Physiologically Difficult Airways: When the Tube Isn’t the Problem

Monday, April 13, 2026

3:45 PM - 4:35 PM PT

Location: Grand III - 4th Floor

CE: 0.75 CME Credit

Panel Moderator(s)

June Gordon, MD (she/her/hers)

Clinical Assistant Professor
Stanford University School of Medicine
Menlo Park, California

Disclosure(s): No financial relationships to disclose

Panelist(s)

OS

Olivia Serigano, MD (she/her/hers)

Assistant Professor of Emergency Medicine
Larner College of Medicine at the University of Vermont
Underhill, Vermont

Disclosure(s): No financial relationships to disclose
Gregory Wu, MD FAAEM (he/him/his)

Associate Professor of Emergency Medicine and Medicine
Albany Medical Center
Albany, New York

Disclosure(s): No financial relationships to disclose
Skyler Lentz, MD FAAEM (he/him/his)

Associate Professor of Medicine and Emergency Medicine
Larner College of Medicine at the University of Vermont
Williston, Vermont

Disclosure(s): No financial relationships to disclose

Disclosure(s):

June Gordon, MD: No financial relationships to disclose

Olivia Serigano, MD: No financial relationships to disclose

Gregory Wu, MD FAAEM: No financial relationships to disclose

Skyler Lentz, MD FAAEM: No financial relationships to disclose

You’ve mastered the anatomically difficult airway—now let’s talk about the ones that truly scare us: the physiologically difficult airway. In patients with acidosis, shock, pulmonary hypertension, or RV failure, even textbook technique can lead to catastrophic decompensation.
This case-driven, interactive session features a panel of EM and Critical Care experts who will walk through “crash intubation” cases that require more than airway skills—they require systems thinking, medication mastery, and pre-intubation optimization. Expect spirited back-and-forth and practical take-home strategies.
Topics will include:

When to delay intubation—and when not to
When to put the patient to sleep–and when to paralyze
How to expertly use NIPPV
How to safely intubate the patient in shock, who is profoundly acidemic, hypoxemic
Managing the peri-intubation crash

Learning Objectives:

Recognize clinical scenarios at high risk for peri-intubation decompensation.
Apply physiologic optimization strategies to reduce morbidity and mortality in high-risk intubations.
Describe how to manage peri-intubation decompensation and ways to minimize the impact on your patient