Clinical Case 081: Intubation Procrastination

This is my first Clinical Case on the podcast.  So hope you like the format – it is a bit mixed media.

Here is what I want you to do – first listen to the podcast below,  take your time to think it over and then give me your opinion.


Either write a comment on the comment section or (and) click on the option in the poll below that best describes your preferred plan.

If you are still procrastinating – then check out the Cricon post from Scott W at Emcrit

Great way to plan your approach and get the team ready

OK – a week or so later and the results are in!   Here is what the 41 people who took the poll said they would do –

Click here to view the survey results.  As you can see the vast majority waned to get control of the airway and do a planned, NO DESAT type induction – which is reflective of the practice in big hospitals (I suspect the readers).

What would I do [what have I done in this scenario]:

I was one of the 3 respondents who decided to stick it out with the NIV and get him through the night.  Of course we also needed to plan for the worst – had the kit and team briefed for a difficult airway etc

So I called off the RFDS / evacuation team and we optimised the NIV and medical therapy, minimised oxygen consumption.

And we had a win – weaned off the NIV 12 hours later.

Not a popular call, but I think a good outcome for all concerned.  As Kurt would say: ” and so it goes…”

Casey

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