The 6P's of PreOx

Dr. Chris Reilly, an Emergency Medicine physician, explains the importance of pre-oxygenation before rapid sequence intubation in his lecture from ResusX: Reset (see link below for more lectures). He highlights the "6 P's of Pre-Oxygenation": Positioning, Prongs, and NRB (non-rebreather), Ponder the SAT (saturation), Pre-ox period, Push meds, and Passive apneic oxygenation.

Positioning involves elevating the head of the bed to 30 degrees and ensuring the patient is in the sniffing position. Prongs and NRB require using both a nasal cannula and a non-rebreather mask at high flow rates. Ponder the SAT means assessing whether the patient's oxygen saturation is prime (above 95%) or poor (below 95%).

The Pre-ox period lasts about three minutes or involves eight deep breaths. Push meds include administering sedatives and paralytics. Lastly, Passive apneic oxygenation ensures continuous oxygen flow during apnea. This thorough preparation maximizes oxygenation and prevents complications like post-intubation cardiac arrest.

00:00 Introduction
00:37 Understanding Pre-Oxygenation
00:55 Physiology and Goals of Pre-Oxygenation
02:29 Denitrogenation Explained
04:36 Oxygen Hemoglobin Dissociation Curve
06:43 The 6 P's of Pre-Oxygenation
08:05 Positioning for Pre-Oxygenation
09:36 Prongs and Non-Rebreather Masks
12:30 Positive Pressure Ventilation
15:40 Pre-Ox Period and Medication
18:45 Review and Conclusion

To watch more videos from the ResusX conference, check out https://www.resusx.com/offers/bwjtxAHf

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