I would like to ask for some of the more experienced ICU/critical Care RN's opinion. (I've only been an ICU RN for 2 yrs.)
Last night we had a 33 y.o. repeated admission for PNA, (last admission a month ago with ARDS, hx COPD, drug abuse). He was deteriorating on HFNC and Dr. elected to intubate using Etomidate and Succinylcholine. He couldn't advance into the airway, so he pulled it back out. Patient's O2 continued to drop despite bagging, and eventually dropped down into 40's-50's (within about 1-2 minutes). Pt. became bradycardic and eventually arrested. Code was called, 1 round of CPR, 1 mg Epi, then ROSC with NSR.
On second try MD successfully intubated with just a little bit of difficulty. He said that the pt. had a small oral cavity and the airway was difficult to access. He said there was no bronchodpasm or edema.
My question is, why did his O2 not come up when the Dr. pulled the tube back out and we were bagging? What could have went wrong?
