a nextgen learning space designed to elevate your airway practice
Resuscitate Before You Intubate
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.” To do that you will have to expand your concept of the difficult airway into the physiologic space so that you can protect your patients from harm. We show you how here.
masterclass with Sara Murphy
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 Critical Care Faculty – Director of the Physiologically Difficult Airway Installation
Where to start
Resuscitate before you intubate! Okay… but how? This learning space is where the rubber meets the road.
pressure – focus on hypotension
1 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
preox – Focus On Hypoxia
2 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 need more advanced pre-oxygenation techniques to provide a safe level of oxygenation prior to intubation.
ph – Focus On acidemia
3 Severe acidosis, puts the patient at risk of postintubation cardiac arrest due to the rapid rise of pCO2 during the apneic period. This station will cover the basics of both metabolic and respiratory acidosis and give you a strategy to prevent post-intubation cardiac arrest and death by hydrogen ion.
the PUMP – Focus On rv failure
4 During intubation, positive pressure ventilation rapidly increases the RV’s afterload while simultaneously decreasing the preload. This leads to decreased LV filling, decreased cardiac output, and eventually, cardiovascular collapse. This section of the installation will teach you how to assess and mitigate the risks of RV dysfunction.
Sure you could stop here, but why would you? Use the digital content in this space for guided self-practice in our pop-up installations, listen to the podcast, or dive into any of the related content below. 👇