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The First Rule of Emergency Airway — Prioritize Oxygenation

How to Understand & Implement This Most Important of Emergency Airway Concepts

Failure to prioritize oxygenation is the greatest mistake you can make in emergency airway management.

Read This Airway Letter – About Prioritizing Oxygenation

Understand the stress-related killers

In order to act effectively, you have to understand the adverse effects of stress. When faced with a hypoxic patient stress hormones will affect your judgement. Here are three stress related killers all clinicians need to learn to identify and be able to address so you can act to prioritize oxygenation.

  • Impaired Recall. You may have been able to recite the latest airway textbook chapter and verse on the subway to work, but add the chaotic environment of a crash airway into the mix and suddenly your memory recall isn’t so great.
  • Normalcy bias. When facing a disaster many people arrive at a mental state called normalcy bias, causing them to underestimate the impending consequences of inaction.
  • Focus Lock. As the stress mounts the desire to try and succeed with one more attempt at endotracheal intubation becomes a thought that overrides all others. Meanwhile your patient’s oxygen level drops to levels not compatible with life. This is focus lock.

Now it’s time to learn about the Vortex Approach and how to think about your three upper airway lifelines.

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