How do you manage patients who are peri-arrest?

In this KZbin summary, Dr. Mohammed Hagahmed, an Emergency Medicine physician, shared a compelling case of a crashing patient and discussed the critical importance of peri-intubation resuscitation. He emphasized the need to avoid pitfalls like hypoxemia and hypotension and to resuscitate patients before intubation. Dr. Hagahmed also touched on the choice of sedation and paralytic agents, highlighting the value of starting sedation immediately upon intubation to ensure patient comfort and safety. The discussion involved considerations for different patient scenarios, such as the use of ketamine in status asthmaticus, and addressed questions from the audience, providing valuable insights into the practice of emergency intubation.
00:00 Introduction and Personal Background
01:19 Case Study: Miss Z's Emergency
04:34 Analysis of Miss Z's Case
05:13 Literature Review: Peri-Intubation Cardiac Arrest
08:23 Discussion on Fluids and Vasopressors
09:47 Debate: Etomidate vs Ketamine
11:56 Reflection on Miss Z's Case
13:01 Q&A Session
17:46 Conclusion

[@ManjitKaur-gr6jj]

I have seen ED physicians intubating pts in icu starting them on levophed drip even when the SBP are as high as 130 - is this necessary

[@CriticalCareNow]

Adds a buffer of safety with the BP

[@farhanqadeer82]

One of the most common reason of people dying peri intubation because Not all emergent intubation needs emergent intubation: if one can bag the patient, give of seal you have time, and if you can oxygenate, unless you need airway in case of GI bleed etc etc: My approach -- fluids wide open, start vasopressin whatever available , use neo stick, use ketamine and minimal medication. Use VL, I will wait for VL instead of DL to make sure it’s first pass. Get A line if I can and have time, get IO or access, get pads on if I have time. Again not all emergent intubation are truly emergent. It’s the physician anxiety not the patient condition is going to kill the patient.

[@CriticalCareNow]

These are some good points

[@EMERGEinEM]

It all comes down to resuscitating your patient before incubating them. A mantra worth repeating. Thank you for your comments.