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SlaveOfTCMC

Full Member
May 8, 2011
334
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Hold patients' hands
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Kind of a dumb question but:

"Elective intubation" would refer to the DOCTOR making the call for intubation in this case?

The question I came across was about someone who had Guillain barre with the ascending paralysis but at the moment the patient had a normal respiratory exam and was breathing all right.

No mention of FEV1 or other spirometry components given.

The choice asked next best step.

Securing the airway does always seem like the right step. But I was thrown off by the term "elective intubation"

The only other answer that would have made sense was IVIG...

The correct one was "elective intubation"


So just to clarify, the "elective" part in this case probably does not refer to the patient making a choice, but rather on the status of the respiratory effort?
 

PMPMD

4G MD
15+ Year Member
Oct 16, 2001
1,431
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  1. Attending Physician
Kind of a dumb question but:

"Elective intubation" would refer to the DOCTOR making the call for intubation in this case?

The question I came across was about someone who had Guillain barre with the ascending paralysis but at the moment the patient had a normal respiratory exam and was breathing all right.

No mention of FEV1 or other spirometry components given.

The choice asked next best step.

Securing the airway does always seem like the right step. But I was thrown off by the term "elective intubation"

The only other answer that would have made sense was IVIG...

The correct one was "elective intubation"


So just to clarify, the "elective" part in this case probably does not refer to the patient making a choice, but rather on the status of the respiratory effort?

What "elective" means in this case is: before the patient's respiratory status decompensates requiring emergent intubation. If there is a risk of ascending paralysis which would compromise respiratory mechanics, you may want to secure the airway even though the current PaO2, SpO2 and PaCO2 are normal. Allowing the situation to progress to hypoxemia, hypercarbia, and/or acidemia is bad for the patient and potentially preventable in this vignette.
 
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