Podcasts about Intubation

The JournalFeed podcast for the week of June 1-5, 2026.These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.Monday's Spoon Feed:This review covers airway management of patients in the acute care (i.e. ED or ICU) setting. It's a solid 16 pages long, so we'll summarize 10 things we know now and what questions we still have.Wednesday's Spoon Feed:A purpose-driven video game can improve triage of elderly trauma patients.

Dr. Will Heuser join the crew in a an altered LOC mystery! Intubation, a mystery of a history, and a blood pressure that is not cooperating with authorities. Will and the guys will also be at FAST26, get your tickets now! fbefast.com

Send us Fan MailCheck our the full viva in the Final Exam Coursehttps://anaesthesia.thinkific.com/courses/FinalExamYou are the duty anaesthetist at a busy tertiary hospital. Your provisional fellow calls you forurgent assistance with an airway emergency.They have performed a rapid sequence induction and attempted to intubate a 22-year-old manfor a Per-Oral Endoscopic Myotomy (POEM) procedure for type 2 achalasia in the maintheatres.Intubation was attempted with a videolaryngoscope and hyperangulated blade. The percentageof glottic opening visible was 10% and they were unable to pass the endotracheal tube or agum elastic bougie. They were then unable to bag-mask ventilate the patient but successfullyplaced a second generation supraglottic airway. Ventilation has been restored, and greentinged fluid has been noted in the gastric port.Current observations are:HR 95 bpmBP 97/56 mmHgSpO2 90% on FiO2 1.0ETCO2 41 mmHg (5.47 kPa)TV 400 mL with a small air leakWeight 169 kgHeight 199 cmBMI 42 kg/m2Past Medical HistoryType 2 achalasiaClass III obesityAttention deficit hyperactivity disorderMild developmental delaySevere anxietyMedicationLisdexamfetamine 70 mg once dailyMelatonin 4 mg nocteDiazepam 10 mg was given orally preoperativelyAllergiesNil knownWhat are your priorities in managing this situation?---------Find us atInstagram: https://www.instagram.com/abcsofanaesthesia/Twitter: https://twitter.com/abcsofaWebsite: http://www.anaesthesiacollective.comPodcast: ABCs of AnaesthesiaPrimary Exam Podcast: Anaesthesia Coffee BreakFacebook Page: https://www.facebook.com/ABCsofAnaesthesiaFacebook Private Group: https://www.facebook.com/groups/2082807131964430---------Check out all of our online courses and zoom teaching sessions here!https://anaesthesia.thinkific.com/collectionshttps://www.anaesthesiacollective.com/courses/---------#Anesthesiology #Anesthesia #Anaesthetics #Anaesthetists #Residency #MedicalSchool #FOAMed #Nurse #Medical #Meded ---------Any questions please email abcsofanaesthesia@gmail.com---------Disclaimer: The information contained in this video/audio/graphic is for medical practitioner education only. It is not and will not be relevant for the general public.Where applicable patients have given written informed consent to the use of their images in video/photography and aware that it will be published online and visible by medical practitioners and the general public.This contains general information about medical conditions and treatments. The information is not advice and should not be treated as such. The medical information is provided “as is” without any representations or warranties, express or implied. The presenter makes no representations or warranties in relation to the medical information on this video. You must not rely on the information as an alternative to assessing and managing your patient with your treating team and consultant. You should seek your own advice from your medical practitioner in relation to any of the topics discussed in this episode' Medical information can change rapidly, and the author/s make all reasonable attempts to provide accurate information at the time of filming. There is no guarantee that the information will be accurate at the time of viewingThe information provided is within the scope of a specialist anaesthetist (FANZCA) working in Australia.The information presented here does not represent the views of any hospital or ANZCA.These videos are solely for training and education of medical

In this high-yield, no-fluff episode, Dennis is joined by Dr. Michael Falk, a pediatric emergency medicine physician, former academic, and combat-experienced relief worker who has run airways in Haiti post-earthquake, Mosul during the ISIS fight, Ukraine, and Gaza. They break down exactly why pediatric airways are a completely different beast in prolonged field care and give you field-proven tactics that actually work when you're the only one there with a BVM and a prayer.Key Takeaways You Can Use TomorrowPositioning is everything: One to two inches under the shoulders (or whole body) prevents automatic obstruction from the massive occiput.Adjuncts > early tube: NPA or OPA + side-lying (gravity is your friend) can keep you from tubing in the field.Tube sizing rule: Child's pinky ≈ ET tube diameter. Depth = 3× tube size. Always go smaller — you can ventilate, you can't un-damage a ripped airway.Intubation mindset: Kid airway is more anterior and cephalad. Slow down, work your way in, or you'll be in the esophagus.GCS decision:

Contributor: Alec Coston, MD Educational Pearls: What are nasal intubations and when do we use them? Nasal intubations function similarly to oral intubations with the end goal of passing an endotracheal tube (ETT) through vocal cords and into the trachea to allow for a patent and secure airway, but differ in the main access point for the ETT (nare v.s. mouth). Nasal Intubations are seldom preferred to oral intubations as they carry risk for inducing bleeding from trauma to the nasal passages.  Indications for nasal intubations include: Anatomical abnormalities that may make access through the mouth difficult (i.e. tumors, macroglossia, or rare dental hardware that clenches the jaw shut). Physiological states such as severe angioedema.  Nasal intubations are often done with the patient awake and could be advantageous if the patient is presenting in a severely hypoxic state such that prolonged hypoxia in a traditional RSI protocol may be detrimental. A 2023 retrospective analysis in Germany found that nasal intubations were associated with requiring less sedation than oral intubations and had more spontaneous breathing during hospitalization than oral intubations. How is a nasal intubation performed? Consider the use of an anxiolytic medication such as versed to calm the patient down but not fully sedate them. If there is adequate time without immediate patient compromise, consider glycopyrrolate to reduce airway secretions and dry up the mucous membranes. Consider the use of Afrin or other local vasoconstrictor in target nare to minimize epistaxis.    Use 5% lidocaine ointment and lubricate an NPA and place it into the target nare. This will allow for local anesthesia as well as help to open up the nare slightly more.  Take 5% lidocaine ointment and place it on a tongue depressor and move it around the back of the tongue, allowing it to further anesthetize the oropharynx.  Remove the NPA and atomize/nebulize 4% lidocaine liquid into the nare and into the oropharynx for further anesthesia.  Insert the ETT without the bronchoscope through the nare and allow it to pass about 10 cm until visible in the oropharynx. This allows for a "clean" plastic tunnel to pass the bronchoscope through. Advance both the ETT and bronchoscope, spraying lidocaine through the bronchoscope while advancing to allow for continued numbing.  Pass the ETT through the cords and inflate.  At this point, stronger sedation medications such as ketamine and propofol may be considered but the use of a paralytic like succinylcholine and rocuronium may not be needed to allow the patient to maintain their own negative pressure ventilation.  Which nare is the best to go through? Most patients will have their right nare be the best (away from the septal deviation) according to a meta-analysis by Tan et al.  The right nare was generally associated with less epistaxis and lower intubation times.  However, do not always default to the right nare, and test which nare is more patent by occluding one nare at a time and assessing which one is less resonant  (less resonant = more patent).  Key Takeaway? Nasal intubations are rarer than oral intubations and can be more technically difficult, but may offer advantages in patients with difficult oral airways, but should never be first line.    References: Grensemann J, Gilmour S, Tariparast PA, Petzoldt M, Kluge S. Comparison of nasotracheal versus orotracheal intubation for sedation, assisted spontaneous breathing, mobilization, and outcome in critically ill patients: an exploratory retrospective analysis. Sci Rep. 2023;13:12616. doi:10.1038/s41598-023-39768-1 Tan YL, Wu ZH, Zhao BJ, Ni YH, Dong YC. For nasotracheal intubation, which nostril results in less epistaxis: right or left?: A systematic review and meta-analysis. Eur J Anaesthesiol. 2021;38(11):1180-1186. doi:10.1097/EJA.0000000000001462 Holzapfel L. Nasal vs oral intubation. Minerva Anestesiol. 2003;69(5):348-352.   Summarized by Dan Orbidan, OMS2 | Edited by Dan Orbidan & Ahmed Abdel-Hafiz, NREMT-P   Donate: https://emergencymedicalminute.org/donate/   Join our mailing list: http://eepurl.com/c9ouHf

