EM Ottawa - By Nicholas Choi - December 01, 2022
Bottom Lines:
- Recognize it! A number of our patients needing intubation in the ED are candidates for an awake intubation, particularly the physiologically difficult cases, and we almost always have more time than we think. You don’t always have to do it, but you should always consider it.
- Awake intubation, when performed correctly, is a safe, low risk, accessible technique that should be considered first-line in any airway where RSI may jeopardize patient safety.
- Every awake intubation should have a backup plan and exit strategy ready to go at the bedside (e.g. RSI equipment and drugs drawn up, surgical airway equipment kit ready, etc.). There should be no delay to implementing plan B if awake intubation fails – it’s what you would have done anyway.