That Blade Can Kill: Peri-Intubation Resuscitation Tactics for Prehospital Providers

Monday, April 24
Intubation, by paramedics, in the prehospital environment continues to be a hot topic of discussion. An area of especially intense debate is drug-assisted intubation (DAI). Patients requiring DAI often present in shock or peri-arrest states that complicate all facets of the elective intubation process. This dynamic, interactive session will allow participants to take a deep dive into the topic of peri-intubation resuscitation. Participants will learn how shock states complicate preoxygenation by causing shifts in the oxyhemoglobin dissociation curve and how we can adequately preoxygenate our patients considering these changes. Fluid resuscitation, blood product administration, and vasopressors including push-dose vasopressors will be discussed. Various induction and paralytic agents will be reviewed, with special attention paid to the pharmacologic profiles of each agent. Rapid sequence induction vs. Delayed sequence induction will be discussed. Techniques for optimizing first-pass intubation success will be reviewed. Eventually, participants will be asked to work through dynamic tabletop scenarios that will allow them to apply what they have learned. The goal is to empower providers with tools they need to incorporate the following mantra into their practice, "Resuscitate before you intubate!"
Jeremy Williams, Clinical Educator, Critical Paramedic, and EMS Program Director - Ascension St. Vincent Indianapolis