“Steps to Avoid Complications of Airway Management in Obese Patients
Order Description
Preoxygenation/Low Functional Residual Capacity Apnea and Atelectasis risk.
Cost related to failure to prevent above things/increased hospital stay/unable to extubate or wake patient prolong ICU stay.
Here some helpful hints :
Must preoxygenate the obese patient.
-safe apnea for obese is shorter than healthy patients due to high O2 consumption decreased rib cage compliance increased lung resistance and most importantly a reduction in Functional Residual Capacity (FRC)
-time needed to increase O2 sat is prolonged
-intubation is delayed due to difficult airway
-vital capacity and expiratory reserve volume are decreased
-downward diaphragmatic movements are limited
-greater atelectasis (put PEEP on ventilator)
*No matter which technique is chosen to preoxygenate obese patients the margin of safety is low and in practice allows only one laryngoscopy attempt.”
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