End-Tidal Oxygen for Intubation in the Emergency Department

Eligibility Criteria

• 1. The patient is located in the ED resuscitation bay of the participating centre.
• 2. The planned procedure is orotracheal intubation using a laryngoscope and RSI technique with preoxygenation for patients who are spontaneously breathing.
• 3. The patient is deemed to be at a high risk of hypoxia during RSI as per the treating ED clinician, as defined by:
• * Any patient requiring any form of oxygen therapy before preoxygenation.
• * Any patient with respiratory pathology based on clinical or radiological findings. Including, but not limited to:
• * Pneumonia, pulmonary oedema, acute respiratory distress syndrome (ARDS), aspiration, pulmonary contusion from trauma, infective exacerbations of known lung disease (e.g. asthma, pulmonary fibrosis, emphysema) or pulmonary embolism (PE)
• * Any patient with high oxygen consumption. Including, but not limited to:
• * Sepsis, Diabetic ketoacidosis, alcohol or drug withdrawal, seizures, thyrotoxicosis
• * Any underlying patient condition that may predispose to hypoxemia. Including, but not limited to:
• * Obesity, pregnancy, underlying lung disease (e.g. asthma, pulmonary fibrosis, emphysema), severe injury- hypovolaemia/haemorrhage.
• * or any other patient that the treating clinician has a high concern for hypoxemia during RSI.
• 1. Patient is known to be less than 18 years old.
• 2. The patient has a supraglottic device in-situ e.g iGel or LMA.
• 3. The patient is known to be pregnant.
• 4. The patient is known to be a prisoner.
• 5. The patient was intubated in the prehospital environment.
• 6. Immediate need for tracheal intubation precludes preoxygenation i.e. the patient is in cardiac arrest.