boingo
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Playing Monday morning quarterback, I would probably have intubated the patient as you presented him, unresponsive, coarse breath sounds w/copious emesis, hypoxic and hypercarbic. The fact that you were able to oxygenate him to the mid 90's w/assisted ventilation is great, it will provide me with a bit more time to intubate. I see opiate OD's on a daily basis and very rarely intubate them, however this patient seems like a good candidate. Waking up someone with lungs full of crap is very likely going to turn to shyte quick. Fighting a hypoxic patient all the way to the hospital is no fun, and is not helping the patient. Secure the airway, deliver some PEEP and improve his oxygenation is what my probable course of action would be on this patient. My $0.02.