Scott Weingart: Tubing the Shocked Patient

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SMACC Conference

The lowdown on getting your priorities straight and your doses optimised when tubing a shocked patient.

Education Business Technology

How to stop killing our
friggin’ patients when
intubating

43 y/o M
Septic
Pneumonia
Sat 96%
BP 62/40

Hypotension in the
Peri-Intubation
is Risky
Schwartz et al. Anesthesiology 1995;82:367 and
J Crit Care 2012 Aug;27(4):417

Keep ‘em Alive
No Memory
No Pain
No Awareness

All Sedatives will Drop BP in
Shock Patients
J Clin Monit Comput 16(3): 183-190
Anesth Analg 59(5): 355-358

Cardiac stable doesn’t mean
what you think it does

Dose Induction based on
plasma volume
&
clinical circumstances

Ephedrine Placebo Esmolol
Cardiac Output
9.1 8 5.5
Onset of
Rocuronium 0.6
mg/kg in sec 52 87 114
ActaAnaesthesiol Scand 2003;47(9):1067

Pretreatment
with
Scopolamine
0.4 mg IVP

Plan Ahead
Dose Smart
PEEP is not always the
solution

Plan Ahead
Dose Smart
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