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1. Why was endotracheal intubation attempted? The respiratory rate
breaths per minute, and oxygenation could have been maintained with a face
2. There is no mention of pre-oxygenation prior to attempting
intubation. This is normal practice even in normothermic patients and is
used to reduce the risk of hypoxia during the intubation since hypoxia
increases the risk of ventricular fibrillation (VF).
3. Endotracheal intubation per se is not a risk factor for VF in
Many patients have been intubated without inducing VF  but in all cases
the patient was pre-oxygenated.
4. Why was the airway suctioned? There is no mention of excess
the case report. This stimulation in a hypothermic, non-pre-oxygenated
patient would be almost guaranteed to trigger VF.
Otherwise I agree with the management and the answers to the
1. Lloyd EL Accidental hypothermia. Resuscitation. 1996;32;111-