Contributor: Aaron Lessen, MD Educational Pearls: How long do we need to watch patients with a presumed overdose who were treated with naloxone in the field? A 2025 study in the Annals of Emergency Medicine took a look at this question Methods Prospective, multi-institutional cohort study Included ED patients with suspected acute opioid overdose with biologic testing to confirm substances. This paper performed a secondary analysis evaluating the risk of "delayed intubation," defined as intubation occurring >4 hours after ED arrival. Results 1,591 patients with presumed opioid overdose were included. Delayed intubation occurred in only 9 patients (0.6%). 8 of the 9 cases had non-respiratory causes contributing to intubation. Only 1 patient had respiratory-related deterioration, presenting with respiratory acidosis after receiving 6.4 mg naloxone prior to intubation. Key Takeaway Delayed respiratory deterioration requiring intubation after 4 hours of ED monitoring is extremely rare, suggesting prolonged monitoring may not be necessary for most stabilized overdose patients. How else can we mitigate risk? Give patients take-home naloxone at discharge and educate them on how to use it (See Episode 673: Leaving the ED with Naloxone). When are naloxone drips necessary? If a patient requires repeated naloxone boluses, consider a drip To get the dose, take the total naloxone dose that restored adequate breathing and give two-thirds of that dose per hour Typically these patients are admitted to the ICU References McCabe DJ, Gibbs H, Pratt AA, Culbreth R, Sutphin AM, Abston S, Li S, Wax P, Brent J, Campleman S, Aldy K, Falise A, Manini AF; ToxIC Fentalog Study Group. Risk of Delayed Intubation After Presumed Opioid Overdose in the Emergency Department. Ann Emerg Med. 2025 Jun;85(6):498-504. doi: 10.1016/j.annemergmed.2025.01.022. Epub 2025 Mar 4. PMID: 40047773; PMCID: PMC12955731. Summarized and edited by Jeffrey Olson MS4 Donate: https://emergencymedicalminute.org/donate/ Join our mailing list: http://eepurl.com/c9ouHf

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🧭 REBEL Rundown 📌 Key Points 💨 HFNC met criteria for non-inferiority to BPAP for preventing intubation or death within 7 days in four of the five ARF subgroups.🧪 Bayesian dynamic borrowing increased power across subgroups but created variable certainty, especially in smaller groups such as COPD.🫁 The immunocompromised hypoxemia subgroup did not meet non-inferiority, leading to early trial stopping for futility.️ Rescue BPAP use, subgroup-specific exclusion criteria, and non-standardized BPAP delivery are important contextual factors that influence how subgroup results should be interpreted. Click here for Direct Download of the Podcast. 📝 Introduction Bilevel Positive Airway Pressure (BPAP) has long been a foundational modality in the management of acute respiratory failure (ARF), particularly in COPD exacerbations and cardiogenic pulmonary edema, where it can rapidly reduce work of breathing and improve gas exchange. It remains a core tool in our respiratory support arsenal.High-flow nasal cannula (HFNC), however, has expanded what we can offer patients by delivering many of the same physiologic benefits through a far more comfortable interface. With high flows, modest PEEP, and effective dead-space washout, HFNC can improve oxygenation and decrease work of breathing while preserving the ability to talk, cough, eat, and interact with staff and family. This combination of physiologic support and tolerability makes HFNC especially attractive in patients where comfort, anxiety, or cardiovascular stability are key considerations, and in settings where prolonged noninvasive support may be needed. Rather than competing with BPAP, HFNC broadens our options in ARF and allows us to better match the modality to the patient and their underlying disease process.The RENOVATE trial set out to answer a high-impact question across five distinct etiologic groups: Is HFNC non-inferior to BPAP (NIV) for preventing intubation or death in acute respiratory failure? 🧾 Paper Azoulay É, et al. High-Flow Nasal Oxygen vs Noninvasive Ventilation in Patients With Acute Respiratory Failure: The RENOVATE Randomized Clinical Trial. JAMA. 2025 PMID: 39657981 🔙Previously Covered On REBEL: HFNC: Part 1 – How It WorksHFNC: Part 2 – Adult and Pediatric IndicationsFLORALI and AVOID TrialFLORALI-2: NIV vs HFNC as Pre-Oxygenation Prior to IntubationThe Pre-AeRATE Trial – HFNC vs NC for RSI ️ What They Did CLINICAL QUESTION Is HFNC non-inferior to BPAP for rate of endotracheal intubation or death at 7 days in patients with acute respiratory failure due to a variety of causes? STUDY DESIGN Multicenter, randomized non-inferiority trial33 Brazilian hospitalsNov 2019 – Nov 2023Adaptive Bayesian hierarchical modeling with dynamic borrowingOpen label, outcome adjudicators blindedPatients were classified into 5 subgroups SUBGROUPS 1. Non-immunocompromised hypoxemiaSpO₂ < 90% on room air orPaO₂ < 60 mm Hg on room air plusIncreased respiratory effort (accessory muscle use, paradoxical breathing, thoracoabdominal asynchrony) orRespiratory rate > 25 breaths/min2. Immunocompromised hypoxemiaDefined as:Use of immunosuppressive drugs for >3 monthsOR high-dose steroids >0.5 mg/kg/dayOR solid organ transplantOR solid tumors or hematologic malignancies (past 5 years)OR HIV with AIDS / primary immunodeficiency3. COPD exacerbation with acidosisHigh clinical suspicion of COPD as primary diagnosisRR >25 with accessory muscle use, paradoxical breathing, and/or thoracoabdominal asynchronyABG: pH 454. Acute cardiogenic pulmonary edema (ACPE)Sudden onset dyspnea and rales± S3 heart soundNo evidence of aspiration, infection, or pulmonary fibrosisCXR consistent with pulmonary edema5. Hypoxemic COVID-19 (added June 2023)Added due to deviations between expected and observed outcome proportionsAny patient across the other 4 groups with PCR-confirmed SARS-CoV-2 infection in any of the above groups POPULATION Inclusion Criteria:≥18 yrs with ARF* in one of 5 pre-defined subgroups excluding COPD was defined by the following:Hypoxemia with SpO₂

We were all taught succinylcholine is contraindicated in hyperkalemia because it can cause potassium release, exacerbating the problem. But does it? Does it really?Dr. Jarvis discusses a recent paper that seems to compare mortality within 24 hours of RSI in hyperkalemic patients between those intubated with succ or rocuronium. And then we discuss methods.. including the Table 1 Fallacy. Citations:1.     Simmer PE, Perza M, Cho YD, et al.: Hyperkalemic emergency department patients intubated with rocuronium or succinylcholine: Retrospective study of clinical outcomes. The American Journal of Emergency Medicine. 2026; February;100:154–64.2.     Cole JB, Knack SKS, Driver BE: The value of P-values in “Table 1.” The American Journal of Emergency Medicine. 2026; February;100:182–6.3.     Pappal RD, Roberts BW, Mohr NM, et al.: The ED-AWARENESS Study: A Prospective, Observational Cohort Study of Awareness With Paralysis in Mechanically Ventilated Patients Admitted From the Emergency Department. Ann Emerg Med. 2021;77(5):532–44.4.     ‘Rick & Jerry' Pass the Baton | Emergency Physicians Monthly. Available at https://epmonthly.com/article/rick-jerry-pass-the-baton/. Accessed January 25, 2026.

