ETT, Nasal intubation, or Supraglottic Airway device
- Verify tube placement through ausculation, continuous capnography and pulse oximetry
- After 3 ventilations, ETCO2 should be > 10 or comparable to pre-intubation values
- Direct Look to confirm ETT placment
- Reposition ETT or remove and ventilate with BVM
- Secure tube
- Remove nasal cannula if using apneic oxygenation
Systolic BP < 90 mm/Hg
- Etiology of hypotension post intubation: Tension pneumothorax, Hyperventilation, Hypovolemia, or shock.
- Ketamine should be used for sedation in the presence of hypotension.
- Waveform capnography and pulse oximetry must be utilized for a minimum of 5 minutes after tube placement prior to the administration of Vecuronium (Norcuron) and is required for intubation verification and ongoing patient monitoring.
- Bradycardia after tube placement is a strong predictor or a misplaced endotracheal tube (ETT).
- It is required that the airway be monitored continuously through waveform capnography and pulse oximetry.
- An Airway evaluation form must be completed on every patient who receives advanced airway management.
- Confirm airway placement by ED staff prior to moving the patient from EMS stretcher.