Question

You are called to the home of a morbidly obese patient. The patient does not have a patent airway and needs ventilation assistance. You recognize that this patient will likely have a difficult​ airway, but you​ don't have time for extensive preparations because the patient already has an oxygen saturation of​ 92%. What should you do​ first?

Answer 1

In the case of a morbidly obese patient requiring emergency airway management with an oxygen saturation of 92%, the first step is to use a bag-valve mask to provide positive pressure ventilation and improve oxygen saturation, ideally positioning the patient to optimize airway management.

Step-by-step explanation:

In the scenario where you are called to the home of a morbidly obese patient who does not have a patent airway and needs ventilation assistance, the immediate step to take is to establish a patent airway using a bag-valve mask (BVM) or similar device to provide positive pressure ventilation. This is crucial given the patient's oxygen saturation of 92%, which indicates hypoxemia. The initial target is to elevate the oxygen saturation above 94% to ensure sufficient oxygen delivery to the tissues.

Emergency airway management can be difficult in morbidly obese patients due to the anatomical and physiological challenges they present. Therefore, it is essential to position the patient appropriately, often in a ramped or reverse Trendelenburg position, to optimize airway access and improve the mechanics of ventilation. Once the airway is secured and ventilation started, you can proceed with further necessary interventions, monitoring the patient's response to treatment closely.