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i'm a physician who works in the e.r. and wanted your opinions on intubating the following patient.
patient presented to the e.r., hx of renal failure on dialysis, cad, htn. patient brought in by EMS after significant fall which by mechanism required activation of trauma team.
patient with hypoxia on non-rebeather at 15 liters, cxr was read as bilateral pna versus edema.
decision is made to intubate to facilatate further trauma w/u and protect airway.
patient remains with sat of 86-87% while getting bagged by respiratory with good seal.
to note, the patient is morbidly obese, c-collar in place but removed with person holding c-spine immobilzation.
do you go with RSI?
do you sedate only with etomidate for example and take a look?
i was concerned about paralyzing the patient with an already low o2 sat who was morbidly obese. any thoughts?
patient presented to the e.r., hx of renal failure on dialysis, cad, htn. patient brought in by EMS after significant fall which by mechanism required activation of trauma team.
patient with hypoxia on non-rebeather at 15 liters, cxr was read as bilateral pna versus edema.
decision is made to intubate to facilatate further trauma w/u and protect airway.
patient remains with sat of 86-87% while getting bagged by respiratory with good seal.
to note, the patient is morbidly obese, c-collar in place but removed with person holding c-spine immobilzation.
do you go with RSI?
do you sedate only with etomidate for example and take a look?
i was concerned about paralyzing the patient with an already low o2 sat who was morbidly obese. any thoughts?