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RSIPodacst - Episode 17 - Should Nurses Touch Ventilators

Jared and Mike are back to answer more of your questions. This will be a quick episode as Mike is on dial up internet! Please keep them coming! If your questions wasn't answered this time we haven't forgotten you, don't worry. The die hard fans can also find us on YouTube with video and outtakes!

1) I’ve heard several paramedics talk about their experiences with intubating airway burns. A common thing that I tend to hear is that “ the airway was swelling shut in front of me just before I passed the tube”. How much do you think the process of intubation exacerbates the already inflamed airway?

2) Interested in hearing your understanding of autopeep. I have learned quite a bit over the past few years, but still have a hard time understanding the concept, especially how it relates to external peep. My brain has a hard time understanding why lowering extrinsic peep in the setting of elevated autopeep would be harmful rather than helpful. I know that the theory of raising extrinsic peep to 75% of the autopeep has been disproven in acute illness, and is only really helpful in weaning patients off the vent to allow them to trigger a breath. I would be interested in hearing your understanding and maybe a review of your threshold for treatments for a patient with high autopeep, ie: reducing RR, increasing I-time, bronchodilate, disconnect and assist with exhalation.

3) Hey, fellas. New flight clinician here. I know you guys have already been asked several questions about being new to flight. But, I have been told as a nurse my medic will take care of the vent during calls/flights and not to worry about it. Is this the case where you guys are? Should I prioritize learning other things?

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