Trick of the Trade: Nasopharyngeal Oxygenation

DesaturationA 76-year-old obese male with a history of severe COPD presents to your emergency department (ED) in acute respiratory distress. The patient’s large beard prevents an adequate seal with the NIV (non-invasive ventilation) mask, and the patient continues to desaturate. You are fairly sure that this patient will be a difficult airway and optimizing oxygenation prior to and during your intubation attempt would be ideal. Now what?

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