Preoxygenation Explained
airway management induction mask ventilation preoxygenation safety Jun 06, 2023
Does preoxygenation even work? Yes, it sure does.
Preoxygenation with a facemask improves safety by prolonging the safe apnoeic time. What does that mean? 🤷🏻♀️
Most patients will stop breathing after an induction dose of anaesthetic. The anaesthetist will then provide oxygen via either a mask, an LMA or an ETT. This happens easily in 95% of cases.
When it doesn’t, there may be a delay in oxygenation while the patient is not breathing. This is called the “apnoeic time”.
Without preoxygenation, the patient may desaturate within seconds. With effective preoxygenation, the patient will have a reservoir of oxygen in their lungs and may remain well oxygenated for up to 5-8 minutes!
What can the anaesthetic assistant do to improve safety? (assuming 100% oxygen is already running at >6L/min)
👉🏻 Ensure the mask is the correct size
👉🏻 Gentle chin lift & neck extension
👉🏻 Encourage the patient to take slow, deep breaths
👉🏻 Gently hold the cheeks up if there is a leak
👉🏻 Use waveform capnography to confirm your technique
👉🏻 Be patient… an ETO2 of >80% is your target!
Now your “apnoeic time” is longer, which means your patient is safer!
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