Preoxygenation Before Intubation | MAJC 24 June 2024 | The Overrun

Summary
In this episode of the Monday Afternoon Journal Club, Dr. Mike DeFilippo discusses a study published in the New England Journal of Medicine on non-invasive ventilation for pre-oxygenation during emergency intubation. The study aimed to determine if using non-invasive positive pressure ventilation (NIPPV) reduces peri-intubation hypoxemia and cardiac arrest compared to standard face mask oxygenation. The study found that NIPPV resulted in less hypoxemia and lower rates of cardiac arrest compared to standard oxygenation. The study also found similar rates of aspiration between the two groups. The findings suggest that NIPPV can be beneficial for pre-hospital critically ill patients undergoing intubation.
Keywords
non-invasive ventilation, pre-oxygenation, emergency intubation, hypoxemia, cardiac arrest, aspiration, NIPPV, EMS
Takeaways
Non-invasive positive pressure ventilation (NIPPV) reduces peri-intubation hypoxemia and cardiac arrest in critically ill patients.
NIPPV can be a valuable tool for pre-hospital intubation in EMS settings.
CPAP can be used as an alternative to BiPAP for pre-oxygenation in the absence of a ventilator.
Resuscitate before intubating and have all necessary equipment ready for intervention.
Consider prophylactic anti-emetics for patients with questionable mental status to reduce the risk of aspiration.
Chapters
00:00 Introduction and Background
02:25 Overview of the Study
06:30 Implications for EMS
09:08 Recommendations for Pre-Hospital Practice
13:54 CPAP as an Alternative to BiPAP
16:16 Changing Pre-Hospital Practices
www.nejm.org/doi/abs/10.1056/...
1.Gibbs KW, Semler MW, Driver BE, Seitz KP, Stempek SB, Taylor C, et al. Noninvasive Ventilation for Preoxygenation during Emergency Intubation. New England journal of medicine/ The New England journal of medicine. 2024 Jun 13;
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