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DSI is not RSI nor BiPAP, what is it? by Dr Seth Trueger

Folks, this is Dr Seth Trueger, Chief Resident at Mt Sinai Hospital EM department, New York City. THIS IS A MUST WATCH EPISODE!

Under the mentorship of Mr EmCrit himself (Dr Scott Weingart), check out what cool critical care airway research they have been doing!

Seth was kind enough to create this screen cast recording of his lecture this week. He runs his own blog, MDAware and recently gave a great vimeo presentation at SAEM2012

He is a generous guy and made available the slides for download from his talk here

Seth’s DSI presentation slides

I have used DSI on a critical retrieval patient with severe pneumonia. It works! When your starting SaO2 is 70%, thats a risky intubation with RSI! In my case I used some fentanyl and that worked fine. Seth talks about this during his presentation. If you decide to control the airway, I dont think fentanyl is a bad choice for DSI personally.  As Napoleon once said, if you think of taking Vienna, then take Vienna!

Send in your comments here and on Twitter  and congratulate Seth and Scott for some very innovative research and practice in critical care airway management!


6 Comments Post a comment
  1. Rob Bryant MD #

    Intermountain Healthcare Hospitals in Salt Lake City, UT, have a DSI protocol. Every ED and ICU in the 4 hospital system has a DSI bag on the crash cart containing extra oxygen adaptors, non-venting NIV masks for NIV using ventilator settings, and a card that describes the process in easy to follow steps.
    All of the respiratory therapists were trained in DSI and the protocol was introduced Feb 2012.
    Feel free to contact me for our protocol.
    DSI works phenomenally well in the agitated head injured trauma pt who is kicking off all their monitoring devices, and unable to have their oxygen sat assessed prior to RSI.
    Rob Bryant MD

    May 22, 2012
    • thanks Rob, that is awesome to hear. great to hear that a concept disseminated mainly on social media and blogging by Scott Weingart( he did publish an article on it though!) has made it into emergency and critical care practice as mainstream.

      May 22, 2012
    • John Fowler, MD #

      Dr. Bryant,
      Yes, please send a copy of your DSI procedure and your equipment list. Thanks very much!
      Sincerely, John Fowler in Izmir

      May 23, 2012
    • Jeff Myers #

      Dr. Bryant,
      I am interested in receiving a copy of the DSI protocol.
      Thank you.

      Jeff Myers RN

      May 25, 2012
    • Brian Katan MD #

      I also would like a copy of the protocol.

      May 28, 2012
  2. Stephen Quinn FP, NREMT-P #

    Yes please send a copy to me as well. Our aeromedical program is looking at several new policies involving DSI and awake intubation.

    June 1, 2012

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