Great videos. From a pre-hospital POV I've had great success with high flow capnography nasal cannulas pre intubation and leaving it flowing during intubation. Using CPAP as a pre-oxygenation tool works great as well especially when short handed and only have a single ALS provider on the ambulance.
In the EMS system where I work, we're doing DSI. HFNC to start off, followed by a CPAP mask with BVM attached flowing at 25. The target is spO2 >94 for at least three minutes. If that isn't achieved, we don't attempt to intubate.
FWIW, the highest rate on our portable (EMS cylinder) regulators is 25lpm. Comparing 15lpm to 50lpm is a great demo. If you re-do something like this again, might you include 25lpm rates as well? If that's insufficient, it may justify getting higher-flow regulators.
As an anaesthesiologist, I would be more than happy to have you or another member of your team apply these principles to me if it was necessary. It's a shame that your anaesthesia colleagues could not be bothered to contribute.
Interesting comment. I did ask three anesthesiologists and three respiratory therapists for input on this topic before the video was finalized and not a single one responded. I had to assume that they didn't feel comfortable enough with the topic to respond or it was to far beneath them.
Great videos.
From a pre-hospital POV I've had great success with high flow capnography nasal cannulas pre intubation and leaving it flowing during intubation.
Using CPAP as a pre-oxygenation tool works great as well especially when short handed and only have a single ALS provider on the ambulance.
Thanks!
In the EMS system where I work, we're doing DSI. HFNC to start off, followed by a CPAP mask with BVM attached flowing at 25. The target is spO2 >94 for at least three minutes. If that isn't achieved, we don't attempt to intubate.
Incredibly interesting demo. Thank you so much!
Thanks!!
FWIW, the highest rate on our portable (EMS cylinder) regulators is 25lpm. Comparing 15lpm to 50lpm is a great demo. If you re-do something like this again, might you include 25lpm rates as well? If that's insufficient, it may justify getting higher-flow regulators.
Interesting. Thanks for the information.
As an anaesthesiologist, I would be more than happy to have you or another member of your team apply these principles to me if it was necessary. It's a shame that your anaesthesia colleagues could not be bothered to contribute.
Thanks!!
Thank you so much for your videos, Dr. Mellick. One question: "flush rate oxygen" simply refers to cranking the O2 up as far as it'll go, right?
Yes, that is correct. You are welcome!
wont the patient become alkalotic?
What about BMV + flush o2 on pediatric population ?
ruclips.net/video/YHrd10qDscA/видео.html It depends on the pediatric bag, but it isn't as clear-cut and easy with pediatric bags.
Thank you boss..another great pearl
You are welcome.
Best left to anaesthesiologists....
Interesting comment. I did ask three anesthesiologists and three respiratory therapists for input on this topic before the video was finalized and not a single one responded. I had to assume that they didn't feel comfortable enough with the topic to respond or it was to far beneath them.
Nice come back