Podcasts about preoxygenation

This episode of Critical Matters will close 2024 with a year in review. Dr. Sergio Zanotti is going solo and will discuss a couple of relevant clinical guidelines and review five clinical trials. To close, he'll share some of his favorite books for 2024. Additional Resources: Critical Care Management of Patients Post Cardiac Arrest (AHA/NCS): Hirsch KG, Abella BS, Amorim E, et al. Critical Care Management of Patients After Cardiac Arrest: A Scientific Statement from the American Heart Association and Neurocritical Care Society. Neurocrit Care. 2024;40(1):1-37: https://bit.ly/4087o1w 2024 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support: Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces. Circulation 2024: https://bit.ly/4fD4o1R PREOXI Trial. Gibbs KW, Semler MW, Driver BE, et al. Noninvasive Ventilation for Preoxygenation during Emergency Intubation. N Engl J Med. 2024;390(23):2165-2177. doi:10.1056/NEJMoa2313680: https://bit.ly/4fD4pCX AMIKINHAL Trial. Ehrmann S, Barbier F, Demiselle J, et al. Inhaled Amikacin to Prevent Ventilator-Associated Pneumonia. N Engl J Med. 2023;389(22):2052-2062. doi:10.1056/NEJMoa2310307: https://bit.ly/4iQQvzU REVISE Trial. Cook D, Deane A, Lauzier F, et al. Stress Ulcer Prophylaxis during Invasive Mechanical Ventilation. N Engl J Med. 2024;391(1):9-20. doi:10.1056/NEJMoa2404245: https://bit.ly/3Pc4nqH TIGHT K Trial. O'Brien B, Campbell NG, Allen E, et al. Potassium Supplementation and Prevention of Atrial Fibrillation After Cardiac Surgery: The TIGHT K Randomized Clinical Trial. JAMA. 2024;332(12):979-988. doi:10.1001/jama.2024.17888: https://jamanetwork.com/journals/jama/fullarticle/2823246 BALANCE Trial. Daneman N, Rishu A, et al. Antibiotic Treatment for 7 versus 14 Days in Patients with Bloodstream Infections. N Engl J Med. Published online November 20, 2024. doi:10.1056/NEJMoa2404991: https://www.nejm.org/doi/abs/10.1056/NEJMoa2404991 CMD Study. Bodien YG, Allanson J, Cardone P, et al. Cognitive Motor Dissociation in Disorders of Consciousness. N Engl J Med. 2024;391(7):598-608. doi:10.1056/NEJMoa2400645: https://www.nejm.org/doi/full/10.1056/NEJMoa2400645 Books Mentioned in this Episode: Slow Productivity: The Lost Art of Accomplishment Without Burnout. By Cal New Port: https://amzn.to/4gTbkJ2 Meditations for Mortals: Four Weeks to Embrace Your Limitations and Make Time for What Counts. By Oliver Burkeman: https://bit.ly/4gURU6N Knife: Meditations After an Attempted Murder. By Salman Rushdie: https://bit.ly/3ZPsAIt

Happy September! This month for the September 2024 episode of the RCEM Learning Podcast, we have a new in EM section looking at the use of NIV for preoxygenation in RSI. We then have Becky and Chris going over a new Guidelines for EM looking at the NICE Guidelines for meningitis. Rob puts on his TERN hat and speaks to the two former TERN Fellows and Dan Horner about the results of the Subarachnoid Haemorrhage in the ED Study before ending with New Online. If you'd like to email us, please feel free to do so here. After listening, complete a short quiz to have your time accredited for CPD at the RCEMLearning website! (02:30) New in EM - NIV for preoxygenation in RSI Noninvasive Ventilation for Preoxygenation during Emergency Intubation (Gibbs et al., 2024) (20:47) Guidelines for EM - NICE Guidance for Meningitis Meningitis (bacterial) and meningococcal disease: recognition, diagnosis and management (NICE, 2024) (01:05:00) The TERN SHED Study - 36:30 Subarachnoid haemorrhage in the emergency department (SHED): a prospective, observational, multicentre cohort study (The Trainee Emergency Research Network, 2004) - link to the paper coming soon The TERN Website TERN on Twitter/X (01:41:35) New Online – new articles on RCEMLearning for your CPD Training for Research in Emergency Care (TREC) - The TREC Team Delivering Bad News - Charlotte Davies Ocular trauma - Deepa Elsa George, Sophie Seguin-Greenstein

