Episode 66: O2: Oxygenation & Optimisation
In collaboration with
A PODCAST LECTURE BY Nicholas Caputo
6/12/22
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SPEAKER Bio
Nicholas Caputo
Dr. Nicholas Caputo is the Associate Chief of the Department of Emergency Medicine at NYC H+H/Lincoln Medical Center in the South Bronx. He is currently an Associate Professor of Clinical Emergency Medicine at the Weill Medical College of Cornell University and also an attending emergency physician at the Columbia University Irving Medical Center/New York Presbyterian Hospital. Dr. Caputo is board certified in Emergency Medicine. He completed his internship in General Surgery at Beth Israel Medical Center in Manhattan, his residency training in Emergency Medicine at NYC H+H/Lincoln, where he served as a Chief Resident and his Fellowship training in Critical Care/Retrieval Medicine at Royal Darwin Hospital/Careflight in Darwin, Northern Territory, Australia. Dr. Caputo's research seeks to understand the evidence behind the conventional wisdom practiced in emergency departments across the world in order to determine the efficacy of current management strategies (such as preoxygenation in RSI, apneic oxygenation during intubation, non-invasive markers for occult shock) in order to improve safety and quality outcomes for patients. He focuses jointly on medical pathology and socioeconomic disparities in medicine. Dr. Caputo also serves as a Major in the United States Army Reserve, currently assigned to the 947th Forward Resuscitative and Surgical Team based in West Hartford, CT.
LECTURE SUMMARY
A review of oxygenation in the context of critical illness and Rapid Sequence Intubation. What are the historical recommendations, how has this changed over time, and what does the evidence support currently?
LEARNING OBJECTIVES
Upon completion of this activity, you should be able to:
Understand the importance of objective measurement of fraction of expired oxygen in determining proper pre-oxygenation during rapid sequence intubation and how denitrogenation of the FRC and maximal oxygenation of the blood will lead to longer duration of apnea without desaturation times
Understand the impact denitrogenation and patient positioning have on potential pulmonary shunting which may place the patient at risk of rapid desaturation
Understand the importance human factors play in challenging procedural situations such as rapid sequence intubation and how situational awareness can be lost during times of high stress