In Podcast 104, we discussed how to avoid killing hemodynamically unstable patients while intubating. Today's podcast takes that concept a step further to allow you achieve a hemodynamically neutral intubation.

The Pieces

Rapid Sequence Awake

Discussed in this podcast

or

Dissociated "Awake" Intubation

or

A Combination

then

you can consider a DSI for Hemodynamics, but only in non-tenuous patients

then

place the patients on CPAP/PSV mode with both set to zero

if the patient requires mechanical ventilatory support because they continue to decline, consider

Higher Vt/Lower Rate as per Davis et al.

and

Sedate with small hits of ketamine or fentanyl

Further Reading

* Pulmonary Hypertension Awake Intubation from CCM

Now on to the Podcast...