As the UK enjoys its unpredictable summer, with everything from sunshine to hailstorms, we bring you a mix of updates and discussions on emergency medicine, blog content, upcoming conferences, and insightful research reviews. So, whether you're basking in the sun or sheltering from the rain, sit back and enjoy our latest insights into the world of emergency medicine. In this round-up of Month Year, we talk about a wide range of issues relating to emergency medicine, including nebulised ketamine for analgesia in the ED, risky intubations, presentation skills, more about the DOSE VF trial and analysis of the much-hyped PREOXI trial about preoxygenation before tracheal intubation. We're excited to announce our participation in two upcoming conferences. The Tactical Trauma Conference in Sweden this October promises to delve into pre-hospital emergency medicine, offering sessions from renowned speakers. It's a fantastic opportunity to learn and network, with flights to Sweden being relatively affordable. The event takes place just north of Stockholm, providing a chance to explore the beautiful city. In March next year, we look forward to the Incrementum Conference in Murcia, Spain. This is a significant event as emergency medicine has recently been recognized as a specialty in Spain. The conference will feature an impressive lineup of speakers from the FOMED world, including Scott Weingart, Ken Milne, Hany Malamatt, and Slim Resie , among others. Our very own Simon Carly will also be presenting. We'll be there to conduct interviews and gather exclusive content for our listeners. Thank you for joining us, please do like and subscribe wherever you get our podcasts.  

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.

The JournalFeed podcast for the week of June 10-14, 2024.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:This was a validation study for the recently published American College of Cardiology (ACC) Expert Consensus Decision Pathway for chest pain. Results suggest this pathway is safe and efficacious for use in patients without known CAD; however, performance was not as good for patients with known CAD.Friday Spoon Feed:Noninvasive ventilation (NIV) was superior to standard non-rebreather (NRB) oxygen mask for preoxygenation of critically ill, adult ED or ICU patients requiring intubation, with a NNT of 11 to prevent 1 episode of hypoxemia

In this episode, I speak about a little bit about my experience in CODA 22 in Melbourne followed by airway techniques that can be used in the daily practice of an emergency physician. You can go through the following papers - 1. Mosier JM, Joshi R, Hypes C, Pacheco G, Valenzuela T, Sakles JC. The Physiologically Difficult Airway. West J Emerg Med. 2015 Dec;16(7):1109-17. doi: 10.5811/westjem.2015.8.27467. Epub 2015 Dec 8. PMID: 26759664; PMCID: PMC4703154. 2. Perbet S, De Jong A, Delmas J, Futier E, Pereira B, Jaber S, Constantin JM. Incidence of and risk factors for severe cardiovascular collapse after endotracheal intubation in the ICU: a multicenter observational study. Crit Care. 2015 Jun 18;19(1):257. doi: 10.1186/s13054-015-0975-9. PMID: 26084896; PMCID: PMC4495680. 3. Mort TC. The incidence and risk factors for cardiac arrest during emergency tracheal intubation: a justification for incorporating the ASA Guidelines in the remote location. J Clin Anesth. 2004 Nov;16(7):508-16. doi: 10.1016/j.jclinane.2004.01.007. PMID: 15590254. 4. Weingart SD, Levitan RM. Preoxygenation and prevention of desaturation during emergency airway management. Ann Emerg Med. 2012 Mar;59(3):165-75.e1. doi: 10.1016/j.annemergmed.2011.10.002. Epub 2011 Nov 3. PMID: 22050948. 5. Weingart SD, Trueger NS, Wong N, Scofi J, Singh N, Rudolph SS. Delayed sequence intubation: a prospective observational study. Ann Emerg Med. 2015 Apr;65(4):349-55. doi: 10.1016/j.annemergmed.2014.09.025. Epub 2014 Oct 23. PMID: 25447559. 6. Schwenk ES, Viscusi ER, Buvanendran A, Hurley RW, Wasan AD, Narouze S, Bhatia A, Davis FN, Hooten WM, Cohen SP. Consensus Guidelines on the Use of Intravenous Ketamine Infusions for Acute Pain Management From the American Society of Regional Anesthesia and Pain Medicine, the American Academy of Pain Medicine, and the American Society of Anesthesiologists. Reg Anesth Pain Med. 2018 Jul;43(5):456-466. doi: 10.1097/AAP.0000000000000806. PMID: 29870457; PMCID: PMC6023582. 7. Green SM, Roback MG, Kennedy RM, Krauss B. Clinical practice guideline for emergency department ketamine dissociative sedation: 2011 update. Ann Emerg Med. 2011 May;57(5):449-61. doi: 10.1016/j.annemergmed.2010.11.030. Epub 2011 Jan 21. PMID: 21256625. 8. Sehdev RS, Symmons DA, Kindl K. Ketamine for rapid sequence induction in patients with head injury in the emergency department. Emerg Med Australas. 2006 Feb;18(1):37-44. doi: 10.1111/j.1742-6723.2006.00802.x. PMID: 16454773. 9. Zeiler FA, Teitelbaum J, West M, Gillman LM. The ketamine effect on ICP in traumatic brain injury. Neurocrit Care. 2014 Aug;21(1):163-73. doi: 10.1007/s12028-013-9950-y. PMID: 24515638. 10. Tsan et al. Comparison of Macintosh Laryngoscopy in Bed-up-Head-Elevated Position With GlideScope Laryngoscopy: A Randomized, Controlled, Noninferiority Trial. Anesth Analg. PMID: 31348051.

