Jun 17, 2026 · 40 min · 10 segments
How do you manage the vent in a critical polytrauma patient who is hypoxemic? Link to the visuals for this episode: https://bit.ly/traumavents. Also, checkout Rapid Sequence, our new…
Sarah KriegerHostNo entities detected.
A couple months ago, I'm up in the ICU minding my own business, and I get a call.
And the call is, "Can you come down to the ED because we have this critical trauma, came into the ED after a high-speed MVC.
They need to go to IR, but they're currently setting seventy percent on an FiO2 of a hundred and a PEEP of ten.
Please advise." Now, as I'm walking downstairs, I'm thinking to myself, which patient with refractory hypoxemia would I rather manage, an arts patient or a critical trauma patient? And the answer is, I think most of us, me included, are more comfortable managing refractory hypoxemia in ARDS.
Also, we have these lovely protocols for ARDS management and the sick ARDS patients, not all the time, but a lot of the time, their lungs are their biggest problem.
The sick trauma patients, we don't do it as often when they're truly refractory hypoxemia.
And if they are sick enough that their lungs are bad enough that they're having refractory hypoxemia in the first place, they probably have multiple other really, really bad injuries that we need to be thinking about simultaneously.
Gets intubated pretty much right away in the emergency department for hypoxemia.
He's already gotten bilateral large bore chest tubes and looks like little apical pneumos left, but nothing big left.
A couple months ago, I'm up in the ICU minding my own business, and I get a call.
And the call is, "Can you come down to the ED because we have this critical trauma, came into the ED after a high-speed MVC.
They need to go to IR, but they're currently setting seventy percent on an FiO2 of a hundred and a PEEP of ten.
Please advise." Now, as I'm walking downstairs, I'm thinking to myself, which patient with refractory hypoxemia would I rather manage, an arts patient or a critical trauma patient? And the answer is, I think most of us, me included, are more comfortable managing refractory hypoxemia in ARDS.
Also, we have these lovely protocols for ARDS management and the sick ARDS patients, not all the time, but a lot of the time, their lungs are their biggest problem.
The sick trauma patients, we don't do it as often when they're truly refractory hypoxemia.
And if they are sick enough that their lungs are bad enough that they're having refractory hypoxemia in the first place, they probably have multiple other really, really bad injuries that we need to be thinking about simultaneously.
Gets intubated pretty much right away in the emergency department for hypoxemia.
He's already gotten bilateral large bore chest tubes and looks like little apical pneumos left, but nothing big left.
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