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practice updates

R.E.B.E.L. EM – Is Apneic Oxygenation Overhyped? with Scott Weingart

ApOx is a concept that has been around for some time in the operating room literature, but only recently been gaining acceptance in the ED, especially after the publication of this concept by Scott and Richard Levitan in the Annals of Emergency Medicine in 2011 [1]. Many nay sayers will argue that the OR studies were in controlled settings with elective surgical patients who were not in critical condition. The believers would argue that ApOx makes sense, its low cost, and low complexity. To date there has been no randomized controlled trials (RCTs) on ApOx in the ED. There has been one ICU Trial (i.e. The FELLOW Trial) [2] and an even more recent observational trial in the ED [3] that have been published on the topic of ApOx. So the question remains: Is Apneic Oxygenation Overhyped?

practice updates

The Difficult Airway: Common Errors During Intubation

Airway management is a vital component to caring for critically-ill patients in the emergency department. The peri-intubation time can be chaotic. Planning for the difficult airway and preparing for all possible scenarios is best done before the arrival of a crashing patient. The following post explores some common failures in airway management and how to avoid making fatal mistakes in a critical situation.