ONE-LUNG VENTILATION: WHAT TO DO WHEN THE SAT STARTS DROPPING (PREMIUM) │ EP130
Show notes
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Welcome to the Atomic Anesthesia podcast hosted by CRNA professor Dr. Rhea Temmermand and Co-Founder Sachi Lord. On this show, you'll hear clear, clinically grounded discussions designed for nurse anesthesia residents and CRNAs who want to feel more confident in complex pharmacology, physiology, and real-world anesthesia decision-making.
Your patient is mid-lobectomy, the SpO2 is sliding from 94 to 88, and the surgeon wants that lung to stay down. In this members-only Week 5 episode of our SEE/NCE series, we walk you through one-lung ventilation from tube choice to physiology to rescue. You'll leave with a stepwise plan for exactly that moment, so you know what to check first and what to do next.
In this episode:
- Spill, leak and wash: the three buckets of absolute indications for lung isolation
- Double-lumen tube vs bronchial blocker, and why a left-sided DLT is the go-to for both right and left chest cases
- Confirming DLT position with fiberoptic bronchoscopy, and why auscultation alone misses so many malpositions
- Where gas and blood go in the anesthetized lateral patient, and how hypoxic pulmonary vasoconstriction cuts the shunt in half
- What weakens HPV, plus a lung-protective setup for the ventilated lung
- A stepwise rescue plan for desaturation, including why CPAP to the nonventilated lung is the single most effective move
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