Podcasts about Intubation

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

Viva StemYou meet a 60yo male for a laparoscopic cholecystectomy.PMx: IHD, T2DM, HTN. Neuropathic foot painMedications:MetoprololMetforminACEiStatinPregabalin---------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 ---------Please support me at my patreonhttps://www.patreon.com/ABCsofA---------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 practitioners, and are not an advertisement. They were not sponsored and offer no discounts, gifts or other inducements. This disclaimer was created based on a Contractology template available at http://www.contractology.com.

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. 

In today's episode, we revisit challenges in the diagnosis and management of oesophageal intubation and anaesthetic crises in general. Recognising an oesophageal intubation may seem simple, but by looking at coroner's cases both here in Australia and in the UK, as well as cases in the NAP4, it can be far more complex. Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you!And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode.Thanks for listening, and happy studying!Resources for today's episode include:NSW Coroner's Court websiteWhy does oesophageal intubation still go unrecognised? Lessons for prevention from the coroner's courtNational Audit Project 4ANZCA Professional DocumentsRed Man Syndrome Feel free to email us at deepbreathspod@gmail.com if you have any questions, comments or suggestions. We love hearing from you! And don't forget to claim CPD for listening if you are a consultant or fellow. Log us as a learning session which you can find within the knowledge and skills division, and as evidence upload a screenshot of the podcast episode. Thanks for listening, and happy studying!

In this podcast Christian Byrne discusses his paper "Challenges and complications of prolonged nasogastric intubation in equine patients".

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.

Die Grippe verwandelt das Gefängnis nach wie vor in eine Todeszone, doch erst mal gibt es Konsequenzen für Carol. Hershel gibt sein Bestes als Seuchen-Doktor, doch am Ende sterben trotzdem viele. Und während alle denken, das sei schon schlimm genug, taucht der Governor mit neuem Bart und alten Problemen wieder auf... Nächste Woche besprechen wir 2 Folgen! Instagram: @aliciajoe und @cashisclay_attitude Learn more about your ad choices. Visit megaphone.fm/adchoices

