A 45 year old man who is a known asthmatic came to the ER with acute
exacerbation. He was dyspneic . His heart rate was 120 per minute and
blood pressure was 160/90 mmHg. A blood gas analysis revealed PaO2 of 55mmHg and
PaCO2 of 65 mmHg. Which of the following is an indication for endotracheal
intubation?
- Age
- Long history of asthma
- Tachycardia
- Hypoxia
Answer: The answer is (d). Usual indications of endotracheal intubation
include impaired gas exchange, rapid onset respiratory failure, refractory to
treatment and respiratory muscle fatigue. Parameters which guide intubation are
hypoxia, respiratory rate >35, hypercarbia and absent gag or cough reflex.