnx into larynx..threaded fiberoptic past vocal cords and passed tube over scope???

wow

great job... Jessica that takes kahonas to do this on a colleague!!!
did you consider nasal...

Jess Mason -

Just to be clear, I did NOT do this intubation - just sharing the case because it is so unique with so many good learning points, I felt compelled to tell it on EMRAP. And yes, that is exactly how they did it.

Todd H. -

just curious

who did the intubation??? was it the ED team?? anesthesia???

it is still heroic work!!!!

Jess Mason -

I believe it was anesthesia, but I think ENT was there as well. Sounds like it was an all hands on deck situation.

ryan harris -

http://www.alcovemedical.com/ez-100g/

Link for ordering EZ sprayer from emcrit.org.

Ryan M. -

Any thoughts to IV Lidocaine to blunt the wretching caused by the airway reflex?

Jess Mason -

Per Scott Weingart:

"Giving an IV anesthetic like lidocaine may sedate the patient and be counterproductive. Ondansetron may be a better choice if you really want to treat this, but I don't bother."

David L., M.D. -

This type of difficult airway (anatomy distorted at laryngeal inlet) may not allow tube passage. Any thoughts about emphasising the need to preparing for a surgical airway in this context?

To join the conversation, you need to subscribe.

Sign up today for full access to all episodes and to join the conversation.

To download files, you need to subscribe.

Sign up today for full access to all episodes.
Break Through The Plateau Full episode audio for MD edition 244:17 min - 340 MB - M4AEM:RAP 2016 Juillet Résumé en Francais Français 36:30 min - 50 MB - MP3EM:RAP 2016 July Aussie Edition Australian 30:02 min - 41 MB - MP3EM:RAP 2016 July Canadian Edition Canadian 28:33 min - 39 MB - MP3EM:RAP 2016 July German Edition Deutsche 146:43 min - 202 MB - MP3EM:RAP 2016 Julio Resumen Español Español 79:25 min - 109 MB - MP3EM:RAP 2016 July Board Review Answers 162 KB - PDFEM:RAP 2016 July Board Review Questions 499 KB - PDFEM:RAP 2016 July Individual MP3 291 MB - ZIPEM:RAP 2016 July Written Summary 522 KB - PDFEMRAP Resumen en Español Julio 2016 1 MB - PDF