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EM Quick Hits 58 – HIV PEP and PrEP, PREOXI Trial, Blast Crisis, Nitrous Oxide Poisoning, Vasopressors in Trauma

Emergency Medicine Cases

NOTE

Adapt Treatment to Patient Needs

Patients cannot be treated uniformly; they must be categorized based on lung condition—abnormal versus normal. For patients with normal lungs, utilizing nitrogen washout with 100% oxygen can significantly increase functional residual capacity (FRC), enhancing safety during apnea in laryngoscopy intubation as part of rapid sequence intubation (RSI). Ensuring that minute ventilation requirements are met is crucial, especially for sick patients who may demand higher rates of oxygen flow. If the oxygen flow does not meet these demands, patients will entrain room air, diluting their fraction of inspired oxygen (FiO2). Thus, adjusting flow rates, potentially up to 50-60 liters per minute, is necessary to meet individual ventilation needs.

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