In this week's episode, Keith and Courtney discuss what Functional Residual Capacity (FRC) is, why we should understand this component of lung volume, and its role in patient ventilation and oxygenation. Have you considered that there is usually about one breath to every 4 or so heartbeats? This is exactly why understanding the FRC is so important. So take a deep breath, sit back and enjoy!

In this episode we'll discuss tips and tricks for dominating your clinical interview. We'll cover Trauma, ABG's, Neuro Emergencies, Labs, RSI, Preoxygenation, DKA, and Pressors.

Calvin A. Brown III, MD presents three nominees for "2020 Airway Article of the Year."  The nominated articles were chosen from among those featured in the 2020 Quarterly Airway Research Updates.  Dr. Brown discusses the merits of each article and the audience votes for the "Airway Article of the Year."  

Dr. Calvin Brown discusses recent research on ketamine, preoxygenation, and the use of aerosol barrier boxes for use during intubation of COVID-19 patients.

Dr. Calvin Brown takes a deep dive into the current state of and recommendations regarding pre-oxygenation and bagging during rapid sequence intubation (RSI).

What’s the common thread among the topics Drs. Pescatore and Raja tackle this month? Tune in to find out when they talk about patients who want a second opinion in the ED, apneic preoxygenation, and techniques for shoulder reduction.

Dr. Calvin Brown discussed four research studies focusing on preoxygenation, hypotension, Video v. Direct Laryngoscopy and predicting difficulty in airway management.  

Podcast summary of articles from the October 2018 edition of Journal of Emergency Medicine from the American Academy of Emergency Medicine.  Topics include intranasal vasoconstrictors, pre-oxygenation with NIPPV and nasal cannula, cardiac glycoside toxicity, age adjusted D-dimer for pulmonary embolism, antibiotic use after abscess drainage, and board review on immune checkpoint inhibitor toxicities.  Guest speaker is Dr. Matthew Addis.

Preoxygenation is not just a step included in the process of Rapid Sequence Intubation, it is critical! The EM GuideWire team takes a quick look on how to optimize the preoxygenation process and what techniques can be applied most practically in the ED.

Calvin Brown III, MD present three nominees for “2016 Airway Article of the Year.” The nominated articles were chosen from among those featured in the 2016 Quarterly Airway Research Updates. Dr. Brown discusses the content and merits of each article and the audience votes for the "Airway Article of the Year.”

Dr. Calvin Brown III introduces the latest published airway research and discusses its impact on clinical practice.

Author: David Rosenberg, M.D. Educational Pearls Preoxygenation is done before rapid sequence intubation, and should be done even if SaO2 is at 100%. Preoxygenation is done to fill the lungs with oxygen rather than ambient air, which is only 20% O2. While the patient is paralyzed, the O2-filled lungs will continue to oxygenate venous blood, buying you more time for intubation.   BiPAP is an effective tool for pre-oxygenation. References: https://lifeinthefastlane.com/ccc/preoxygenation/

I det här avsnittet diskuteras en av de mest basala färdigheterna inom mitt område – intubation. Begreppet NODESAT (Nasal Oxygen During Efforts Securing A Tube). Weingart, S. D., Levitan, R. M., Mort, T. C., Davis, D. P., Hwang, J. Q., Dunford, J. V. (2012). Preoxygenation and Prevention of Desaturation During Emergency Airway Management. Annals of […]

Episode 83: Flush rate preoxygenation before intubation

Calvin Brown III, MD present three nominees for “2016 Airway Article of the Year.” The nominated articles were chosen from among those featured in the 2016 Quarterly Airway Research Updates. Dr. Brown discusses the content and merits of each article and the audience votes for the "Airway Article of the Year.”

