11. The Physiologically Difficult Airway

In this episode of Critical Care Time, co-hosts Dr. Nick Mark and Dr. Cyrus Askin discuss the physiologically difficult airway, differentiating it from the anatomically difficult airway. They emphasize the importance of understanding the physiological challenges during intubation, including vasodilation, hypoxemia, increased intracranial pressure, and decreased preload. Through detailed case studies, they illustrate how to manage patients with conditions like hemorrhagic shock, severe acidosis, hypoxia, RV failure, and traumatic brain injury, focusing on pre-oxygenation, hemodynamic stabilization, and careful selection of induction agents and vasopressors to mitigate risks and improve patient outcomes.

Outlines

Sign in to continue reading, translating and more.

Continue

Critical Care Time

Introduction to Difficult Airways

Defining and Differentiating Difficult Airways

Physiological Effects of Intubation and Induction

Case Study: The Under-Resuscitated Patient

Airway Management and Team Coordination in Hemorrhagic Shock

Case Study: The Acidemic Patient and Non-Invasive Ventilation

Bicarbonate Use and Temporizing Acidosis

Intubation Strategy for the Acidemic Patient

Case Study: The Hypoxemic Patient and Pregnancy Considerations

Intubation Strategy for the Hypoxemic Pregnant Patient and RV Failure

Airway Management and Vasopressor Choice in RV Failure

Rocuronium vs. Succinylcholine and High ICP Airway

Summary and Closing

11. The Physiologically Difficult Airway

Critical Care Time

00:00Introduction to Difficult Airways

Introduction to Difficult Airways

04:36Defining and Differentiating Difficult Airways

Defining and Differentiating Difficult Airways

13:31Physiological Effects of Intubation and Induction

Physiological Effects of Intubation and Induction

21:07Case Study: The Under-Resuscitated Patient

Case Study: The Under-Resuscitated Patient

28:30Airway Management and Team Coordination in Hemorrhagic Shock

Airway Management and Team Coordination in Hemorrhagic Shock

35:56Case Study: The Acidemic Patient and Non-Invasive Ventilation

Case Study: The Acidemic Patient and Non-Invasive Ventilation

44:04Bicarbonate Use and Temporizing Acidosis

Bicarbonate Use and Temporizing Acidosis

50:33Intubation Strategy for the Acidemic Patient

Intubation Strategy for the Acidemic Patient

57:58Case Study: The Hypoxemic Patient and Pregnancy Considerations

Case Study: The Hypoxemic Patient and Pregnancy Considerations

1:05:16Intubation Strategy for the Hypoxemic Pregnant Patient and RV Failure

Intubation Strategy for the Hypoxemic Pregnant Patient and RV Failure

1:12:34Airway Management and Vasopressor Choice in RV Failure

Airway Management and Vasopressor Choice in RV Failure

1:19:57Rocuronium vs. Succinylcholine and High ICP Airway

Rocuronium vs. Succinylcholine and High ICP Airway

1:27:06Summary and Closing

Summary and Closing