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The desaturating patient

A good read.

When you have faced a desaturating patient in the anaesthetic room, you will understand how scary this can be, and most importantly how fast this can happen. Honestly it can take seconds!!

For example, today I had to do a RSI (rapid sequence induction) on a young previously fit guy. He was going for an appendicectomy as he had started to become septic - very pyrexial, lots of pain. The trick in RSI is PRE-OXYGENATION. So once you start the procedure, they have enough oxygen on board to tide them over. However, as the article explains, there are many factors that can affect the saturation of a patient.

I had pre-oxygenated for 3 mins (plenty of time), applied cricoid pressure, gave the drugs, took the mask away, used the laryngoscope and the ETT was in within 15 seconds. Back onto the oxygen. His sats had dropped from 94% - 60% in those 15 secs.


I just want to highlight how fast this can happen. So watch out for very sick patients, septic patients, ladies with very big breasts (the weight can make them drop their sats amazingly quickly) and kiddies, unless you like building villages in your underpants!

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