The FlightBridgeED Podcast

CRASH & BURN: Airway Management in Hemodynamically Unstable Patients - Part 2


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In Episode 264 of the FlightBridgeED Podcast: MDCAST, Dr. Mike Lauria, Dr. Jeff Jarvis, and trauma anesthesiologist Dr. Chris Stevens return for Part 2 of their deep dive into airway management in profoundly hemodynamically unstable patients. In this episode, the trio explores controversial topics such as the use of pressors in trauma patients, mechanical ventilation in the pre-hospital setting, and the pharmacology of paralytic agents like rocuronium. They also address the highly debated practice of withholding sedatives in certain critically ill patients and emphasize the importance of proper timing when using neuromuscular blockade. This episode provides practical insights for new and seasoned pre-hospital and critical care transport medicine providers, especially when managing CRASH airways and peri-arrest situations.

Some Takeaways to Listen For in this Episode:

  • Pressors in Trauma Patients: Dispels the myth that trauma patients shouldn’t receive pressors. Pressors can temporarily stabilize blood pressure while awaiting blood products or other resuscitation efforts.
  • Mechanical Ventilation Post-Intubation: Highlights the importance of gentle, positive-pressure ventilation to avoid worsening hypotension in trauma patients.
  • Rocuronium Use: This episode discusses optimal dosing and the importance of waiting the full 60–90 seconds for the drug to take effect to ensure successful intubation.
  • Withholding Sedation: Explores the controversial practice of omitting sedatives in patients with a GCS of 3 who are completely unresponsive and peri-arrest. This is common in trauma anesthesia but remains debated in pre-hospital and critical care transport settings.

FAST25 | May 19-21, 2025 | Lexington, KY

🔥 FAST25 is back—bigger, bolder, and hotter than ever! 🔥

This isn’t just another conference—a high-energy, immersive experience for pre-hospital and critical care transport pros. Expert-led sessions, hands-on workshops, and unfiltered discussions will take your practice to the next level.

🚀 New for 2025: The Creator Festival – Featuring “Burnt Ones,” a spicy take on Hot Ones, where top EMS creators tackle scorching hot wings while answering the most challenging questions in the industry. Expect live demos, interactive exhibits, and big-name influencers sharing their insight in a way you won’t find anywhere else.

Plus, a killer vendor experience, special guests, catered lunches, and after-hours events that make networking effortless and enjoyable. FAST25 is where it all happens.

📍 Central Bank Center | Lexington, KY
🏨 Hilton Lexington/Downtown (special rates available!)
🎟️ Tickets are limited—grab yours now: flightbridgeed.com/fast25

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