In dieser Podcast-Folge geht es um die aufregende Vorliebe der Dilatoren-Spiele im BDSM. Ich erkläre, was genau Dilatoren sind, warum sie einen besonderen Reiz ausüben, und wie man sie sicher und lustvoll verwendet. Außerdem beleuchte ich die verschiedenen Formen, Materialien und Anwendungsmöglichkeiten sowie die wichtigen Aspekte rund um Hygiene und Sicherheit. Lass uns gemeinsam in dieses spannende Thema eintauchen.ShownotesWelches Gleitmittel kannst du denn nun verwenden? Bei der Verwendung von Dilatoren ist die Wahl des richtigen Gleitmittels entscheidend für Komfort und Effektivität. Folgende Punkte solltest du beachten: Wasserbasierte Gleitmittel: Diese sind am besten geeignet, da sie die empfindlichen Schleimhäute nicht reizen und leicht abwaschbar sind. Sie hinterlassen keine Rückstände und sind mit allen Arten von Dilatoren (einschließlich Silikon) kompatibel. Keine Zusatzstoffe: Wähle ein Gleitmittel ohne Parfüme, Farbstoffe oder potenziell reizende Chemikalien. Hypoallergene Produkte sind besonders empfehlenswert. Silikonbasierte Gleitmittel vermeiden: Diese können in einigen Fällen mit Silikondilatoren reagieren und die Oberfläche beschädigen. PH-neutral und frei von Glycerin: Ein pH-neutraler Wert schützt die natürliche Balance der Vaginalflora. Glycerin kann bei einigen Menschen zu Reizungen oder Pilzinfektionen führen und sollte daher vermieden werden. Test auf Verträglichkeit: Vor der regelmäßigen Anwendung solltest du das Gleitmittel an einer kleinen Hautstelle testen, um sicherzugehen, dass keine allergischen Reaktionen auftreten. Medizinische Produkte: Einige Gleitmittel sind speziell für medizinische Anwendungen entwickelt und bieten zusätzliche Feuchtigkeitsspender, die die Heilung fördern und die Anwendung angenehmer machen. Wir benutzen in Domina-Studios gern Endosgel. Das wird in der Medizin auch für Katheter verwendet. Hierbei musst du aber bedenken, dass darin leichte Betäubung drin ist und somit der Schwanz zB betäubt ist und ein Orgasmus somit schwieriger wird OptiLube™ Ein steriles, wasserlösliches und pH-neutrales Gleitmittel ohne aktive Inhaltsstoffe, ideal für Patienten mit Allergien oder Unverträglichkeiten. Gelicain® Gleitgel Ein wasserlösliches, klares Gel mit lokalanästhetischer und antiseptischer Wirkung, das Lidocain und Chlorhexidin enthält. Orgasmusschwierigkeit K-Y Gleitgel Steril Ein wasserbasiertes, geruchsneutrales Gleitgel in steriler Verpackung, geeignet für medizinische Anwendungen und kompatibel mit Kondomen. Aqua-Gel Ein Gleitmittel für die schonende Intubation, abgepackt in praktischen Portionsbeuteln zu je 5 g. Gyn-Lys Gleitgel Ein medizinisches Gleitgel, erhältlich in verschiedenen Packungsgrößen, geeignet für gynäkologische Untersuchungen und andere medizinische Anwendungen. Meine Workshops:FemDom-Workshop: https://www.mistressacademy.de/femdom-workshop/Dom-Sub-Workshop: https://www.mistressacademy.de/dom-sub-paar-workshop/Meine Kurse und Coachings:DOMINA MASTERCLASS: https://www.domina-ausbildung.info/ Online-Kurs "Perfect Slave - der Sklaven-Guide": https://www.mistressacademy.de/perfect-slave/Online-Kurs "How to be a FemDom": https://www.mistressacademy.de/how-to-be-a-femdom/Coaching "The perfect FemDom": https://www.mistressacademy.de/coaching-the-perfect-femdom/ Dein Einzelcoaching mit mir: https://www.mistressacademy.de/einzelcoachingAuroras kostenloser Telegram-Kanal: https://t.me/auroranianoxxchannelAurora auf BestFans: https://www.bestfans.com/auroranianoxxMein Buch "Abends heiße ich Aurora": https://amzn.to/2UmZr6d Kontakt Aurora: aurora@mistressacademy.deInstagram: @auroranianoxxofficialAlles zu meiner MISTRESS ACADEMY: https://www.mistressacademy.deAlles zu meinem MISTRESS EMPIRE:Website: https://www.mistressempire.de/Phone: 040 41125057Mail: info@mistressempire.dePrivate Mietung:https://www.mistressempire.de/booking/private

Je reçois aujourd'hui Thaïs qui a 39 ans et qui souffre de myasthénie. Thaïs m'a profondément touchée par son histoire, sa force et sa demande de laisser une trace de son histoire avec sa voix avant qu'elle ne subisse une trachéotomie.Ce qui est incroyable dans son parcours, c'est que le bon diagnostic a été posé très rapidement sur ces symptômes. Malheureusement, étant un cas atypique, les médecins sont revenus sur celui-ci. Lorsque son état se dégrade, on lui propose alors des rendez-vous en psychiatrie, c'est à partir de là que sa prise en charge se complique.Je vous laisse découvrir l'histoire de cette femme pleine de force et vous souhaite une très bonne écoute.Vous pouvez suivre le podcast sur son compte Instagram : Un mot sur mes mauxMontage : Yasmine FleurotMixage : SebMusique Oak StudioHébergé par Ausha. Visitez ausha.co/politique-de-confidentialite pour plus d'informations.

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].