Through a case discussion, Dr. Calvin Brown III introduces the latest published airway research and discusses its impact on clinical practice.

NC: yea or nay

This week we discuss some of the critical issues in preparation, preoxygenation and positioning in RSI. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_54_0_Final_Cut.m4a Download Leave a Comment Tags: 7 Ps, High-flow Nasal Cannula, Intubation, Preoxygenation, RSI Show Notes Read More EM Updates: Intubation Checklist Core EM: Episode 4.0 – Perimortem C-section, Procedural Sedation and Airway Pearls Core EM: Episode 6.0 – Airway Workshops Sales JC et al. The Importance of First Pass Success When Performing Orotracheal Intubation in the Emergency Department. Acad Emerg Med 2013; 20(1): 71-8. PMID: 23574475

This week we discuss some of the critical issues in preparation, preoxygenation and positioning in RSI. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_54_0_Final_Cut.m4a Download Leave a Comment Tags: 7 Ps, High-flow Nasal Cannula, Intubation, Preoxygenation, RSI Show Notes Read More EM Updates: Intubation Checklist Core EM: Episode 4.0 – Perimortem C-section, Procedural Sedation and Airway Pearls Core EM: Episode 6.0 – Airway Workshops Sales JC et al. The Importance of First Pass Success When Performing Orotracheal Intubation in the Emergency Department. Acad Emerg Med 2013; 20(1): 71-8. PMID: 23574475

This week we discuss some of the critical issues in preparation, preoxygenation and positioning in RSI. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_54_0_Final_Cut.m4a Download Leave a Comment Tags: 7 Ps, High-flow Nasal Cannula, Intubation, Preoxygenation, RSI Show Notes Read More EM Updates: Intubation Checklist Core EM: Episode 4.0 – Perimortem C-section, Procedural Sedation and Airway Pearls Core EM: Episode 6.0 – Airway Workshops Sales JC et al. The Importance of First Pass Success When Performing Orotracheal Intubation in the Emergency Department. Acad Emerg Med 2013; 20(1): 71-8. PMID: 23574475

The importance of preoxygenation before RSI.

It's Janu-Airway: Here's a little update on preox (you know the topic I think about 20 hours a day)

Hot on the heels of Dr. Weingart's latest publication in the Annal of EM on Preoxygenation & Delayed Sequence Intubation, we have Dr. Weingart, perhaps the world's most influential critical care educator, and Dr. Walter Himmel, 'The Walking Encyclopedia of EM' discussing how the community ED doc can use preoxygenation, apneic oxygenation and delayed sequence intubation to help improve airway management knowledge and skills. Whether you work in a rural setting or a big urban community hospital, Dr. Himmel and Dr. Weingart explain how these concepts and skills are easily adaptable to your work environment. We introduce the Triple 15 Rule for preoxygenation as a memory aid that will help you the next time you're faced with a critically ill patient who's oxygen saturation isn't good enough on a non-rebreather. The post Episode 54: Preoxygenation and Delayed Sequence Intubation appeared first on Emergency Medicine Cases.

Hot on the heels of Dr. Weingart's latest publication in the Annal of EM on Preoxygenation & Delayed Sequence Intubation, we have Dr. Weingart, perhaps the world's most influential critical care educator, and Dr. Walter Himmel, 'The Walking Encyclopedia of EM' discussing how the community ED doc can use preoxygenation, apneic oxygenation and delayed sequence intubation to help improve airway management knowledge and skills. Whether you work in a rural setting or a big urban community hospital, Dr. Himmel and Dr. Weingart explain how these concepts and skills are easily adaptable to your work environment. We introduce the Triple 15 Rule for preoxygenation as a memory aid that will help you the next time you're faced with a critically ill patient who's oxygen saturation isn't good enough on a non-rebreather. The post Episode 54: Preoxygenation and Delayed Sequence Intubation appeared first on Emergency Medicine Cases.

A week ago, I posted an airway review paper by Scott Weingart and Richard Levitan that I think is a must read. Today I decided to do a podcast reviewing the paper in order to really get it out there and talk about the major points. The best part of the paper is the description of the NO DESAT technique which virtually eliminates hypoxia during RSI and will make your next intubation a lot easier. While this podcast is a lot more advanced than the usual "basic" topics that I usually talk about, its important to know about these techniques. My 0.02- they will become the new standard of care in the near future but you can hear about them now.

How to make your crappy BVM into a powerful preoxygenation device--on the cheap.