Anaesthesia Coffee Break

How do you PREVENT HYPOXAEMIA when performing a rapid sequence induction (RSI)?


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You've probably performed a few RSIs in your anaesthesia practice. But have you though about all the techniques you do to make this inherently risky technique safer?

In this episode we chat about the approach to the question from the April 2014 and September 2013 SAQ paper

Describe the physiological basis of methods used to prevent hypoxaemia prior to intubation in a rapid sequence induction. Include any adverse effects of these methods.

 The exam paper
https://networks.anzca.edu.au/d2l/le/content/7669/Home?itemIdentifier=D2L.LE.Content.ContentObject.ModuleCO-86745

Atomic Habits summary by James Clear
https://www.samuelthomasdavies.com/book-summaries/self-help/atomic-habits/

The book
https://jamesclear.com/atomic-habits

Interview with James Clear on Making Sense Podcast with Sam Harris
https://samharris.org/subscriber-extras/200-creatures-habit/

Plateau of Latent potential
https://i0.wp.com/www.samuelthomasdavies.com/wp-content/uploads/2019/01/The-Plateau-of-Latent-Potential-1.png?w=2000&ssl=1

Bleomycin and oxygen toxicity
https://www.mayoclinicproceedings.org/article/S0025-6196(12)60489-3/fulltext

Oxygen therapy for sats <94% in acute coronary syndrome
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4952356/

Alveolar gas equation for FiO2 100%
FiO2 (Patmos - PH2O) - pCO2/R
1.0(760-47) - 40/0.8
713 - 50
= 663mmHg

for FiO2 at room air of 21%
0.21 (713) -50
= 99.7mmHg
~ 100mmHg

Cricoid - 20N applied to the cricoid cartilage to cause external pressure constricting the oesophagus and thereby decreasing the chance of aspiration. 
BUT
Increases the time to intubation
Impairs the laryngoscope view
No proven benefit
Can cause discomfort



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Any questions please email [email protected] 

 

Disclaimer:

The information contained in this podcast is for medical practitioner education only. It is not and will not be relevant for the general public.

This contains general information about medical conditions and treatments. The information is not advice and should not be treated as such. 

The medical information is provided “as is” without any representations or warranties, express or implied. 

The presenter makes no representations or warranties in relation to the medical information on this video. 

You must not rely on the information as an alternative to assessing and managing your patient with your treating team and consultant.

You should seek your own advice from your medical practitioner in relation to any of the topics discussed in this episode’

 Medical information can change rapidly, and the author/s make all reasonable attempts to provide accurate information at the time of filming. There is no guarantee that the information will be accurate at the time of viewing

 The information provided is within the scope of a specialist anaesthetist (FANZCA) working in Australia.

 The information presented here does not represent the views of any hospital or ANZCA.

 These podcasts are solely for training and education of medical practitioners, and are not an advertisement. They were not sponsored and offer no discounts, gifts or other inducements. 

This disclaimer was created based on a Contractology template available at http://www.contractology.com. 




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Anaesthesia Coffee BreakBy Lahiru Amaratunge

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