Kevin Hazzard Author of A Thousand Naked Strangers and American Sirens (you can find these on Amazon or wherever books are sold). You can find Kevin Hazzard at KevinHazzard.comKevin talks about the story Jesus told of the good Samaritan as really the first example of EMS. Jesus tells this story in response to a lawyer asking him how to obtain eternal life. A man was attacked on the road and left for dead. Many people that society perceives as “good” pass by this man but a Samaritan took the time to stop, dress his wounds and takes him somewhere to put a roof over his head and allow him to healKevin talks about how society has never put sustained efforts into saving people outside of the hospital until the 60'sThe white paper published in the 60's indicated that you were more likely to survive a gunshot wound in the Vietnam war than in the streets of the United States because you would have someone trained in first aid at your sideThere was significant emphasis on intubation for early paramedics. This was a skill very important to the early physicians because they knew the life saving potential We talk about the evolution of intubation and how emphasis seems to be changing and the important of still training on this skill because it can be very difficult and high stressI think it is important to increase training rather than remove a skill set from paramedicsWe talk about video options for intubation and the potential future of trainingThe first paramedics in American Sirens were black men that served their community called “The Hill”Pittsburgh in the 1960's was a very difficult city for African Americans. Jobs were not available. They were told they had no value. Then Freedom House ambulance gave them a purpose designed by the father of CPR himself, Peter SafarGoing from not worthy of anything to being trusted with paramedicine at the highest level for your own neighbors, your own communityThe first call they run is in the aftermath of Dr. Martin Luther King Jr's assassinationPeter Safar, the father of CPR and an anesthesiologist, designed the early ambulances in a configuration that is still used today, a captains chair because he wanted good access to the airwayTheir first medical director, Nancy Caroline, wrote the foundational EMT education text bookThe great tragedy is no one can really tell you about Freedom House ambulance until now, the story was intentionally buried and forgotten“This need to be corrected,” Kevin Hazzard tells the important storySupport the showFull show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, ParamedicsMost efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours. If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you. 1st Phorm | The Foundation of High Performance Nutrition Everything you hear today from myself and my guests is opinion only and doesn't represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.

There's a shortage of specialized nurses who play a critical role in providing care to sexual assault survivors. Particularly in Louisiana, Mississippi, and Alabama. They are called sexual assault nurse examiners — or SANEs.As Drew Hawkins reports for the Gulf States Newsroom, one potential solution is to use telemedicine — but it's currently not available in the Gulf South.College textbooks are expensive. You might already know this if you've been to college, but prices have accelerated just in the last few years. And while tuition hikes and admission practices often create barriers of entry to higher education, sometimes it's that are prohibitively expensive, as they're often not covered by scholarships. As the spring semester gets into swing at schools across Louisiana, we found ourselves interested in efforts LSU is taking to address the accelerating problem of college textbook prices. Allen LeBlanc, Open Scholarship Librarian, at LSU Libraries tells us more about solutions.In June 2024, researchers released a medical study involving one Out Lady of the Lake Regional Medical Center in Baton Rouge. It looked at techniques for intubating patients, the practice putting a tube down your throat to provide ventilation, is something that's generally done when you're in critical condition. The trial involved Our Lady of the Lake Regional Medical Center in Baton Rouge as well as other ERs and ICUs across the nation. They're using a BPAP, a bilevel positive airway pressure machine.Dr. Christopher Thomas is a pulmonary critical care specialist at the hospital. He tells us more about this study, what researchers are hoping to find, and the results of a new airway pressure machine. ___Today's episode of Louisiana Considered was hosted by Adam Vos. Our managing producer is Alana Schrieber. We get production support from Garrett Pittman and our assistant producer Aubry Procell. You can listen to Louisiana Considered Monday through Friday at noon and 7 p.m. It's available on Spotify, the NPR App and wherever you get your podcasts. Louisiana Considered wants to hear from you! Please fill out our pitch line to let us know what kinds of story ideas you have for our show. And while you're at it, fill out our listener survey! We want to keep bringing you the kinds of conversations you'd like to listen to.Louisiana Considered is made possible with support from our listeners. Thank you!

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!

