Identifying and preventing Post-Intubation; Part I: Identifying the patient at risk

• Intubating patient who are sick, hypoxic, and need definitive airway management is inevitable and the stakes for this intubation are higher than normal.
• About 25% of patients intubated in the ED experience some form of post-intubation hypotension (PIH) while as many as 3% of which will experience cardiac arrest.
• PIH has been shown to increase mortality, ICU length of stay, and increased risk of in-hospital cardiac arrest!
• To better prepare for these intubations, we must predict which patients are at an increased risk for PIH, these include:
• patients with an elevated shock index (HR/SBP) ≥ 0.8
• elderly patients (less cardiopulmonary reserve)
• patients with intravascular volume depletion
• Next week, part II will discuss how we should prepare and deal with PIH when it occurs.