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Great video of breathing pattern in severe acidosis.
Be worried if you have to intubate someone like this. Any apnea will make CO2
https://abs.twimg.com/emoji/v2/... draggable="false" alt="⬆️" title="Pfeil nach oben" aria-label="Emoji: Pfeil nach oben"> and pH https://abs.twimg.com/emoji/v2/... draggable="false" alt="⬇️" title="Pfeil nach unten" aria-label="Emoji: Pfeil nach unten">
Also, near impossible to match minute ventilation of someone like this who is very actively breathing in and out.
#FOAMed
#FOAMcc https://twitter.com/grepmeded/status/1306608128256077824">https://twitter.com/grepmeded...
Be worried if you have to intubate someone like this. Any apnea will make CO2
Also, near impossible to match minute ventilation of someone like this who is very actively breathing in and out.
#FOAMed
#FOAMcc https://twitter.com/grepmeded/status/1306608128256077824">https://twitter.com/grepmeded...
If intubation unavoidable
Minimize apnea time during induction, BVM, or ketamine only in select case
ETCO2 helps, try to match pre tube ETCO2 to post tube ETCO2. Get a blood gas to correlate
PaCO2 target~serum bicarb + 15 mm Hg
Most will tolerate RR 30/min (if no obstruction)
Minimize apnea time during induction, BVM, or ketamine only in select case
ETCO2 helps, try to match pre tube ETCO2 to post tube ETCO2. Get a blood gas to correlate
PaCO2 target~serum bicarb + 15 mm Hg
Most will tolerate RR 30/min (if no obstruction)
Have vasopressors hanging, these tend to get unstable
Use of sodium bicarb peri-intubation is controversial here with no good studies.
Aggressively correct underlying cause. The ventilator is only supportive.
Use of sodium bicarb peri-intubation is controversial here with no good studies.
Aggressively correct underlying cause. The ventilator is only supportive.
