Saturday, July 14, 2018


PatientSafe Network on April 2, 2017
"Pre-oxygenation is a vital part of airway management immediately prior to intubation and any situation where airway control is taken away from a patient.
We often overestimate our ability to predict airway difficulty – in one study of 3991 difficult intubations 93% were unanticipated (see here). Further the NAP4 study has revealed that airway difficulty is encountered 60 times more frequently in critical care environments than in anaesthesia (see here).
Pre-oxygenation should be performed in the best way possible to provide the greatest time for successful airway control before a patient suffers hypoxic tissue damage.
The Difficult Airway Society have generated guidelines discussing pre-oxygenation in detail (see here).
The DAS guidelines stipulate the requirement for a face mask seal: ‘De-nitrogenation can be achieved with an appropriate flow of 100% oxygen into the breathing system, maintaining an effective face-mask seal’.
Non-rebreather masks (NRM) do not provide a face mask seal. The use of NRM for pre-oxygenation appears to be a culture in some emergency departments. In changing this culture we may provide our patients with a significant increase in the safety of their care..."