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The Physiologically Difficult Airway

nextgen learning designed to elevate your airway practice

000 -Introduction

There’s a dangerous intersection between critically ill physiology and intubation. If you don’t want to crash and burn, you must pay attention to the number one rule of the road “resuscitate before you intubate.” In this space we will expand your understanding of what makes an airway difficult, and show you an effective method for navigating the dangerous physiology of the peri-intubation period, so that you can protect your patients from the negative impact that medications, endotracheal tube placement, and positive pressure ventilation can have on critically ill patients. 

meet the creator

If “resuscitate before you intubate” is the meme of the physiologically difficult airway, then the four P’s of peri-intubation resuscitation are its organizing principle.

— Sara Murphy DO, Critical Care Faculty – Director of the Physiologically Difficult Airway Installation

Map Your own Journey

We design education programs that merge digital and physical space for an enhanced learning experience. Move seamlessly between them and follow your own path.

Resuscitate Before You Intubate

001 – identify danger

Resuscitate before you intubate! Okay, but how? This learning space is where the rubber meets the road, so let’s start with the shock index. A cognitive tool to help you predict danger during the peri-intubation period.

010 – pressure

Peri-intubation hypotension is an independent risk factor for cardiac arrest, longer ICU stays, and in-hospital mortality. Vasodilation, loss of intrinsic sympathetic surge, and increased intrathoracic pressure from positive pressure ventilation are all potential hazards of intubation. Learn how to avoid these risks and protect your patients from peri-intubation hypotension

020 – pre-ox

Safe apnea time is a cornerstone of safe airway management, but the rate at which oxygen is consumed increases substantially in the critically ill, and shunt physiology means you may need more advanced pre-oxygenation techniques to provide a safe level of oxygenation prior to intubation.

030 – PH

Severe acidosis, puts your patient at risk of post-intubation cardiac arrest due to the rapid rise of pCO2 during the apneic period. We cover the basics of both metabolic and respiratory acidosis and give you a strategy to prevent post-intubation death by hydrogen ion.

PUMP – Focus On rv failure

During intubation,  positive pressure ventilation rapidly increases the RV’s after load while simultaneously decreasing preload. This diminishing cardiac output, can spiral into cardiovascular collapse without the ability to assess and mitigate the risks of RV dysfunction.

integrated simulations

Turn this learning space into an immersive flipped classroom and test your knowledge in our simulation.

What’s Next

Sure you could stop here, but why would you? Use the guided practice resources in this space in our pop-up installations, come to one of our live events, or dive into any of the theme based learning spaces below.👇

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