I Confess, I believe and practice safe D.S.I.

December 31, 2015



Hard to believe, not really. I am a fan of great medicine and new innovations to improve patient care. Delayed Sequence Intubation made sense to me and have practiced it many times. Many times than not, successful. One less intubated..patient. 
Less Vent associated pneumonia. Less worry about sedation and analgesia postintubation. 
One big thing, it is hard to practice new medicine without "practicing" new innovations and techniques. I am an EM attending not doing residency or fellowship again. I can practice old guidelines that don't work and harm the patient or try new ones to improve my ability to treat critically sick patients. 
Older attendings or new graduates, get over the fear, and improve. Don't become a person who hides waiting for many years to pass before Rosen or Tintinelli publishes new innovations into text. I at least won't. Thankful for Weingart of Emcrit and Levitan of airwaycam for such Free Open Access Meducation.

Dsi can be done with a poor man's CPAP as learned from Kovacs of AIME. Learning to use nasal prongs aka nasal cannula with a bag valve mask and peep valve to make a closed circuit for high flow oxygenation. Poor man's Continuous Positive Airway Pressure system.

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