Nick talks about a difficult RSI intubation and his struggle to overcome the feeling that he didn't do his bestWe talk about how intubation success was such a critical point as a paramedic that everyone would have judged you on in the pastWe talk about the direct laryngoscopy vs the new video techniquesAdvice for the newbies:  Brent: You're going to struggle with burnout. You need to recognize it early. Prepare for that possibility. Nick: The things that affect you are different for everyone. Certain things you think may not affect you will actually become a problem for you later. You can't choose the things that you will struggle with. Always treat the patient well and don't blame them for the problem they are having. It is not all about you. Treat people with respect and give them options. Let them save face.Mark: Recognize that your happiness is up to you. Don't expect the company or organization to give you your happiness or your wellbeing. If you see yourself getting less happy, you don't owe the organization anything. You make the decisions that affect your life. We can't blame the environment we choose. Make a change if you need to.The mountain will always be the mountain. We have better gear than we did before but that doesn't make the challenge itself that much easier. EMS is tough field and that will always be the caseKnowing when to step away is also importantNick's metaphor: Event horizons are the edge of a black hole. If you were in space and you passed into an event horizon you probably wouldn't even notice.  But from the outside, you would just appear to disappear. Event horizons appear in our careers as well. You may not really understand you are at that point of terminal burnout but looking back you might be able to pinpoint that point of no return that you crossed.Where is the event horizon on a call? That point of no return where the outcome is assured.Support the showIf you want to support the show, follow the links below for some great health and fitness products.My favorite protein:https://1stphorm.com/products/phormula-1/?a_aid=PracticalEMS My favorite 1ST Phorm Energy Drinks: https://1stphorm.com/products/1st-phorm-energy/?a_aid=PracticalEMS My favorite creatine supplement https://1stphorm.com/products/micronized-creatine-monohydrate/?a_aid=PracticalEMS My favorite pre-workout supplementhttps://1stphorm.com/products/project-1/?a_aid=PracticalEMS If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you. 1st Phorm | The Foundation of High Performance Nutrition Everything you hear today from myself and my guests is opinion only and doesn't represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for ed...

Dr Gyula Tövisházi talking about Intubation. This talk is part of the Paediatric Emergencies 2024 event. To get your CME certificate for watching the video please visit https://www.paediatricemergencies.com/conference/paediatric-emergencies-2024/ #PaediatricEmergencies #PaediatricEmergencies2024 #Intubation

How old are you in EMS years? Are you using clinical skills that should be put out to pasture? Listen as cohosts Chris Cebollero and Kelly Grayson debate the effectiveness of “retired” EMS skills, like nasal and digital intubation, and whether the value of those skills has held up over time. Memorable quotes “If you're not proficient with all the tools in your box, what does that say about your training?” “I take a lot of pride in having a deep bag of tricks to pull from. And I can't count the number of times that some obscure piece of knowledge, or an assessment or treatment technique worked for me in the field when everyone else had given up or not even considered it.” ----more---- ABOUT THE SPONSOR Whether replacing radio reports, alerting specialty teams, or managing mass casualty incidents, Pulsara simplifies communication. Pulsara scales to meet your dynamic communication needs. From routine patient alerts to managing large-scale emergencies, every responder and clinician connects seamlessly. Familiar yet powerful, Pulsara streamlines your response, from routine transfers to regional disasters. One tool. Every day. Regardless of event. Discover more at Pulsara.com. ENJOYING THE SHOW? Contact the Inside EMS team at theshow@ems1.com to share ideas, suggestions and feedback, or let us know if you'd like to join us as a guest.

In this week's DeviceTalks Weekly Podcast, Host Tom Salemi interviews Dr. Andrew Napier, a former army medic and ER doc who saw a need for sh*t that works, specifically an intubation tool that allowed for easier access to the airway. He developed his own device and started a company, IntuBlade, to make his vision a reality. Thank you to Dr. Napier and all listeners who have served in the military. Happy Veterans Day. MassDevice Editor Chris Newmarker brings his Newmarker's Newsmakers – Philips, Precision Neuroscience, Integra Lifesciences, Boston Scientific, and Johnson & Johnson. Thanks for listening to the DeviceTalks Weekly Podcast. Subscribe now to the DeviceTalks Podcast Network.

