Table 1: Risk categorization of patients during preoxygenation
Risk Category Based on pulse oximetry whilst receiving high flow oxygen | Preoxygenation Period (3 minutes) | Onset of muscle relaxation (~ 60 seconds) | Apnoeic period (Variable duration dependent on airway difficulty, ideally <30 seconds) |
---|---|---|---|
Low risk (SpO2 96-100%) |
|
|
|
High risk (SpO2 91-95%) |
|
|
|
HYPOXAEMIC (SpO2 <91%) |
|
|
|
Figure 1: reverse Trendelenberg positioning
Figure 2: Hamilton T1 Ventilator settings for VAPOX
Settings | |
---|---|
Extended Care: | |
Colour assist: |
Simpson GD, Ross MJ, McKeown DW, Ray DC. 2012. Tracheal intubation in the critically ill: a multi-centre national study of practice and complications. Br J Anaesth; 108:792-9
Farmery AD, Roe PG. 1996. A model to describe the rate of oxyhaemoglobin desaturation during apnoea. Br J Anaesth; 76:284-91
Grant S, Khan F et al. 2016. Ventilator-assisted preoxygenation: Protocol for combining non-invasive ventilation and apnoeic oxygenation using a portable ventilator. EMJ; 28:67-72
Baillard C, Fosse JP Sebbane M et al. 2006. Noninvasive ventilation improves preoxygenation before intubation of hypoxic patients. Am J Respir Crit Care Med; 174:171-77
Cressey DM, Berthoud MC, Reilly CS. 2001. Effectiveness of continuous positive airway pressure to enhance pre-oxygenation in morbidly obese women. Anaesthesia; 56:680-684
Jaber S, Jung B, Corne P et al. 2010. An intervention to decrease complications related to endotracheal intubation in the intensive care unit: a prospective, multi-centre study. Intensive Care Med; 36:248-255
Weingart S, Levitan RM. 2012. Preoxygenation and Prevention of Desaturation During Emergency Airway Management. Annals of Emergency Medicine; 59:165-75
Rothen HU, Sporre B, Engberg G et al. 1995. Prevention of atelectasis during general anaesthesia. Lancet; 345: 1533-1543
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