Pre-oxygenation: Implications in emergency airway management

Pourmand, Ali; Robinson, Chelsea; Dorwart, Kelsey; O’Connell, Francis

doi:10.1016/j.ajem.2017.06.006

Cited by 28 publications

(43 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Desaturation and subsequent hypoxemia during intubation are associated with serious complications (e.g., myocardial ischemia and unfavorable neurological outcomes) . The main goals of preoxygenation are to extend the duration of safe apnea and to prevent hypoxemia during the apneic phase of intubation.…”

Section: Preparationmentioning

confidence: 99%

Advancing emergency airway management practice and research

Goto

Hagiwara

et al. 2019

Acute Medicine & Surgery

View full text Add to dashboard Cite

Emergency airway management is one of the vital resuscitative procedures undertaken in the emergency department (ED). Despite its clinical and research importance in the care of critically ill and injured patients, earlier studies have documented suboptimal intubation performance and high adverse event rates with a wide variation across the EDs. The optimal emergency airway management strategies remain to be established and their dissemination to the entire nation is a challenging task. This article reviews the current published works on emergency airway management with a focus on the use of airway management algorithms as well as the importance of first‐pass success and systematic use of rescue intubation strategies. Additionally, the review summarizes the current evidence for each of the important airway management processes, such as assessment of the difficult airway, preparation (e.g., positioning and oxygenation), intubation methods (e.g., rapid sequence intubation), medications (e.g., premedications, sedatives, and neuromuscular blockades), devices (e.g., direct and video laryngoscopy and supraglottic devises), and rescue intubation strategies (e.g., airway adjuncts and rescue intubators), as well as the airway management in distinct patient populations (i.e., trauma, cardiac arrest, and pediatric patients). Well‐designed, rigorously conducted, multicenter studies that prospectively and comprehensively characterize emergency airway management should provide clinicians with important opportunities for improving the quality and safety of airway management practice. Such data will not only advance research into the determination of optimal airway management strategies but also facilitate the development of clinical guidelines, which will, in turn, improve the outcomes of critically ill and injured patients in the ED.

show abstract

Section: Preparationmentioning

confidence: 99%

Advancing emergency airway management practice and research

Goto

Hagiwara

et al. 2019

Acute Medicine & Surgery

View full text Add to dashboard Cite

show abstract

“…9 Common practice in emergency settings to achieve adequate preoxygenation is to ensure SpO 2 levels > 93% for at least 3 minutes. 10 Unfortunately, this practice may not adequately predict adequate preoxygenation. 11 End-tidal oxygen (EtO 2 ) is a commonly measured value in anesthesia and, when > 85%, is considered an indication of adequate denitrogenation and preoxygenation.…”

mentioning

confidence: 99%

Is adequate preoxygenation about more than just 3 minutes?

Jarvis

King

2020

JACEP Open

View full text Add to dashboard Cite

“…The use of an NMBA results in the cessation of spontaneous ventilation and consequently an interruption of alveolar oxygen delivery. A crucial step in maximizing the safety of RSI is preoxygenation, which creates a large intrapulmonary oxygen reservoir that can be utilized during the period of apnea until mechanical ventilation can be initiated . Even with preoxygenation, a significant number of patients undergoing RSI in the ED experience desaturation .…”

mentioning

confidence: 99%

“…While apneic oxygenation recently has come into vogue for emergent intubation, perhaps the issue that warrants greater consideration is the provision of proper preoxygenation in the critically ill . Increased attention to this crucial step of RSI is likely to reduce the likelihood of desaturation in the critically ill and thus have the greatest impact on patient safety .…”

mentioning

confidence: 99%

Maintenance of Oxygenation During Rapid Sequence Intubation in the Emergency Department

Sakles

2017

Academic Emergency Medicine

View full text Add to dashboard Cite

Pre-oxygenation: Implications in emergency airway management

Cited by 28 publications

References 37 publications

Advancing emergency airway management practice and research

Advancing emergency airway management practice and research

Is adequate preoxygenation about more than just 3 minutes?

Maintenance of Oxygenation During Rapid Sequence Intubation in the Emergency Department

Contact Info

Product

Resources

About