Send us a textDie Wahl des Hypnotikums zur Notfallintubation kritisch kranker Patient:innen ist seit Jahren Gegenstand intensiver Diskussionen. In dieser Episode analysieren wir die RSI-Studie aus dem New England Journal of Medicine, die Ketamin und Etomidat hinsichtlich Mortalität und kardiovaskulärer Komplikationen während der Intubation systematisch vergleicht.Casey JD, Seitz KP, Driver BE, et al.; for the RSI Investigators and the Pragmatic Critical Care Research Group.Ketamine or Etomidate for Tracheal Intubation of Critically Ill Adults.New England Journal of Medicine. Published online December 9, 2025.DOI: 10.1056/NEJMoa2511420Die tracheale Intubation kritisch kranker Patient:innen ist mit einer hohen Morbidität und Mortalität assoziiert. Während Etomidat aufgrund seiner hämodynamischen Stabilität eingesetzt wird, bestehen seit Langem Bedenken hinsichtlich einer durch Etomidat induzierten Suppression der Nebennierenfunktion und möglicher negativer Effekte auf das Überleben. Ketamin gilt als Alternative, da es die Kortisolproduktion nicht hemmt, jedoch ebenfalls potenziell hämodynamische Nebenwirkungen aufweist.In einer pragmatischen, multizentrischen, randomisierten Studie wurden 2365 kritisch kranke Erwachsene in 14 Notaufnahmen und Intensivstationen in den USA entweder Ketamin oder Etomidat zur Narkoseeinleitung bei der endotrachealen Intubation zugeteilt. Der primäre Endpunkt war die Gesamtmortalität im Krankenhaus bis Tag 28. Als sekundärer Endpunkt wurde ein kardiovaskulärer Kollaps während der Intubation definiert, bestehend aus schwerer Hypotonie, neuem oder eskaliertem Vasopressorbedarf oder Herzstillstand.Die 28-Tage-Mortalität unterschied sich nicht signifikant zwischen den Gruppen (28,1 % unter Ketamin vs. 29,1 % unter Etomidat). Dieses Ergebnis war konsistent über alle präspezifizierten Subgruppen hinweg, einschließlich Patient:innen mit Sepsis oder septischem Schock, hoher Krankheitslast (APACHE-II-Score ≥ 20) sowie präinterventioneller Vasopressortherapie. Im Gegensatz dazu trat ein kardiovaskulärer Kollaps während der Intubation unter Ketamin signifikant häufiger auf als unter Etomidat, insbesondere bei Patient:innen mit Sepsis oder hoher Erkrankungsschwere.Die Ergebnisse der RSI-Studie zeigen, dass Ketamin im Vergleich zu Etomidat keine Reduktion der kurzzeitigen Mortalität bewirkt, jedoch mit einem erhöhten Risiko hämodynamischer Instabilität während der Intubation einhergeht. Damit liefern die Daten eine wichtige evidenzbasierte Grundlage für die individualisierte Auswahl des Induktionshypnotikums bei kritisch kranken Patient:innen.Weiterführende Literatur:1. Ketamine Versus Etomidate for Rapid Sequence Intubation: A Systematic Review and Meta-Analysis of Randomized Trials. Critical Care Medicine. 2025. Greer A, Hewitt M, Khazaneh PT, et al.2. Readdressing Rapid Sequence Induction and Intubation Using Ketamine or Etomidate: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.Medicine. 2025. de Morais LB, Radel-Neto GR, Dos Santos Valsecchi VA, Costa RA, Hueb W.3. Ketamine Versus Etomidate as an Induction Agent for Tracheal Intubation in Critically Ill Adults: A Bayesian Meta-Analysis.Critical Care. 2024. Koroki T, Kotani Y, Yaguchi T, et al.4. Society of Critical Care Medicine Clinical Practice Guidelines for Rapid Sequence Intubation in the Critically Ill Adult Patient. Critical Care Medicine. 2023. Acquisto NM, Mosier JM, Bittner EA, et al.

Mit zwölf Jahren sieht sie Franco Zeffirellis «La Traviata» im Fernsehen. Tief beeindruckt beschliesst sie, Opernsängerin zu werden. Während des Studiums erleidet sie nach einer unsachgemässen Intubation ein Stimmbandödem. Sie lehnt eine Operation ab und wählt den Weg der langsamen Heilung. Während anderthalb Jahren spricht und singt sie kaum. 1995 debütiert Damrau als Eliza in «My Fair Lady» in Würzburg. Bald darauf erobert sie als Königin der Nacht in Mozarts «Zauberflöte» die grossen Bühnen - von Wien bis New York. Kritiker loben ihre Technik und Bühnenpräsenz. Damrau gilt als Diva ohne Allüren. Als sie 2013 als Violetta in Verdis «Traviata» an der Mailänder Scala auf der Bühne steht, ist ihr Mädchentraum wahr geworden. Die Süddeutsche Zeitung schreibt, Damrau habe die höchste Stufe des Operngesangs erreicht: die Callas Stufe. Wie die Mutter zweier Söhne Bühne und Familie vereint, warum die Königin der Nacht zu ihren Lieblingsrollen zählt und weshalb sie sich als Bühnentier sieht, erzählt Diana Damrau in «Musik für einen Gast» bei Simon Leu. Die Musiktitel: - Giuseppe Verdi: La Traviata: 1. Act, E'strano (Maria Callas / Coro Cetra / Orchestra Sinfonica di Torina de la Rai / Gabriele Santina, Leitung) - Edvard Grieg: «Morgenstimmung», aus Peer Gynt (Berliner Philharmoniker / Herbert von Karajan, Leitung) - Wolfgang Amadeus Mozart: «Der Hölle Rache kocht in meinem Herzen», Arie der Königin der Nacht, aus «Die Zauberflöte» (Edda Moser, Sopran / Bayerisches Staatsorchester München / Wolfgang Sawallisch, Leitung) - Michael Jackson: Thriller - Richard Strauss: «Die Zeit, die ist ein sonderbar Ding». Arie der Marschallin aus «Der Rosenkavalier» (Philharmonia Orchestra / Elisabeth Schwarzkopf, Sopran / Otto Edelmann, Bass / Herbert von Karajan, Leitung) Der Einspieler: Wolfgang Amadeus Mozart: «O zittre nicht, mein lieber Sohn - Zum Leiden bin ich auserkoren». Rezitativ und Arie der Königin der Nacht, aus «Die Zauberflöte» (Diana Damrau, Sopran / Cercle de l'Harmonie / Jérémie Rhorer, Leitung)

 Endotrachael intubation is a highly important critical care procedure, and as such, clinicians are working to improve the procedure to ensure the best patient outcomes. As Stephanie DeMasi, MD, MS, assistant professor of emergency medicine at Vanderbilt University Medical Center, goes through the detailed review she wrote, along with her colleagues, on different evidence-based decisions clinicians face when intubating a patient, with host Eddie Qian, MD, Vanderbilt University Medical Center. Read Dr. DeMasi's paper, "Evidence-based Emergency Tracheal Intubation": https://www.atsjournals.org/doi/10.1164/rccm.202411-2165CI 

