# Preoxygenation before intubation in cardiac arrest.



## zuki (May 26, 2008)

Ok so trying to answer a question at school as to if we should preoxygenate before a intubation attempt on a cardiac arrested patient. Also would it make a difference if it was only a respiratory arrest patient? (and i need evidence )

anyone have any journal articles etc relevant?


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## Ridryder911 (May 26, 2008)

Okay, here is another assignment. Learn how to perform a literature research, one will not learn if you do not do it yourself. 

I suggest such as  ..._" Journal of Anesthesia, Heart & Lung, AHA-ACLS"_...

R/r 911


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## emtlady76877 (May 26, 2008)

Does your school have an online library? There are a lot of online Journals to read. They come in handy while doing your home work sometimes.


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## MSDeltaFlt (May 26, 2008)

Ridryder911 said:


> Okay, here is another assignment. Learn how to perform a literature research, one will not learn if you do not do it yourself.
> 
> I suggest such as  ..._" Journal of Anesthesia, Heart & Lung, AHA-ACLS"_...
> 
> R/r 911



Amen, Rid.  Google and the like can be one's bestest friend in the whole-wide-world.


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## newtonfb19 (May 26, 2008)

MSDeltaFlt said:


> Amen, Rid.  Google and the like can be one's bestest friend in the whole-wide-world.





emtlady76877 said:


> Does your school have an online library? There are a lot of online Journals to read. They come in handy while doing your home work sometimes.



Something that has really helped me with research at school is Google Scholar.  It's a search engine for scholarly articles, and depending on your school, it may provide you with a huge assortment of full length articles.

http://scholar.google.com/

To tap into your school's online library (if it has one and has enabled this feature), click on "Scholar Preferences" to the right of the main search box.  Then, on the next page, type in your school's name next to "Library Links".

Hope that helps!


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## MasterIntubator (May 26, 2008)

"Pre-oxygenation" is such a crazy buzz-word.  I mean, really.... what the heck is that supposed to mean?   The patient is either anoxic/hypoxic, desaturating or oxygenated.  ( The human phys book may hold all your answers ).

If the pt is not circulating, where is that oxygen gonna go?  If you ventilate a pt during CPR, hopefully the cells are still metabolizing to do good.  All in all... what is your goal?  Get enough oxygen in the pt to prevent anoxic injuries.... right?

Over saturation of oxygen is not good for the cells ( look up Apoptosis ).  Right now studies are being done regarding this phenomenon in the high flow oxygen arena. 

Soooooooo back to your question...... One should ventilate the pt, in a normal fashion 6-10/min.  If it a fresh respiratory arrest, you have some time.   ( Look up oxygen desaturation curve ).  Either way, you ventilate.... at which point do you call it "pre-oxygenation"?  Ideally you want to use oxygen.  And is 80-100% FIO2 any better than ambient air?  

Studies going on right now are saying Ambient is just as good. But I am sure it will be a good 10 years before that is published.

( You can quote me in class )

:-/


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## AnthonyM83 (May 27, 2008)

Doesn't pre-oxygenation just mean a slightly increased rate of ventilations (not to be confused with hyperventilating) done just prior to an intubation attempt to try to off balance the upcoming lack of ventilations? Regardless of situation or sats etc


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## Ridryder911 (May 27, 2008)

Actually, pre-oxygenation is to assure that you slightly hyperventilate your patient that while your doing your procedure (patient not breathing) does not become anoxic. The same as before suctioning, etc. Even vent patients has a mode to assure the oxygenation level is increased before the procedure. 

Although, hyperventilation has become a "bad" word, most miss that those patients are studied are not hypoxic to begin with or they have a good v/Q ratio already, so hyperventilation is not needed. 

R/r 911


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## AnthonyM83 (May 27, 2008)

What if they don't need it now, but will benefit from it while you do your procedure and their oxygen levels drop? Isn't that what pre-oxygenation is for? Regardless of current sats


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## Meursault (May 27, 2008)

zuki said:


> Ok so trying to answer a question at school as to if we should preoxygenate before a intubation attempt on a cardiac arrested patient. Also would it make a difference if it was only a respiratory arrest patient? (and i need evidence )
> 
> anyone have any journal articles etc relevant?




http://forums.studentdoctor.net/showthread.php?p=6701654#post6701654

Asking around?

Try Pubmed. Sometimes, you need to do your own work.


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## MSDeltaFlt (May 27, 2008)

MrConspiracy said:


> http://forums.studentdoctor.net/showthread.php?p=6701654#post6701654
> 
> Asking around?
> 
> Try Pubmed. Sometimes, you need to do your own work.



Also, if you follow the AHA ACLS guidelines *verbatum*, you will end up oxygenating and adequately ventilating the pt prior to intubation anyway.  So, why is this a question?


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## MasterIntubator (May 27, 2008)

BINGO!!!

That is kinda what I was leading too.


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