nextgen learning to elevate your airway practice
Introduction
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Pre-Ox, Ap-Ox, and Re-Ox are concepts and skills essential for a successful intubation strategy that prioritizes safety.
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Pre-Oxygenation
Rapid Review
What is pre-ox
Pre-oxygenation is a procedure used to improve safe apnea time and provide you with an increased margin of safety during laryngoscopy when your patient is apneic and no positive pressure ventilation is occurring.
Standard Pre-Ox
Standard pre-oxygenation includes administering 100% oxygen for 3-5 minutes using the technique below. If the patient can cooperate, you can ask them to take 7-8 deep breaths to speed up denitrogenation.
Optimize Your Pre-OX
Let’s dig into the details of how to perform effective standard pre-oxygenation prior to RSI and any intubation attempt.
Troubleshooting
Apneic Oxygenation
Extend your safe apnea time
Apneic oxygenation (AP-OX) provides a passive oxygen flow into the alveoli because of the different rates of alveolar oxygen absorption and carbon dioxide excretion. A mass flow of gas from the upper respiratory tract into the lungs is created. It is a SUPPLEMENTAL PRE-OX technique and not a primary means of preoxygenation. It works best in patients without airway obstruction or physiological shunting. It can add an additional layer of safety to your pre-ox strategy.
Evidence Based
CURATED meded
Watch this video from one of our favorite MedEd resources and learn a bit more about successful approaches and pitfalls during pre-oxygenation.
Re-Oxygenation
Reoxygenation is the application of positive pressure ventilation during airway management in order to return oxygen stores to the functional residual capacity (FRC). By returning low oxygen saturations to normal levels, you can restore the safe apnoea time and allow for further interruption to alveolar oxygen delivery in further intubation attempts.
What’s Next
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