Brian K. Parker, MD, MS; Sara Manning, MD; Michael E. Winters, MD, MBA


Western J Emerg Med. 2019;20(2):323-330. 

In This Article


Resuscitation of the crashing obese ED patient presents numerous challenges for the EP. Even prior to the development of critical illness, obese patients have alterations in respiratory physiology, circulatory physiology, and pharmacokinetics that significantly affect their ED evaluation and resuscitation. These alterations greatly affect the EP's approach to rapid sequence intubation; initiation and management of mechanical ventilation; circulatory assessment; vascular access; CPR; and the dosing of critical, high-risk medications. It is our hope that, through the application of the pearls and pitfalls discussed in this article, the EP can minimize morbidity and mortality in this very sick patient population.