Physiologically Difficult Intubation

Physiology
-when the pH or BP is low, optimize prior to giving sedative/paralytic and making the pt apneic
if you have time, check the blood gas, give fluid boluses, consider a bicarb push prior to intubation
-now is the time for push-dose epi! (NOT phenylephrine unless the pt is in afib RVR)

Oxygenation
-preoxygenate via nasal cannula + NRB each set to 15L/m, high flo, or BiPAP if underlying physiology dictates and pt can tolerate

O2 concentration in arterial blood:

CaO2 = (SaO2 x Hb x 1.34) + .003(PaO2)

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