231: Emergence Reactions with Kevin

Last Updated: July 7, 2025

In this episode of the PFC Podcast, Dennis and Kevin discuss the intricacies of waking patients after sedation, focusing on procedural sedation techniques, managing emergence delirium, and the challenges of airway management. They share insights from real-world experiences, particularly in combat and austere environments, emphasizing the importance of monitoring and patient safety during the awakening process. The conversation also covers extubation strategies, the differences between Cric and ET tube management, and the significance of having a well-thought-out emergence plan from the start of anesthesia.

Takeaways:

Waking a patient requires careful monitoring and reorientation. Emergence delirium can occur with ketamine; vigilance is key. Communication with the patient is crucial during awakening. Airway management is critical, especially in trauma cases. TIVA can complicate the emergence process; planning is essential. Extubation should be based on patient readiness and safety. Cric tubes may be better tolerated than ET tubes. Ventilation support may be necessary during the emergence phase. Understanding the patient’s history aids in sedation decisions. Always be prepared for unexpected airway challenges.