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

LISTENER DISCRETION IS ADVISED References: Anand Swaminathan, "REBEL Cast Ep107: The BOUGIE Trial – Bougie First in All Emergency Intubations?", REBEL EM blog, February 17, 2022. Available at: https://rebelem.com/rebel-cast-ep107-the-bougie-trial-bougie-first-in-all-emergency-intubations/. AirTraq vs. Bougie: PMID 28515522 McGrath vs. AirTraq: PMID 28781449 Bougie vs. Stylet: PMID 29800096 Rigid vs. Standard Stylet: PMID 22273475

Intubieren im Notfall: Sicher einleiten, sicher intubieren

Experts in critical care share their approach to post-intubation sedation. Contributors: Check out the Intensive Care Academy here! Find us on Patreon here! Buy your merch here!

Reference: Gibbs et al. Noninvasive Ventilation for Preoxygenation during Emergency Intubation (The PREOXI trial). NEJM June 2024. Date: July 17, 2024 Guest Skeptic: Dr. Aine Yore is an Emergency Physician, practicing in the Seattle, Washington area for over twenty years. She is the former president of the Washington chapter of ACEP and her career focus outside of […] The post SGEM#447: Just What I Needed – Preoxygenation Prior To Intubation first appeared on The Skeptics Guide to Emergency Medicine.

What's the best way to pre-oxygenate our patients prior to intubation? The evidence for this question has been mixed for some time. Dr Jarvis discusses the PREOXI Trial that directly compares preoxygenation with non-invasive ventilation compared to face mask, to see which provides the best protection against peri-intubation hypoxia. This is an important trial that sheds light on a key component of our bundle of care to make intubation safer.Citations: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. (2024)Jarvis JL, Gonzales J, Johns D, Sager L: Implementation of a Clinical Bundle to Reduce Out-of-Hospital Peri-intubation Hypoxia. Annals of Emergency Medicine. 2018;72:272–9.Groombridge C, et al: A prospective, randomised trial of pre-oxygenation strategies available in the pre-hospital environment. Anaesthesia. 2017;72:580–4.Groombridge C, et al: Assessment of Common Preoxygenation Strategies Outside of the Operating Room Environment. Acad Emerg Med. 2016;March;23(3):342–6.Baillard C, et al: Noninvasive ventilation improves preoxygenation before intubation of hypoxic patients. Am J Respir Crit Care Med. 2006;July 15;174(2):171–7.Ramkumar V, et al: Preoxygenation with 20-degree head-up tilt provides longer duration of non-hypoxic apnea than conventional preoxygenation in non-obese healthy adults. J Anesth. 2011;25:189–94.Pourmand A, et al: Pre-oxygenation: Implications in emergency airway management. American Journal of Emergency Medicine. doi: 10.1016/j.ajem.2017.06.006Solis A, Baillard C: Effectiveness of preoxygenation using the head-up position and noninvasive ventilation to reduce hypoxaemia during intubation. Ann Fr Anesth Reanim. 2008;June;27(6):490–4.April MD, Arana A, Reynolds JC, Carlson JN, Davis WT, Schauer SG, Oliver JJ, Summers SM, Long B, Walls RM, et al.: Peri-intubation cardiac arrest in the Emergency Department: A National Emergency Airway Registry (NEAR) study. Resuscitation. 2021;May;162:403–11.Trent SA, Driver BE, Prekker ME, Barnes CR, Brewer JM, Doerschug KC, Gaillard JP, Gibbs KW, Ghamande S, Hughes CG, et al.: Defining Successful Intubation on the First AttemptUsing Both Laryngoscope and Endotracheal Tube Insertions: A Secondary Analysis of Clinical Trial Data. Annals of Emergency Medicine. 2023;82(4):S0196064423002135.Pavlov I, Medrano S, Weingart S: Apneic oxygenation reduces the incidence of hypoxemia during emergency intubation: A systematic review and meta-analysis. AJEM. 2017;35(8):1184–9.

