EMCrit Podcast
EMCrit 325 - The Hypoxemic Difficult Airway with Jarrod Mosier
Jun 5, 2022
Expert Jarrod Mosier discusses strategies for managing hypoxemic difficult airways, emphasizing pre-oxygenation methods and monitoring techniques. The podcast explores denitrogenation techniques, high-flow nasal oxygenation in shunt patients, and challenges of mask ventilating a hypoxemic airway. It also covers the pendulum phenomenon in refractory hypoxemia, physiological changes in sick lungs, delayed sequence intubation, and airway management strategies.
25:47
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Quick takeaways
- Monitoring end-tidal O2 levels aids in pre-oxygenation for difficult airways.
- Tailored approaches like awake intubation are essential for managing refractory hypoxemic patients.
Deep dives
Stratifying Patients for Airway Management
Patients are stratified based on their rate-limiting step in airway management: denitrogenation, functional residual capacity, or pure shunt. Denitrogenation involves using flush rate oxygen to prevent desaturation. Increase FRC in recruitable conditions to reduce VQ mismatch. In patients with pure shunt, challenges arise due to the lack of oxygenation potential.
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