The FlightBridgeED Podcast

TRAPPED IN FLESH: Respiratory Failure in Obese Patients


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Join Eric Bauer and Dr. Mike Lauria as they dissect two challenging critical care transport cases centered on managing respiratory failure in obese and morbidly obese patients. Get ready for a deep dive into advanced physiological concepts, practical tips for troubleshooting ventilator settings, and real-world lessons you can apply to patient care right away. From recognizing unique challenges in the obese population to fine-tuning pressures and understanding how to balance protective ventilation with the realities of chest wall resistance, this episode offers clear, expert-level insights delivered in an approachable way.


Key Takeaways

  • Appreciating that obesity significantly reduces functional residual capacity, requiring thoughtful increases in ventilatory pressures.
  • Using waveform analysis, plateau pressures, and driving pressures to differentiate between obstructive and restrictive components, especially when chronic illnesses overlap with acute processes.
  • Strategic positioning such as ramping or partial proning can be employed to recruit lung volume and improve oxygenation.
  • Recognizing that some patients will need alarm limits and inspiratory pressures far beyond standard protocols—especially when chest wall resistance is extremely high.
  • Incorporating a systematic approach, including incremental changes and close monitoring, rather than relying on one-size-fits-all protocols.
  • Leveraging collaborative practice and direct medical oversight to fine-tune treatment in the face of complex physiology.

The FlightBridgeED Podcast has been your go-to resource for critical care, EMS, and emergency medicine education since 2012. Access this episode and the entire library wherever you get your podcasts or by visiting flightbridgeed.com. While you’re there, you can also explore our award-winning courses that have helped countless professionals master advanced practice concepts.

We invite you to explore our full range of podcast shows, where our network of FlightBridgeED creators and contributors deliver dynamic discussions on everything from critical care to cutting-edge EMS topics. You’ll also find unique blogs, training resources, and opportunities to engage in our growing community. And don’t forget to check out our upcoming courses and see what’s happening at FAST this year.

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The FlightBridgeED PodcastBy Long Pause Media | FlightBridgeED

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