In this conversation, Dennis, Evan, and Doug discuss the debate between intubation and cricothyrotomy (cric) in the field. Dennis confesses his belief that intubation is the better option, while Evan and Doug argue for the use of cric in certain situations. They discuss the resource limitations in the field, the need for resuscitation prior to intubation, the challenges of obtaining and administering sedation medications, and the potential complications of intubation. They also touch on the importance of training and maintaining skills in a resource-constrained environment. The conversation explores the challenges of airway management in austere environments and the training and resources needed to optimize patient care. The speakers discuss the importance of experience and judgment in performing airway procedures and the need for ongoing training and skill sustainment. They highlight the differences between intubation and cricothyrotomy and the factors to consider when choosing the appropriate procedure. The conversation also touches on the training of role-one providers and the need for educational materials on difficult airway management. Takeaways The decision between intubation and cricothyrotomy depends on the resources available in the field. Intubation requires the ability to resuscitate the patient prior to the procedure and access to suction. Obtaining and administering sedation medications can be challenging in resource-constrained environments. Intubation can lead to hemodynamic instability and worsen shock in already unstable patients. Training and maintaining skills in a resource-constrained environment is crucial for successful airway management. Airway management in austere environments presents unique challenges and requires experience and judgment. Training and skill sustainment are crucial for optimizing patient care in these environments. The choice between intubation and cricothyrotomy depends on various factors, including patient stability and available resources. Role one providers need training and educational materials on difficult airway management. Standard of care should be maintained even in field environments, with deviations made consciously and deliberately. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care⁠

Let's talk about the crashing intubated patient. What's your strategy? What if the nearest ICU requires transport? EM/intensivist Andrew Phillips gives EMRA*Cast host Kyle Duke some high-yield tips that you'll want to hear, too.

Description:There is evidence that clinician experience with intubation is associated with improved success rates and evidence that missed intubation attempts are associated with worse survival, at least in cardiac arrest. The recent Airway EBG paper recommends EMS agencies with low intubation proficiency should use SGAs instead of intubation in cardiac arrest. This all begs the question of whether agencies who intubate more often have higher success rates than those who do not. That's exactly the question a new paper from Annals of Emergency Medicine attempts to answer. Join Dr. Jarvis for a discussion of the paper and his thoughts on how to integrate its findings into practice.Citations:1.        Jarvis JL, Panchal AR, Lyng JW, Bosson N, Donofrio-Odmann JJ, Braude DA, Browne LR, Arinder M, Bolleter S, Gross T, et al.: Evidence-Based Guideline for Prehospital Airway Management. Prehospital Emergency Care. 2024;28(4):545–57.2.        Murphy DL, Bulger NE, Harrington BM, Skerchak JA, Counts CR, Latimer AJ, Yang BY, Maynard C, Rea TD, Sayre MR: Fewer Tracheal Intubation Attempts are Associated with Improved Neurologically Intact Survival Following Out-of-Hospital Cardiac Arrest. Resuscitation. 2021;July 13;167(Oct 2021):289–96.3.        Crewdson K, Lockey DJ, Røislien J, Lossius HM, Rehn M: The success of pre-hospital tracheal intubation by different pre-hospital providers: a systematic literature review and meta-analysis. Crit Care. 2017;December;21(1):31.4.        Thomas J, Crowe R, Schulz K, Wang HE, De Oliveira Otto MC, Karfunkle B, Boerwinkle E, Huebinger R: Association Between Emergency Medical Service Agency Intubation Rate and Intubation Success. Ann Emerg Med. Published online: January 2024. doi: 10.1016/j.annemergmed.2023.11.005 (Epub ahead of print).5.        Carlson JN, De Lorenzo R: Does Practice Make Perfect, or Is There More to Consider? Ann Emerg Med. Published online: January 2024. doi: 10.1016/j.annemergmed.2024.04.019 (Epub ahead of print).