You've read about how this groundbreaking trial on ketamine vs etomidate for RSI "Changes Everything!" on the socials. Or perhaps "it's horribly biased and unnecessary... we're already knew all this!". Why? Well.. social media. Listen in as Dr Jarvis discusses not just this trial, but what the evidence landscape was before it was released. Why was it done, how was it done, what does it show, and how can we integrate it into our practice?Citations:1. Casey JD, Seitz KP, Driver BE, et al. Ketamine or Etomidate for Tracheal Intubation of Critically Ill Adults. N Engl J Med. Published online December 9, 2025.2. Jabre P, Combes X, Lapostolle F, et al. Etomidate versus ketamine for rapid sequence intubation in acutely ill patients: a multicentre randomised controlled trial. Lancet. 2009;374(9686):293-300. 3. Matchett G, Gasanova I, Riccio CA, et al. Etomidate versus ketamine for emergency endotracheal intubation: a randomized clinical trial. Intensive Care Med. 2022;48(1):78-91. 4. Koroki T, Kotani Y, Yaguchi T, et al. Ketamine versus etomidate as an induction agent for tracheal intubation in critically ill adults: a Bayesian meta-analysis. Crit Care. 2024;28(1):48. 5. Yeh RW, Valsdottir LR, Yeh MW, et al. Parachute use to prevent death and major trauma when jumping from aircraft: randomized controlled trial. BMJ. 2018;363:k5094. doi:10.1136/bmj.k5094

In this World Shared Practice Forum Podcast, Dr. Vinay Nadkarni discusses emergent tracheal intubation in pediatric critical care. Drawing from the NEAR4KIDS registry and comparing with recent adult-focused evidence, Dr. Nadkarni discusses the challenges of airway management in children, emphasizing the importance of patient-specific physiology. He highlights how patient positioning and equipment choices can improve intubation outcomes. Additionally, the episode explores the benefits of video laryngoscopy and apneic oxygenation. This content is pertinent for healthcare professionals seeking to enhance their understanding of pediatric airway management, offering practical insights supported by recent research. LEARNING OBJECTIVES - Compare pediatric and adult emergency tracheal intubation evidence and practices - Explore the role of the NEAR4KIDS registry in improving pediatric intubation practices - Identify effective strategies to enhance first-attempt success in tracheal intubations - Assess the impact of patient positioning and equipment choices on intubation outcomes - Evaluate the benefits of video laryngoscopy and apneic oxygenation in pediatric settings AUTHORS Vinay Nadkarni, MD, MS Professor, Anesthesiology Critical Care and Pediatrics University of Pennsylvania Perelman School of Medicine Jeffrey Burns, MD, MPH Emeritus Chief Division of Critical Care Medicine Department of Anesthesiology, Critical Care and Pain Medicine Boston Children's Hospital Professor of Anesthesia Harvard Medical School DATE Initial publication date: November 25, 2025. ARTICLES REFERENCED - DeMasi SC, Casey JD, Semler MW. Evidence-based Emergency Tracheal Intubation. Am J Respir Crit Care Med. 2025;211(7):1156-1164. doi:10.1164/rccm.202411-2165CI - Garcia-Marcinkiewicz AG, Kovatsis PG, Hunyady AI, et al. First-attempt success rate of video laryngoscopy in small infants (VISI): a multicentre, randomised controlled trial. Lancet. 2020;396(10266):1905-1913. doi:10.1016/S0140-6736(20)32532-0 - Hagberg CA, Artime CA, Aziz MF, eds. Hagberg and Benumof's Airway Management. 5th ed. Philadelphia, PA: Elsevier; 2023. - Khanam D, Schoenfeld E, Ginsberg-Peltz J, et al. First-Pass Success of Intubations Using Video Versus Direct Laryngoscopy in Children With Limited Neck Mobility. Pediatr Emerg Care. 2024;40(6):454-458. doi:10.1097/PEC.0000000000003058 - Waheed S, Kapadia NN, Jawed DR, Raheem A, Khan MF. Randomized controlled trial to assess the effectiveness of apnoeic oxygenation in adults using a low-flow or high-flow nasal cannula with head side elevation during endotracheal intubation in the emergency department. BMC Res Notes. 2025 Jul 1;18(1):264. doi: 10.1186/s13104-025-07328-7. Erratum in: BMC Res Notes. 2025 Sep 8;18(1):384. doi: 10.1186/s13104-025-07412-y. PMID: 40598378; PMCID: PMC12219693. TRANSCRIPT https://cdn.bfldr.com/D6LGWP8S/as/mr2657n4ckgpz7g3tw37gbx/202511_WSP_Nadkarni_transcript Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu CITATION Nadkarni V, Burns JP. Pediatric Intubation Practices: Insights from NEAR4KIDS. 11/2025. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/pediatric-intubation-practices-insights-from-near4kids-by-v-nadkarni-openpediatrics.

Dr Chris Flannigan talking about Intubation in a Paediatric Cardiac Arrest. This talk is part of the Paediatric Emergencies 2025 event. To get your CME certificate for watching the video please visit https://www.paediatricemergencies.com/conference/paediatric-emergencies-2025/ #PaediatricEmergencies #PaediatricEmergencies2025 #Intubation

This episode discusses the evolving standards of care in providing support after rapid sequence intubation (RSI) and highlights RSI pharmacology and the management of post-intubation analgesia and sedation. CE for this episode expires on November 1, 2027.  The information presented during the podcast reflects solely the opinions of the presenter. The information and materials are not, and are not intended as, a comprehensive source of drug information on this topic. The contents of the podcast have not been reviewed by ASHP, and should neither be interpreted as the official policies of ASHP, nor an endorsement of any product(s), nor should they be considered as a substitute for the professional judgment of the pharmacist or physician.

Welcome to the emDOCs.net podcast! Join us as we review our high-yield posts from our website emDOCs.net. Today on the emDOCs cast with Brit Long (@long_brit), we have Part 2 on EBM updates for intubation. We'll cover induction medications, paralytics, VL vs. DL, using the bougie, confirming ETT placement, and post intubation sedation.  Please see Part 1 for background, predicting difficult BVM/intubation/cricothryotomy, physiologic factors associated with peri-intubation decompensation, preoxygenation, and apneic oxygenation. To continue to make this a worthwhile podcast for you to listen to, we appreciate any feedback and comments you may have for us. Please let us know!Subscribe to the podcast on one of the many platforms below:Apple iTunesSpotifyGoogle Play 

Welcome to the emDOCs.net podcast! Join us as we review our high-yield posts from our website emDOCs.net.Today on the emDOCs cast with Brit Long (@long_brit), we start a series on EBM updates for intubation. We cover some background, predicting difficult BVM/intubation/cricothryotomy, physiologic factors associated with peri-intubation decompensation, preoxygenation, and apneic oxygenation. To continue to make this a worthwhile podcast for you to listen to, we appreciate any feedback and comments you may have for us. Please let us know!Subscribe to the podcast on one of the many platforms below:Apple iTunesSpotifyGoogle Play 

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Reference:  George S, et al. Effectiveness of nasal high-flow oxygen during apnoea on hypoxaemia and intubation success in paediatric emergency and ICU settings: a randomised, controlled, open-label trial. Lancet Respir Med. March 2025 Date: July 10, 2025 Guest Skeptic: Dr. Spyridon Karageorgos is a Pediatric Chief Resident at Aghia Sophia Children's Hospital, Athens, Greece and […] The post SGEM#487: Tell Me How I'm Supposed to Breathe with No Air? Nasal High Flow or Standard Care for Pediatric Intubation first appeared on The Skeptics Guide to Emergency Medicine.

