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Can you intubate while awake?

The two arms of awake intubation are local anesthesia and systemic sedation. The more cooperative your patient, the more you can rely on local; perfectly cooperative patients can be intubated awake without any sedation at all. More commonly in the ED, patients will require sedation.

What is a common complication of sedating a patient prior to intubation?

Combatting Hypotension. Post-intubation hypotension (PIH) is another common complication of emergent ETI and post-intubation sedation. Nearly 50% of all patients requiring emergent airway control experience some period of significant hypotension.

How common is awake intubation?

The annual number of awake fiberoptic intubations at each hospital is estimated to 20 per year. Prior to anaesthesia, each patient was preoperatively airway assessed by anaesthesiologists, who also explained the procedure in accordance with their local standardized approach.

Why is propofol given before intubation?

Abstract. Purpose: Propofol is known to provide excellent intubation conditions without the use of neuromuscular blocking agents. However, propofol has adverse effects that may limit its use in the critically ill patients, particularly in the hemodynamically unstable patient.

Is sedation required for intubation?

Unless the patient is already unconscious or if there is a rare medical reason to avoid sedation, patients are typically sedated for intubation. Intubation is a medical procedure used by doctors to keep the airway open or safe during a medical emergency or a surgical procedure.

Why would you intubate an awake patient?

Awake intubation is used in patients with a predicted difficult airway or an unstable cervical spine. This technique allows patients to maintain their own airway until intubation is achieved, thereby greatly reducing the risk for aspiration: risk. No manipulation of the cervical spine is needed.

Do you have to be asleep to be intubated?

What are the risks of conscious sedation?

Some common side effects of conscious sedation may last for a few hours after the procedure, including:

  • drowsiness.
  • feelings of heaviness or sluggishness.
  • loss of memory of what happened during the procedure (amnesia)
  • slow reflexes.
  • low blood pressure.
  • headache.
  • feeling sick.

What are the risks of deep sedation?

Some possible side effects are:

  • Changes in heart rate and blood pressure (rare)
  • Decreased rate of breathing.
  • Headache.
  • Inhalation of stomach contents into your lungs (rare)
  • Nausea and vomiting.
  • Unpleasant memory of the experience.

Is propofol a sedative or paralytic?

Propofol is commonly administrated for sedation in the ICU. It acts on the gamma-aminobutyric acid receptor at a different binding site than benzodiazepines. It is an intravenous general anesthetic agent with sedative, hypnotic, amnestic, and anticonvulsant properties.

Why are patients vulnerable during an awake intubation?

Patients are vulnerable during an awake intubation because it is impossible to vocally communicate when the tube is inserted. Patients need to trust the staff caring for them. In our study, patients expressed the importance of eye contact during the procedure, so they could communicate with staff if something felt wrong during the procedure.

Do patients who have undergone awake fiberoptic intubation experience similar feelings?

One can speculate if patients who have undergone awake fiberoptic intubation experience similar feelings as those patients above since the procedures are nearly the same, but clinical experience and previous research contradict this hypothesis.

Is intubation an acceptable experience?

Undergoing awake intubation was an acceptable experience for most patients, whereas others experienced it as being painful and terrifying because they felt they could not breathe or communicate during the procedure itself. Conclusions

How can we reduce the psychological distress of intubation patients?

Even if their study did not focus of being awake while the intubation per se, the patients expressed communication difficulties with the staff. By having eye contact and give breathing instructions may reduce the psychological distress and thereby help patients to feel more comfortable in the situation.