In my CA-2 year I encountered an elderly gentleman who needed an angiogram of his dialysis fistula. After starting the propofol infusion I placed an oral airway because his tongue obstructed his breathing by flipping back into his oropharynx. Easy first case.

The surgeon was halfway done with the procedure.

Then he started coughing. Easy fix. Remove the oral airway. He stopped breathing. I put it back in and gave more propofol.

Then he stopped breathing. Now his oxygen saturation started dropping. I gave him a jaw thrust. No reaction.

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