Prolonged Field Care Podcast #7 of 2025 Top Ten: Airway Decisions
Dec 29, 2025
Dr. Jim Ducanto, a seasoned anesthesiologist with a passion for airway management, shares vital insights from his extensive career in emergency medicine. He discusses the importance of effective decision-making under pressure and highlights the critical first step of neurological assessments. Ducanto emphasizes preparation for airway interventions and the necessity of clear communication, even with unconscious patients. He offers tips on performing timely procedures, managing challenging situations, and reassures that neck wounds generally heal well, urging new practitioners to act decisively.
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Neurologic Exam Drives Airway Decisions
- Assess neurologic status first to decide airway urgency; consciousness and arousability guide need for intervention.
- If patient is neurologically incompetent and can't protect airway, escalate early rather than wait.
Make The Scene Safe Or Move The Patient
- If the scene is unsafe, move the patient or make them movable before attempting airway procedures.
- Prioritize rapid evacuation when environment or threats prevent safe prolonged care.
Use SpO2 Trends To Trigger Action
- Use pulse oximetry trends to guide timing; falling saturations predict rapid deterioration.
- Treat an SpO2 below 90% as a sign to prepare definitive airway action.