Flush rate oxygen for emergency airway preoxygenation. Quality Of Evidence ?ĭriver BE, Prekker ME, Kornas RL, et al. *Dosing is based on total body weight for succinylcholine and ideal body weight for rocuronium. Succinylcholine will not wear off fast enough to prevent harm in CICO.TBI is not a contraindication for ketamine as it has not been shown to increase ICP.Ketamine can cause hypotension at doses greater than 1.5mg/kg or in patients that are catecholamine deplete from their underlying disease.Common ED delivery methods with lower oxygen flow rates will not deliver 100% FiO 2 and thus will not adequately pre-oxygenate prior to RSI.Direct visualization of ETT passing through vocal cords.Cricoid pressure has also been shown to increase the difficulty of tracheal intubation.
No evidence of cricoid pressure reducing the risk of aspiration.External laryngeal manipulation (BURP maneuver) may improve visualization of glottis.Once oxygen saturation drops below 93%, resume BMV to oxygenate and optimize the plan before re-attempting intubation.Video laryngoscopy is quickly becoming the preferred intubation device.Wait 45 seconds after succinylcholine or 60 seconds after rocuronium administration prior to laryngoscopy. There is a shift towards rocuronium given succinylcholine’s multiple contraindications (table 2).Be prepared to treat hypotension with vasopressors. All induction agents are direct myocardial depressants.Ketamine is preferred for induction in hemodynamically unstable patients (table 1).Consider non-invasive positive pressure ventilation for hypoxemic or morbidly obese patients.
Apneic oxygenation has been shown to increase safe apnea time in obese patients and reduce incidence of hypoxemia during RSI.
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