Show Notes 3 October 2025Story 1: Some Layers of Your Brain Actually Get Stronger as You AgeSource: ScienceAlert.comStory by: Michelle StarrLink: https://www.sciencealert.com/some-layers-of-your-brain-actually-get-stronger-as-you-ageResearch Paper: https://www.nature.com/articles/s41593-025-02013-1Story 2: Engineers harness light to help heart cells beat stronger and healthierSource: Knowridge.com (News from UC Irvine)Link: https://knowridge.com/2025/09/engineers-harness-light-to-help-heart-cells-beat-stronger-and-healthier/Research Paper: https://www.pnas.org/doi/10.1073/pnas.2509467122Story 3: UCSB-designed soft robot intubation device could save livesSource: UC Santa Barbara “The Current”Story by: Sonia FernandezLink: https://news.ucsb.edu/2025/022019/ucsb-designed-soft-robot-intubation-device-could-save-livesResearch Paper: https://doi.org/10.1126/scitranslmed.ads7681Story 4: Wi-Fi sleep monitoring method offers a non-intrusive, accurate alternative to more cumbersome techniquesSource: MedicalXpress.comStory by: David BradleyLink: https://www.msn.com/en-us/health/other/wi-fi-sleep-monitoring-method-offers-a-non-intrusive-accurate-alternative-to-more-cumbersome-techniques/ar-AA1Mn7tvResearch Paper: https://www.inderscience.com/info/inarticle.php?artid=148201Honorable MentionsStory: A new catalyst could make mixed plastic recycling a realitySource: Phys.orgStory by: Robert EganLink: https://phys.org/news/2025-09-catalyst-plastic-recycling-reality.htmlResearch Paper: https://www.nature.com/articles/s41557-025-01892-yStory: A New Solar Panel Shield Made From Onion Peels Outlasted Industry Plastics in TestsSource: ZME ScienceStory by: Tudor TaritaLink: https://www.zmescience.com/ecology/renewable-energy-ecology/a-new-solar-panel-shield-made-from-onion-peels-outlasted-industry-plastics-in-tests/Story: Bio-oil made with corn stalks, wood debris could plug orphaned fossil fuel wellsSource: Iowa State UniversityLink: https://www.news.iastate.edu/news/bio-oil-made-corn-stalks-wood-debris-could-plug-orphaned-fossil-fuel-wellsStory: Biochar yields triple win for cotton: Healthier soil, less water, and 87% less nitrogen runoffSource: Anthropocene MagazineStory by: Emma BryceLink: https://www.realclearscience.com/2025/08/11/biochar_yields_a_triple_win_for_cotton_1127969.html

The JournalFeed podcast for the week of Sept 5-19, 2025.These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.Monday's Spoon Feed:The ACEP subcommittee made policy recommendations on what peri-procedural interventions reduce peri-intubation hypoxia and hypotension.Wednesday's Spoon Feed:Pediatric patients with a positive ultrasound (US) and Pediatric Appendicitis Risk Calculator (pARC) score ≥ 25% are highly likely to have pathology-proven appendicitis.

Podcast summary of articles from the July 2025 edition of the Journal of Emergency Medicine from the American Academy of Emergency Medicine.  Topics include intermediate risk chest pain, pre-hospital stroke notifications, intubating patients with neurologic injury, event medicine, ultrasound guided serratus anterior plane blocks, and pediatric zipper injuries.  Guest speaker is Dr. Arjun Sarin.

Send us a textAtropine Versus Placebo for Neonatal Nonemergent Intubation: A Randomized Clinical Trial. Afifi J, El-Naggar W, Hatfield T, Sandila N, Baier J, Narvey M.J Pediatr. 2025 Jul 9;286:114719. doi: 10.1016/j.jpeds.2025.114719. Online ahead of print.PMID: 40645282Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Learn how to sharpen your pediatric intubation skills and make evidence-based decisions at the bedside. Today, Dr. Pradip Kamat, Dr. Monica Gray, and Dr. Rahul Damania expertly dissect the nuances of selecting optimal induction agents for critically ill children in the PICU. Through engaging, real-world case scenarios, our hosts guide you through drug choices in complex situations such as cardiogenic shock, septic shock, and elevated intracranial pressure—always prioritizing hemodynamic stability and patient safety. Gain valuable insights into the advantages, limitations, and clinical pearls of agents like propofol, fentanyl, ketamine, and midazolam, along with practical strategies for rapid sequence intubation, neuromuscular blockade, and individualized patient care. Don't miss this high-yield discussion, packed with actionable knowledge!Show Highlights:Induction agents for endotracheal intubation in critically ill childrenClinical scenarios highlighting optimal choices of induction agents and neuromuscular blockersImportance of maintaining hemodynamic stability during intubationPharmacology and clinical considerations of various induction agents (e.g., propofol, ketamine, fentanyl, etomidate)Use of neuromuscular blocking agents (NMBAs) in pediatric intubationDifferences between depolarizing and non-depolarizing neuromuscular blockersRisks associated with specific induction agents in patients with cardiac dysfunction or septic shockModified rapid sequence intubation (RSI) techniques for unstable patientsKey takeaways for managing critically ill pediatric patients requiring intubationPractical tips for optimizing intubation conditions and minimizing complicationsReferences:Fuhrman & Zimmerman - Textbook of Pediatric Critical Care 6th Edition. Chapters 127 - 135, Pages 1510 - 1610Hendrix JM, Regunath H. Intubation Endotracheal Tube Medications. [Updated 2025 Jan 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459276/Agrawal, Dewesh. Rapid sequence intubation (RSI) in children for emergency medicine: Medications for sedation and paralysis. UpToDate. Last updated Dec 4, 2024.Vanlinthout LE, Geniets B, Driessen JJ, Saldien V, Lapré R, Berghmans J, Uwimpuhwe G, Hens N. Neuromuscular-blocking agents for tracheal intubation in pediatric patients (0-12 years): A systematic review and meta-analysis. Paediatr Anaesth. 2020 Apr;30(4):401-414. doi: 10.1111/pan.13806. Epub 2020 Mar 9. PMID: 31887248.Tarquinio KM, Howell JD, Montgomery V, Turner DA, Hsing DD, Parker MM, Brown CA 3rd, Walls RM, Nadkarni VM, Nishisaki A; National Emergency Airway Registry for Children; Pediatric Acute Lung Injury and Sepsis Investigators Network. Current medication practice and tracheal intubation safety outcomes from a prospective multicenter observational cohort study. Pediatr Crit Care Med. 2015 Mar;16(3):210-8. doi: 10.1097/PCC.0000000000000319. PMID: 25581629.Conway JA, Kharayat P, Sanders RC Jr, Nett S, Weiss SL, Edwards LR, Breuer R, Kirby A, Krawiec C, Page-Goertz C, Polikoff L, Turner DA, Shults J, Giuliano JS Jr, Orioles A, Balkandier S, Emeriaud G, Rehder KJ, Kian Boon JL, Shenoi A, Vanderford P, Nuthall G, Lee A, Zeqo J, Parsons SJ, Furlong-Dillard J, Meyer K, Harwayne-Gidansky I, Jung P, Adu-Darko M, Bysani GK, McCarthy MA, Shlomovich M, Toedt-Pingel I, Branca A, Esperanza MC, Al-Subu AM, Pinto M, Tallent S, Shetty R, Thyagarajan S, Ikeyama T, Tarquinio KM, Skippen P, Kasagi M, Howell JD, Nadkarni VM, Nishisaki A; National Emergency Airway Registry for Children (NEAR4KIDS) and for the Pediatric Acute Lung Injury and Sepsis Investigators...

