r/emergencymedicine • u/justbrowsing0127 ED Resident • Dec 03 '24

Advice Situations in which intubation is avoided at all costs.

Obviously we avoid tubes if we can, but I’m looking for times you really really want to avoid tubing…such as… - severe hyperK - R heart failure - severe metabolic acidosis - copd + blebs - pneumo prior to chest tube placement - increased ICP

What am I missing?

Edit: maybe my wording is poor. Basically “in what patients will intubation potentially cause more problems even if it helps others? Which patients should you be on alert for rapid decompensation during RSi? Etc.

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u/drinkwithme07 Dec 06 '24

If you're googling rates of esophageal intubation, you probably don't have the expertise to comment on contraindications to intubation. If someone needs an airway, that overrides the theoretical possibility of causing bleeding if you put it in the esophagus and happened to rupture a varix.

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u/cloake Dec 07 '24

Yea you're right, I'm neither an emergentologist nor an anesthesiologist. Upon looking at the WedMD literature variceal condition does not predipose to more adverse outcomes. Just spitting ideas for OP.