Managing the Physiologically Difficult Airway | Critical Care Webinar

The Physiologically Difficult Airway (PADA) presents a major challenge in Critical Care, demanding a shift from anatomical focus to addressing complex physiologic derangements. The high complication rate (45%) found in the INTUBE Study underscores the need for robust preparation and efficient, life-saving management strategies.

This webinar enhances clinical readiness by covering comprehensive strategies, including modified RSI, advanced pre-oxygenation, ensuring hemodynamic stability, and stringent tube placement verification. Key practical insights covered are cardiovascular protection, HELP positioning, and the use of waveform capnography.

Join our experts as they share evidence-based approaches, real-world case discussions (including "the tube is in, but the patient crashes"), and actionable strategies to strengthen safety during ICU intubations.

Speaker: Prof. Sheila Nainan Myatra
Moderator: Dr. Kaladhar S
Organising Chairperson: Dr. Venkat Raman Kola

Video Timelines:

00:00:00 – Introduction & Case Overview
00:02:41 – Physiologically Difficult Airway in Critical Care
00:07:08 – Defining PADA: Collapse Post-Intubation
00:09:31 – INTUBE Study: 45% Complications & Cardiovascular Collapse
00:14:39 – PADA Delphi Consensus Definition
00:18:00 – Modified RSI & Optimization Strategies
00:20:06 – HELP (Head Elevated Laryngoscopy Position)
00:21:38 – Pre-oxygenation & Apneic Oxygenation
00:26:14 – NIV/HFNO vs Face Mask for Oxygenation
00:29:38 – Delayed Sequence Intubation (DSI) with Ketamine
00:33:10 – Why Hypotension Occurs Post-Intubation
00:35:08 – Drug Selection: Ketamine/Etomidate vs Propofol
00:39:33 – Pre-emptive Vasopressors (Norepinephrine)
00:43:55 – Video Laryngoscopy as Default Tool
00:47:09 – Waveform Capnography Importance
00:49:29 – Seven-Trace Capnography Rule
00:52:19 – Physiological Optimization: Key Takeaway
00:54:09 – Q&A: Severe Metabolic Acidosis Intubation
00:55:59 – Q&A: Awake Intubation & SGA Rescue
01:05:24 – Final Recommendations by Prof. Myatra
01:06:50 – Closing Remarks & Thanks

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