Matthew Humar presents 4 case studies which discuss unrecognised oesophagael intubation.  This session was recorded at the SAS workshop at CODA22 which took place in Melbourne in September 2022. For more information about the CODA Project go to: https://codachange.org/ 

  Tim Cook uses individual cases and analysis of the systems, processes and human factors involved in unrecognised oesophageal intubation to investigate why this tragic occurrence is still a problem around the world. He offers us some tools and advice to prevent unregognised oesophageal intubation from happening in our practice. This session was recorded at the SAS workshop at CODA22 which took place in Melbourne in September 2022. For more information about the CODA Project go to: https://codachange.org/ 

Nicholas Chrimes, Andy Higgs and Tim Cook - three of the authors of the recently published PUMA guidelines - outline their key recommendations for the prevention of unrecognised oesophagael intubation. As a component of PUMA, these guidelines are intended for airway practitioners of all disciplines working in any context and have been endorsed by the world's major airway societies. This session was recorded at the SAS workshop at CODA22 which took place in Melbourne in September 2022. For more information about the CODA Project go to: https://codachange.org/ 

Episode 39! In this episode we talk about steroids in septic shock from community acquired pneumonia - a secondary from the APROCCHSS trial. We then dive into our mailbag to talk about a couple of topics we've been asked questions about and address them in a more broad sense. A pseudo-mailbag but with real answersAPROCCHSS-CAP: https://pubmed.ncbi.nlm.nih.gov/38310918/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!

Send us a Text Message.Video 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!

As you already know, in the months when we have a 5th Monday, we have an extra airway series episode.  This month, the team is talking blind-insertion airways. Interesting note, even anesthesia prefer a supraglottic airway device over intubation in short cases. Be sure to head to our Prehospital Paradigm Podcast YouTube channel to see the team demonstrate each of th skills discussed on this extra episode.

FAST24 | June 10 - 12, 2024 | Wilmington, North CarolinaFAST24 is our annual conference for pre-hospital and critical care transport professionals, including nurses, paramedics, and other disciplines. It features engaging workshops, talks by industry leaders, and focused sessions on air and surface critical care transport medicine. The event also offers a unique vendor experience, special guest appearances from notable talent in the industry, catered lunches, as well as relaxing and entertaining networking and social opportunities. Tickets are limited so don't wait! Visit https://fastsymposium.com for more information.The debate about which drug to use for sedation prior to RSI will.. just.. not… die. Advocates for both ketamine and etomidate approach the argument with near-religious zeal. There have been studies. We've even covered some here. What we need is a systematic review and meta-analysis, preferably using a type of analysis that recognizes that this likely isn't a black and white question and can bring some.. .nuance to it. That's were our friend Bayes comes in. Dr. Jarvis is joined by Drs Remle Crowe and CJ Winkler to discuss this paper and what in the hell Bayesian analysis actually is. We get some nice book recommendations in the process. Plus, we check in with ChatGPT for answers.Oh, BTW... don't take zoological advice from Dr. Winkler. Contrary to his thoughts, Giraffe's do NOT, in fact, have larger hearts than elephants. Citations:1. Koroki T, Kotani Y, Yaguchi T, Shibata T, Fujii M, Fresilli S, Tonai M, Karumai T, Lee TC, Landoni G, Hayashi Y. Ketamine versus etomidate as an induction agent for tracheal intubation in critically ill adults: a Bayesian meta-analysis. Crit Care. 2024 Feb 17;28(1):48. doi: 10.1186/s13054-024-04831-4. PMID: 38368326; PMCID: PMC10874027.2. Russotto V, Myatra SN, Laffey JG, et al. Intubation Practices and Adverse Peri-intubation Events in Critically Ill Patients From 29 Countries. JAMA. 2021;325(12):1164-1172.Bonus book recommendations3. Heller J. Catch-22. New York, NY: Simon & Schuster; 1961.4. McGrayne SB. The Theory That Would Not Die. How Bayes' Rule Cracked The Enigma Code, Hunted Down Russian Submarines & Emerged Triumphant From Two Centuries of Controversy. Yale University Press; 2011.5. Salsburg D. The Lady Tasting Tea: How Statistics Revolutionized Science In The Twentieth Century. Henry Holt & Company; 2001.

