Preoxygenation and prevention of desaturation during emergency airway management
Abstract
Patients requiring emergency airway management are at great risk of hypoxemic hypoxia because of primary lung pathology, high metabolic demands, anemia, insufficient respiratory drive, and inability to protect their airway against aspiration. Tracheal intubation is often required before the complete information needed to assess the risk of periprocedural hypoxia is acquired, such as an arterial blood gas level, hemoglobin value, or even a chest radiograph. This article reviews preoxygenation and peri-intubation oxygenation techniques to minimize the risk of critical hypoxia and introduces a risk-stratification approach to emergency tracheal intubation. Techniques reviewed include positioning, preoxygenation and denitrogenation, positive end expiratory pressure devices, and passive apneic oxygenation.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Apneic oxygenation using conventional or specialized nasal prongs to administer high-flow oxygen (10-70 LPM) may extend the safe apnea time after an RSI by continuously replenishing the FRC oxygen stores.
“By continuously replenishing the FRC oxygen stores, apneic oxygenation using conventional or specialized nasal prongs to administer high-flow oxygen (10-70 LPM) may extend the safe apnea time after an RSI.103,104”
From Airway Management in Trauma (2018) · cites this paper as [103]
Patients with preintubation oxygen saturations of less than 95% are at risk of abrupt desaturation within 90 seconds of the onset of apnea.
“Patients with preintubation oxygen saturations of less than 95% are at risk of abrupt desaturation within 90 seconds of the onset of apnea.103”
From Airway Management in Trauma (2018) · cites this paper as [103]
By the time peripheral oxygen saturation begins to fall, cerebral hypoxemia has already occurred, a phenomenon known as pulse-ox lag.
“By the time peripheral oxygen saturation begins to fall, cerebral hypoxemia has already occurred, a phenomenon known as “pulse-ox lag.” 103”
From Airway Management in Trauma (2018) · cites this paper as [103]
Cited by
Sorted by citations
Kovacs, G., & Sowers, N. (2018) · Emergency Medicine Clinics of North America · doi:10.1016/j.emc.2017.08.006 · Cited by 115 · see citing works
- Authors
- Weingart, S. D., & Levitan, R. M.
- Affiliations
- Mount Sinai Hospital (US)
- Thomas Jefferson University Hospital (US)
- Corresponding author
- Levitan, Richard M.
- ORCID
- Weingart, Scott D.
- Venue
- Annals of Emergency Medicine
- Publisher
- Elsevier BV
- Published
- 2012-03
- Volume
- 59
- Issue
- 3
- Pages
- 165-175.e1
- ISSN
- 0196-0644 (ISSN-L)
- OpenAlex
- W2072663675
- Cited by
- 554
- References
- 0
- Citations by year
- 2026: 34 · 2025: 36 · 2024: 28 · 2023: 37 · 2022: 36 · 2021: 34 · 2020: 48 · 2019: 38 · 2018: 47 · 2017: 61 · 2016: 47 · 2015: 55 · 2014: 27 · 2013: 18 · 2012: 5
- FWCI
- 2.93
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Emergency Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Airway Management and Intubation Techniques
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Sedative Agents
- Keywords
- preoxygenation, emergency airway management, endotracheal intubation, hypoxemia prevention, denitrogenation, positive end-expiratory pressure, risk stratification, patient positioning
- MeSH terms
- Hypoxia, Emergencies, Humans, Intubation, Intratracheal, Neuromuscular Depolarizing Agents, Oxygen Inhalation Therapy, Positive-Pressure Respiration, Posture, Respiration, Artificial, Risk Factors, Time Factors, Airway Management
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