We've covered pre-oxygenation strategies and intubation alot on this podcast, mayber more than anyting else. We covered the definition of FPS in E74, the DEVICE trial on DL vs VL in E75, and the PREOXI trial of NIV vs Mask Pre-oxygenation in E86. Now we have another Preoxygenation paper, this one that reports no difference between preoxygenation with BVM and face mask. WTAF? Better listen, because it turns out words matter, definitions are... definitional, and we absolutely MUST read more than just the abstract.  Citations:1.     Gottlieb M, Alexander R, Love AK: Comparison of Preoxygenation Strategies for Intubation of Critically Ill Patients. Annals of Emergency Medicine. doi: 10.1016/j.annemergmed.2025.06.621 (Epub ahead of print).2.     Chou CD, Palakshappa JA, Haynie H, Garcia K, Long D, Gibbs KW, White HD, Ghamande S, Dagan A, Stempek S, et al.: Association of Two Preoxygenation Approaches With Hypoxemia During Tracheal Intubation: A Secondary Analysis. Annals of Emergency Medicine. doi: 10.1016/j.annemergmed.2025.06.003 (Epub ahead of print).3.     Pitre T, Liu W, Zeraatkar D, Casey JD, Dionne JC, Gibbs KW, Ginde AA, Needham-Nethercott N, Rice TW, Semler MW, et al.: Preoxygenation strategies for intubation of patients who are critically ill: a systematic review and network meta-analysis of randomised trials. The Lancet Respiratory Medicine. 2025;July;13(7):585–96.4.     Gibbs KW, Semler MW, Driver BE, Seitz KP, Stempek SB, Taylor C, Resnick-Ault D, White HD, Gandotra S, Doerschug KC, et al.: Noninvasive Ventilation for Preoxygenation during Emergency Intubation. N Engl J Med. doi: 10.1056/NEJMoa2313680 (Epub ahead of print).5.     Prekker ME, Driver BE, Trent SA, Resnick-Ault D, Seitz KP, Russell DW, Gaillard JP, Latimer AJ, Ghamande SA, Gibbs KW, et al.: Video versus Direct Laryngoscopy for Tracheal Intubation of Critically Ill Adults. N Engl J Med. 2023;June 16;389(5):418–29.6.     Trent SA, Kaji AH, Carlson JN, McCormick T, Haukoos JS, Brown CA, National EARI: Video Laryngoscopy is Associated With First-Pass Success in Emergency Department Intubations for Trauma Patients: A Propensity Score Matched Analysis of the National Emergency Airway Registry. Ann Emerg Med. doi: 10.1016/j.annemergmed.2021.07.115 (Epub ahead of print).

In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Kyle B. Enfield, MD, FCCM, speaks with Garrett McDougall, MS, MSc, and Ben Forestell, MD, of McMaster University about their recent study, “Direct Laryngoscopy Versus Video Laryngoscopy for Intubation in Critically Ill Patients: A Systematic Review, Meta-Analysis, and Trial Sequential Analysis of Randomized Trials,” published in the November 2024 issue of Critical Care Medicine. The study included 20 randomized controlled trials encompassing 4569 patients to investigate whether video laryngoscopy (VL) offers advantages over direct laryngoscopy (DL) for intubation in critically ill patients.  A key finding of the study was that VL probably improves first-pass success rates and reduces the risk of esophageal intubation and dental injury. These benefits extend across the spectrum of operator experience, especially among novice operators but also among seasoned operators.   Drs. McDougall and Forestell discuss findings that surprised them, such as seeing equal benefit for standard VL and hyperangulated VL devices. Additionally, no clear benefits were found for patients who were intubated emergently with VL as compared to those who underwent elective intubation. The discussion covers what could be next for resuscitation and airway research in critically ill patients. There may be more to learn about scenarios involving difficult airways, soiled airways, and emergent versus elective intubation. More research on device characteristics could also provide important insights. To wrap up, the guests underscore the importance of maintaining both VL and DL proficiency since DL can be a more appropriate choice for some patients. Resources referenced in this episode: Direct Laryngoscopy Versus Video Laryngoscopy for Intubation in Critically Ill Patients: A Systematic Review, Meta-Analysis, and Trial Sequential Analysis of Randomized Trials (McDougall GG, et al. Crit Care Med. 2024;52:1674-1685).

This week, we have another presentation from the Medicine in the Mediterranean conference from January 2025. Dr Matt Moront is a pediatric surgeon who provides an in-depth exploration of pediatric trauma care, emphasising the unique anatomical and physiological differences in children compared to adults. The speaker discusses common pediatric injuries, particularly in urban settings, and highlights the importance of airway management, weight estimation for medication dosing, and recognising signs of shock. Techniques for intubation and intravenous access in children are also covered, along with concerns regarding radiation exposure in pediatric imaging. The session concludes with key takeaways for healthcare providers working with pediatric patients.TakeawaysAirway management is critical in pediatric patients.Children are not just smaller adults; they have unique anatomical differences.Most pediatric trauma cases involve motor vehicle accidents and falls.Weight estimation is crucial for medication dosing in children.Children can maintain blood pressure until a significant volume of blood is lost.Intubation in children requires specific techniques and considerations.Radiation exposure in children should be minimised due to their sensitivity.Pediatric patients often present differently than adults in shock situations.Using the right size equipment is essential for pediatric care.Clinical indicators of shock in children are often visual rather than reliant on technology.Chapters00:00 Introduction to Pediatric Trauma Care02:40 Understanding Pediatric Injuries in Urban Settings05:23 Anatomical and Physiological Differences in Children08:34 Airway Management in Pediatric Patients11:21 Weight Estimation and Medication Dosing for Children14:12 Assessing Pediatric Vital Signs and Shock Indicators16:54 Intubation Techniques and Considerations for Children20:08 Practical Tips for Pediatric Emergency Care25:55 Intubation Techniques for Pediatric Patients29:00 Medications in Pediatric Intubation33:57 IV Access in Children40:00 Radiation Considerations in Pediatric Care

The JournalFeed podcast for the week of July 14-18, 2025.These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.Monday Spoon Feed:A single high-quality CT scan is highly accurate at detecting serious cervical spine injuries in children after trauma and may be enough to clear the spine without further imaging safely in majority of patients.Thursday Spoon Feed:For patients with ROSC after OHCA who required vasopressors transported by Finnish helicopter EMS (HEMS), normotension (100-140 mm Hg) was associated with improved 30-day mortality compared to hypo and hypertension.Friday Spoon Feed:This study of a trauma database found patients intubated in the emergency department (ED) who required hemorrhage control surgery had worse outcomes than those who were intubated in the operating room (OR). However, a study published just two months ago, from the same database of patients, found no difference in patients based on intubation location. What gives?

On this EM Quick Hits podcast: Pediatric Torticollis with Dr. Deb Shconfeld, Approach to Stable Wide Complex Tachydysrhythmias with Dr. Anand Swaminathan, Post-intubation Neurocritical Care 5 best practices with Dr. Andrew Petrosoniak, Hyponatremia Correction Rates with Dr. Justin Morgenstern, Paronychia Management with Dr. Andrew Tagg, and Women in EM Leader Series with Judith Tintinalli and Dr. Victoria Myers...Donate to EM Cases to help ensure continued Free Open Access Medical Education in the future here: https://emergencymedicinecases.com/donation/

Ready for a refreshing summer dive into the latest anesthesia safety research? This episode explores three groundbreaking studies that could transform perioperative practice and patient outcomes.First, we examine a fascinating randomized clinical trial on "just-in-time" training for inexperienced clinicians performing infant intubations. The results are impressive: trainees who received just 10 minutes of structured training immediately before the procedure achieved a 91.4% first-attempt success rate—significantly better than the 81.6% rate in the standard training group. Could this approach revolutionize how we prepare for all high-stakes medical procedures? The study suggests decreased cognitive load and improved competency with this targeted preparation technique.Next, we explore a comprehensive meta-analysis of how intravenous antihypertensive medications affect cerebral blood flow. Good news: most medications maintain cerebral autoregulation even when reducing blood pressure. However, nitroprusside and nitroglycerin stand out as exceptions, potentially reducing cerebral perfusion even at appropriate doses. This critical information helps anesthesia professionals make more informed medication choices based on each patient's specific needs.Finally, we investigate emerging research on GLP-1 receptor agonist medications (increasingly popular for diabetes, weight loss, and cardiovascular disease) and their potential link to vision problems. Several studies suggest these medications may increase the risk of non-arteritic ischemic optic neuropathy—a leading cause of vision loss. While the absolute risk remains small and no direct connection to postoperative vision loss has been established, additional research is needed going forward.Each of these studies provides valuable insight into how we can continue improving anesthesia safety. Share this episode with your colleagues and join us next time as we work toward ensuring no one is harmed by anesthesia care.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/262-medical-literature-deep-dive-from-infant-intubation-to-glp-1-agonist-risks-and-more/© 2025, The Anesthesia Patient Safety Foundation

Show notes at pharmacyjoe.com/episode1037. In this episode, I'll discuss whether there is an association between the sedative dose and postintubation hypotension and rapid sequence intubation. The post 1037: Hypotension After Intubation – Is It the Sedative Dose That Matters? appeared first on Pharmacy Joe.

