This month, Patrick Fink (MS4) sits down with critical care fellow and human supercomputer Dr Ran Ran to discuss the physiology of intubation and whether the risk of killing your patient is justified by the benefits of a definitive airway.

We cover the commonly cited indications for intubation and hash out how the decision to sedate, paralyze and intubate inevitably drives your patient’s physiology down the tubes at the most inopportune moments.

With the basic physiology under our belt, we then talk through some common ER and critical care cases, and discuss whether intubation is the best choice that we can make for these patients. Dr Ran also gives our medical student listeners food for thought, so that next time they’re observing airway management, they can study and plan their own approach to the situation.

This episode is not just for ER-bound students. Dr Ran emphasizes that no matter one’s discipline, the decision to call for an ER, crit care, or anesthesia doc to intubate your patient is made based on your judgment of your patient’s physiology and their airway needs. Intubation is the procedure that you’re calling for, but you need to make that call, and you know the patient best.

You can find more of Dr Ran’s clear and well-structured clinical thinking on his website, Ran Squared

More reading:

-Does intubation improve survival to discharge during in-hospital arrest?    PDF (here)

–EMCrit: Laryngoscope as Murder Weapon

–Life in the Fast Lane (LITFL): RSI Overview

-Bonus: Selfie Awake Intubation Video

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