Preoxygenation, Reoxygenation, and Delayed Sequence Intubation in the Emergency Department

Scott D. Weingart, MD


J Emerg Med. 2011;40(6):661-7. 

In This Article


Conventional preoxygenation techniques provide safe intubation conditions for a majority of emergency airways. However, in a subset of high-risk patients, these techniques will lead to inadequate preoxygenation and fail to prevent desaturation. To safely intubate this group, meticulous attention must be paid to optimizing preoxygenation, preventing deoxygenation and, if necessary, providing reoxygenation in a controlled manner. Future research is needed to delineate optimal timing, dosing, and methods to achieve these goals.

New techniques such as NIV as a preoxygenation technique, the ventilator as a better BVM, and breaking the sequence of RSI using the concepts of delayed sequence intubation may make the peri-intubation period safer.