Train the Best. Change EMS.Howdy, y'all, I'm Dr Jeff Jarvis, and I'm the host of the EMS lighthouse project podcast, but I'm also the medical director for the new EMS system we're building in Fort Worth Texas. We are looking for an experienced critical care paramedic who is an effective and inspiring educator to lead the initial and continuing training and credentialing of a new team of Critical Care Paramedics who will be responding to our highest acuity calls. The salary is negotiable but starts between $65,000 and $80,000 a year for this office position. Whether y'all wear cowboy boots or Birkenstocks, Fort Worth can be a great place to live and work. So if you're ready to create a world-class EMS system and change the EMS world with us, give us a call at 817-953-3083, take care y'all.The next time you go to intubate a patient, should you give the sedation before the paralytic or the paralytic before the sedative? Does it matter? And what the hell does Bayes have to do with any of this? Dr Jarvis reviews a paper that uses Bayesian statistics to calculate the association between drug sequence and first attempt failure. Then he returns to Nerd Valley to talk about how to interpret 95% confidence intervals derived from frequentists statistics compared to 95% credible intervals that come from Bayesian statistics. Citations:1.     Catoire P, Driver B, Prekker ME, Freund Y: Effect of administration sequence of induction agents on first‐attempt failure during emergency intubation: A Bayesian analysis of a prospective cohort. Academic Emergency Medicine. 2025;February;32(2):123–9. 2.     Casey JD, Janz DR, Russell DW, Vonderhaar DJ, Joffe AM, Dischert KM, Brown RM, Zouk AN, Gulati S, Heideman BE, et al.: Bag-Mask Ventilation during Tracheal Intubation of Critically Ill Adults. N Engl J Med. 2019;February 28;380(9):811–21.3.     Greer A, Hewitt M, Khazaneh PT, Ergan B, Burry L, Semler MW, Rochwerg B, Sharif S: Ketamine Versus Etomidate for Rapid Sequence Intubation: A Systematic Review and Meta-Analysis of Randomized Trials. Critical Care Medicine. 2025;February;53(2):e374–83.

Start your journey to excellence in veterinary dentistry! Request your invitation to the Veterinary Dental Practitioner Program at: https://ivdi.org/inv Gain hands-on training, evidence-based protocols, and the confidence to deliver superior dental care. ----------------------------------------------------------- Host: Dr. Brett Beckman, DVM, FAVD, DAVDC, DAAPM Welcome Back to The Vet Dental Show! This week, we're featuring a special episode packed with clinical pearls from past content that remains highly relevant for everyday practice. Whether you're a veterinarian or a technician, you'll gain practical insights to elevate your dental care standards. On this episode, Dr. Brett Beckman, a Board Certified Veterinary Dentist, addresses essential questions from veterinary professionals about periapical lucency, abscesses, safe dental toys, digital radiography techniques, and patient monitoring during dental procedures. What You'll Learn in This Episode: ✅ The clinical difference between periapical lucency and an abscess ✅ Best practices for treating infected fourth premolars ✅ When and why to use antibiotics in dental extractions ✅ Tips for effective dental radiography in small dogs ✅ Safe and unsafe chew toys for dental health ✅ How to monitor anesthetized patients during radiography ✅ Where to source quality cadaver heads for training ✅ Intubation techniques for small-statured practitioners Key Veterinary Dentistry Takeaways: ✅ Periapical lucency signifies bone loss without active pus drainage; abscesses involve active infection ✅ Extraction and thorough debridement are essential for both conditions ✅ Antibiotics are reserved for cases with active infection or facial wounds ✅ Sensor size limitations can be overcome with strategic tube head positioning ✅ Avoid hard chews like antlers and Nylabones; opt for KONGs and VOHC-approved items ✅ Monitoring can begin with minimal setup and ramp up as the procedure progresses ✅ Solo intubation is viable with good positioning and visibility techniques Final Call to Action and Resource Links: Start your journey to excellence in veterinary dentistry! Request your invitation to the Veterinary Dental Practitioner Program at: https://ivdi.org/inv For more in-depth training, visit: https://www.veterinarydentistry.net Questions or insights? Drop them in the comments! ----------------------------------------------------------- veterinary dentistry abscess treatment periapical lucency in dogs canine dental infection management safe chew toys for dogs dental health veterinary dental radiography tips dental x-rays for small dogs VOHC approved dental products monitoring anesthesia during dental x-rays dog tooth extraction protocol veterinary dentistry training veterinary dental practitioner program veterinary oral surgery techniques dental debridement in dogs vet dentistry continuing education vet tech dental training tips #veterinarydentistry #periapicallucency #dentalabscess #vetdentaltips #safechewtoys #dentalradiography #vetxray #VOHC #vetdentist #animaldentistry #veterinarysurgery #monitoringanesthesia #vettechtraining #vetdentaleducation

In Episode #38 of EM Logic, Dr. Pregerson reviews what you can do before intubation in order to prevent triggering a subsequent cardiac arrest. Read more details here in the Show Notes. 

Podcast summary of articles from the January 2025 edition of the Journal of Emergency Medicine from the American Academy of Emergency Medicine.  Topics include pediatric appendicitis, end tidal oxygen measurements, Lyme disease, POCUS in GI bleeding patients, use of ultrasound in septic patients, and stroke screening.  Guest speaker is Dr. John Bennison.

Welcome to the emDOCs.net podcast! Join us as we review our high-yield posts from our website emDOCs.net. Today on the emDOCs cast Brit Long interviews Zachary Aust on a mental model for the airway and intubation. To continue to make this a worthwhile podcast for you to listen to, we appreciate any feedback and comments you may have for us. Please let us know!Subscribe to the podcast on one of the many platforms below:Apple iTunesSpotifyGoogle Play

Abby and Patrick welcome psychoanalyst and author Jamieson Webster to discuss her brand-new book, On Breathing: Care in a Time of Catastrophe, out in March 2025 from Catapult. It's a wide-ranging conversation that traverses clinical, social, and political domains while remaining firmly grounded in one of the most basic prerequisites for human life: the activity of breathing. In what ways does the history of psychoanalysis represent a repression of the fact of breathing? How do analytic accounts from Freud to Winnicott to Bion to Lacan variously take up or downplay the necessity of respiration? How does thinking about breath implicate our ideas about development, embodiment, the production of speech, and more? And how does thinking in a sustained way about breath challenge our assumptions about individuality, independence, and wellbeing? The three explore the stakes and meanings of breathing, from COVID wards to police violence to the wellness industry and beyond. A pre-order link for On Breathing is available here: https://books.catapult.co/books/on-breathing/Conversion Disorder: Listening to the Body in Psychoanalysis is here: https://cup.columbia.edu/book/conversion-disorder/9780231184083Disorganization and Sex is here: https://divided.online/all-books/disorganisation-and-sexMarch and April book tour dates for On Breathing:3/11/25 7pm Eastern at Brooklyn Public Library - Central Library, Dweck Center (Brooklyn, NY) in conversation with Jia Tolentino3/15/25 6pm Eastern at Riffraff (Providence, RI) in conversation with Kate Schapira3/30/25 1pm Eastern virtual event with The Psychosocial Foundation4/13/25 2pm Eastern at Pioneer Works (Brooklyn, NY) in conversation with Leslie Jamison and a performance by Andros Zins-Browne as part of the Second Sunday seriesHave you noticed that Freud is back? Got questions about psychoanalysis? Or maybe you've traversed the fantasy and lived to tell the tale? Leave us a voicemail! (646) 450-0847A podcast about psychoanalysis, politics, pop culture, and the ways we suffer now. New episodes on Saturdays. Follow us on social media: Linktree: https://linktr.ee/ordinaryunhappiness Twitter: @UnhappinessPod Instagram: @ordinaryunhappiness Patreon: patreon.com/OrdinaryUnhappiness

You intubate... and then your patient codes. What did you do wrong? When is "ABC" the wrong order? Let's dive into this nuanced topic in critical care. Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind at here. Cite this podcast as: Briggs, Blake. 249. Clean kill: how intubation kills your pt. February 2nd, 2024. Accessed [date].

