UMEM Educational Pearls

Category: Critical Care

Title: Want more apnea time during Rapid Sequence Intubation? Raise the head of the bed.

Keywords: apnea time, rapid sequence intubation, atelectasis, crticial care, intubation, hypoexemia, obesity (PubMed Search)

Posted: 3/26/2012 by Haney Mallemat, MD (Emailed: 3/27/2012) (Updated: 3/27/2012)
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The supine position during rapid sequence intubation may result in posterior lung atelectasis thereby reducing lung volumes, oxygenation reserve, and ultimately apnea time.

Several studies have shown that elevating the head of the bed by at least 20 degrees or placing a patient in reverse Trendelenberg position (for patients with contra-indications to elevating the head of the bed) during RSI may significantly increase apnea time.

Elevating the head of the bed may be especially helpful for patients with BMIs >35


Weingart, S and Levitan, R. Preoxygenation and prevention of desaturation during emergency airway management. Ann Emerg Med. 2012 Mar; 59(3):165-175.e1; here's the article for FREE:

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