tag:blogger.com,1999:blog-3339915911356078232.post4573680908620585400..comments2024-03-07T09:10:48.658-05:00Comments on MDaware.org: RSA A-OKmdawarehttp://www.blogger.com/profile/11511273712090189564noreply@blogger.comBlogger2125tag:blogger.com,1999:blog-3339915911356078232.post-26118303930839957402013-03-07T13:45:18.850-05:002013-03-07T13:45:18.850-05:00Tyro- Thanks -- I agree with you all around. But I...Tyro- Thanks -- I agree with you all around. But I have had patients who preoxygenated perfectly with NIV but desat before you can even get the laryngoscope seated. Some patients just don't have enough o2-time to get an ET tube.mdawarehttps://www.blogger.com/profile/11511273712090189564noreply@blogger.comtag:blogger.com,1999:blog-3339915911356078232.post-32160886538072801542013-03-07T13:33:12.239-05:002013-03-07T13:33:12.239-05:00Good post and discussion. For a patient that you ...Good post and discussion. For a patient that you cannot pre-oxygenate successfully even with NINV and a sedative (i.e., ketamine then BiPAP) this is a great idea and I agree overall that desaturation is a larger evil than aspiration; these patients with a poor reserve rarely seem to have a 'brief' desaturation because it takes so long to drag them back up the steep part of the dissociation curve with FM/BVM. IF you can get the patient ready with BiPAP, I don't see why you wouldn't try an ETT first time once the pulse ox is 100% even with a low reserve. However, in that situation I would have the intubating LMA open, lubed, checked, and ready, and take only one shot, after which RSA would be a good way to go.Tyrohttps://www.blogger.com/profile/06274875231456958701noreply@blogger.com