Show notes at pharmacyjoe.com/episode991. In this episode, I’ll discuss what dose of steroids can prevent post-extubation stridor. The post 991: What Dose of Steroids Prevents Post-Extubation Stridor and Re-Intubation? appeared first on Pharmacy Joe.

Don't come at us with your chicken buildings. By Blueberry Standards. Whistling Archery. Jersey Mike: Sandwich Assassin. 20 Years Not Driving the Porcelain Bus. Send that to the Southern office. Brekkie tacos. I feel like crap, this will make good content. Hello. I'm Mr. Typecast. The day that will live in stupidity. Subconsciously Streaking! GOONIES . . . IN . . . SPACE. Iraqi oil vat of popcorn. Taint West Virginia. Throbby Strange Light with Bobby and more on this episode of The Morning Stream. Hosted on Acast. See acast.com/privacy for more information.

Don't come at us with your chicken buildings. By Blueberry Standards. Whistling Archery. Jersey Mike: Sandwich Assassin. 20 Years Not Driving the Porcelain Bus. Send that to the Southern office. Brekkie tacos. I feel like crap, this will make good content. Hello. I'm Mr. Typecast. The day that will live in stupidity. Subconsciously Streaking! GOONIES . . . IN . . . SPACE. Iraqi oil vat of popcorn. Taint West Virginia. Throbby Strange Light with Bobby and more on this episode of The Morning Stream. Hosted on Acast. See acast.com/privacy for more information.

Send us a Text Message (please include your email so we can respond!)Episode 55 and Happy New Year! In this episode we talk broad strokes about the CCR Down Under Conference and the trials that were presented, then Todd and Eddie go over a bunch of articles from the year 2024 that they didn't have time to go over or want to re-emphasize for whatever reason. Big show and we hope you enjoy!TIGHT K: https://pubmed.ncbi.nlm.nih.gov/39215972/PROPHY VAP: https://pubmed.ncbi.nlm.nih.gov/38262428/REVISE: https://pubmed.ncbi.nlm.nih.gov/38875111/Point (withdrawal of ECMO): https://pubmed.ncbi.nlm.nih.gov/39663030/Counterpoint: https://pubmed.ncbi.nlm.nih.gov/39663031/DanGer SHOCK: https://pubmed.ncbi.nlm.nih.gov/38587239/Intubation in physiologic difficult airway guidelines: https://pubmed.ncbi.nlm.nih.gov/39162823/If you enjoy the show be sure to like and subscribe, leave that 5 star review! Be sure to follow us on the social @icucast for the associated figures, comments, and other content not available in the audio format! Email us at icuedandtoddcast@gmail.com with any questions or suggestions! Thank you Mike Gannon for the intro and exit music!

Contributor: Megan Hurley MD Educational Pearls: What is the mediastinum? The thoracic cavity is separated into different compartments by membranes The lungs exist in their own pleural cavities, and the mediastinum is everything in between The mediastinum extends from the sternum to the thoracic vertebrae and includes the heart, the aorta, the trachea, the esophagus, the thymus, as well as many lymph nodes and nerves. What is a pneumomediastinum? Air in the mediastinum How can pneumomediastinum be categorized? Traumatic Ex. Stab wound to the trachea Ex. Boerhaave's Syndrome of the esophagus, possibly from an endoscopic procedure. This mechanism in particular is a higher risk of infection because not only air but food can accumulate in the mediastinum Ex. Intubation with a bougie These will likely need surgical repair Nontraumatic Ex. Forceful inhalation causing microperforations in the trachea. Possibly while inhaling something like drugs Ex. Bad asthma for similar reasons Ex. Gas forming bacteria What happens if you use positive pressure ventilation on a patient with a hole in their trachea? The positive pressure will force extra air into the mediastinum The air will move between the layers of subcutaneous tissue and can track up into the neck and face regions recognized as crepitus on exam This can also cause a tension pneumomediastinum in which the air pressure in the compartment constricts the heart, impeding its ability to fill during diastole These patients can undergo bronchoscopy because that procedure does not require positive pressure and will not worsen the condition. Endoscopies do require positive pressure so endoscopies are not an option How is a tension pneumomediastinum treated? By inserting a needle into the space from below the xiphoid process to allow the air to escape, similar to a pericardiocentesis As a temporizing measure, if the hole is high enough in the trachea, the intubation can be continued by deliberately pushing the endotracheal tube into the right main bronchus, creating a seal, and only ventilating the right lung while the patient heads to surgery. This is called right-mainstemming. References Clancy DJ, Lane AS, Flynn PW, Seppelt IM. Tension pneumomediastinum: A literal form of chest tightness. J Intensive Care Soc. 2017 Feb;18(1):52-56. doi: 10.1177/1751143716662665. Epub 2016 Aug 3. PMID: 28979537; PMCID: PMC5606356. Grewal, J., & Gillaspie, E. A. (2024). Pneumomediastinum. Thoracic surgery clinics, 34(4), 309–319. https://doi.org/10.1016/j.thorsurg.2024.06.001 Underner, M., Perriot, J., & Peiffer, G. (2017). Pneumomédiastin et consommation de cocaïne [Pneumomediastinum and cocaine use]. Presse medicale (Paris, France : 1983), 46(3), 249–262. https://doi.org/10.1016/j.lpm.2017.01.002 Summarized by Jeffrey Olson, MS3 | Edited by Meg Joyce & Jorge Chalit, OMS3 Donate: https://emergencymedicalminute.org/donate/  

Send us a textVideo versus Direct Laryngoscopy for Urgent Intubation of Newborn Infants.Geraghty LE, Dunne EA, Ní Chathasaigh CM, Vellinga A, Adams NC, O'Currain EM, McCarthy LK, O'Donnell CPF.N Engl J Med. 2024 May 30;390(20):1885-1894. doi: 10.1056/NEJMoa2402785. Epub 2024 May 5.PMID: 38709215 Clinical Trial.As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

The principles of preoxygenation and passive oxygenation should be familiar to any experienced intubator. Best practice recommends the use of a nasal cannula in conjunction with either a non-rebreather mask or bag-valve mask (BVM) to prevent hypoxemia during the apneic phase of Rapid Sequence Intubation (RSI). In the PREOXI Trial, the authors pushed this concept further, questioning whether non-invasive positive pressure ventilation (NIPPV) might be more effective than these formally mentioned adjuncts. In this podcast, we dive into the strengths and weaknesses of the trial and explore whether its findings are truly practice-changing. We might even disagree along the way… (We also provide a rebuttal to some of the feedback we received on our previous podcast episode.) Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet Website heavyliesthehelmet.com Email contact@heavyliesthehelmet.com Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment. --------------------------------------------  Crystals VIP by From The Dust | https://soundcloud.com/ftdmusic Music promoted by https://www.free-stock-music.com