Rob Flanagan is a husband and father who lives with his family outside of Boulder, Colorado, and roughly one year ago he and his wife Dana began an ordeal that changed their lives. After a few days of fighting a cold and a slight fever while missing out on attending kindergarten, their daughter Saoirse was suddenly hospitalized and then intubated, and it was unclear if she would ever wake up.  On this episode of Paternal, Flanagan recounts the experience of spending days in the ICU with his wife while they awaited word on the health of their daughter, what the doctor's diagnosis meant for their family, and how he learned to embrace both acceptance and hope on the path to becoming a better father. Episode Timestamps: 00:00 - 05:43 - Introduction 05:43 - 11:54 - A frightening trip to the hospital 11:54 - 18:48 - Intubation and the diagnosis 18:48 - 23:13 - Asking for help and dealing with complex emotions 25:06 - 30:24 - A reawakening and an uncertain future 30:24 - 37:45 - A new reality, and changes in parenting 37:45 - 41:16 - Balancing what is, and what could have been Read The Transcript For This Episode

Anand Swaminathan on an update on the appropriate selection of induction agents. Hans Rosenberg on when to use gabapentinoids for pain control in the ED. Katie Lin on pearls for neuroprotective intubation. Nour Khatib and Hamza Jalal on an approach to paresthesias in the ED. Eric Wortmann on preventing burnout in emergency medicine. Please support EM Cases with a donation https://emergencymedicinecases.com/donation/ The post EM Quick Hits 55 – Induction Agents, Gabapentinoids, Neuroprotective Intubation, Approach to Paresthesias, Preventing Burnout appeared first on Emergency Medicine Cases.

Contributor: Aaron Lessen MD Educational Pearls: Is the adage, “GCS of 8, you've got to intubate” accurate? A recent study published in the November 2023 issue of JAMA attempted to answer this question. Design Multicenter, randomized trial, in France from 2021 to 2023. 225 patients experiencing comatose in the setting of acute poisoning were randomly assigned to either a conservative airway strategy of withholding intubation or “routine practice” of much more frequent intubation. The primary outcome was a composite endpoint including in-hospital death, length of intensive care unit stay, and length of hospital stay. Secondary outcomes included adverse events from intubation and pneumonia within 48 hours. Results Results showed that in the intervention group (with intubation withholding), only 16% of patients were intubated, compared to 58% in the control group. No in-hospital deaths occurred in either group. The intervention group demonstrated a significant clinical benefit for the primary endpoint, with a win ratio of 1.85 (95% CI, 1.33 to 2.58). The conservative airway management strategy also saw a statistically significant decrease in adverse events from intubation and pneumonia. Conclusion Among comatose patients with suspected acute poisoning, a conservative strategy of withholding intubation was associated with a greater clinical benefit. This suggests that a judicious approach to intubation is appropriate in many other settings and clinicians should rely on more than the GCS to make this decision. References Freund Y, Viglino D, Cachanado M, Cassard C, Montassier E, Douay B, Guenezan J, Le Borgne P, Yordanov Y, Severin A, Roussel M, Daniel M, Marteau A, Peschanski N, Teissandier D, Macrez R, Morere J, Chouihed T, Roux D, Adnet F, Bloom B, Chauvin A, Simon T. Effect of Noninvasive Airway Management of Comatose Patients With Acute Poisoning: A Randomized Clinical Trial. JAMA. 2023 Dec 19;330(23):2267-2274. doi: 10.1001/jama.2023.24391. PMID: 38019968; PMCID: PMC10687712. Summarized by Jeffrey Olson MS2 | Edited by Meg Joyce & Jorge Chalit, OMSII  

Unplanned extubation in the PCICU patient is a serious concern with many untoward associations. Who is at highest risk for this complication? Why is this complication associated with worse outcomes in general? How does race or ethnicity impact the likelihood of this complication? We speak with Assistant Professor of Pediatrics at the University of Cincinnati and pediatric cardiac critical care expert, Dr. Tanya Perry about a recent PC4 registry study on unplanned extubation in the PCICU. doi: https://doi.org/10.1097/pcc.0000000000003235