EBQ:ED Preoxygenation

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Under Review Journal Club Article
Weingart, S. et al. "Preoxygenation and Prevention of Desaturation During Emergency Airway Management". Annals of Emergency Medicine. 2012. 59(=3):165-75.
PubMed PDF

Clinical Question

Reviews preoxygenation and peri-intubation oxygenation techniques to minimize the risk of critical hypoxia and introduces a risk-stratification approach to emergency tracheal intubation.

Major Points

Design

Review of methods and approaches to preparing for intubation of patients with varying levels of risk of hypoxia.

CME

1 What do they recommend while awaiting the onset of muscle relaxation for a patient who is hypoxemic (<90% SpO2)?

NRB and nasal oxygen at 15L/min
NRB, CPAP or BVM with peep and nasal oxygen at 15L/min
CPAP or BVM with peep and nasal oxygen at 15L/min

2 What is the recommendation for passive oxygenation in low risk (>96% or above SpO2) intubation patients?

It is always indicated
It may not be necessary but could extend safe apnea in the event of repeated intubation attempts.
It could increase the risk of adverse events due to complications from equipment confusion

Sources