Category Archives: Airway management

CODE BROWN: AHHH…THE OLD SCANCRIT SWITCHEROO…

Someone once said that ‘an esophageal intubation is no sin, but there is great sin in not recognizing such a placement‘. What’s that about? I intentionally intubate the esophagus and I demand recognition for it.

Posted in Airway management, Code Brown, Emergency Medicine, Uncategorized | 10 Comments

MEGAN’S SONG

There is an important article about intubation in EMSWorld. It is about a prehospital intubation gone terribly wrong. It is essential reading for all of us who manage airways outside or inside hospitals. Read it here.

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ETT DEPTH CONFIRMATION BY TRACHEAL PALPATION

A study in Can J Anesth looks at the accuracy of confirming endotracheal tube position by palpating the sternal notch.

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NOT SO IMPRESSIVE CICV MANAGEMENT

The outcomes from a Canadian questionnaire study of anaesthetists preferences in difficult airway management is disappointing. When faced with establishing an airway in cannot-intubate-cannot-ventilate scenarios, the majority would go for  seldinger- or needle-techniques ie one of the ready-made kits.

Posted in Airway management, Anesthesia, Emergency Medicine | 2 Comments

COPD ICU MORTALITY

In intensive care, we are often called to deal with marginal or crashing COPD patients. Often, we end up intubating them. Then, in the morning rounds there always seems to be at least one passive-aggressive (†) colleague in the back, shaking … Continue reading

Posted in Airway management, Intensive Care | 1 Comment

KANYE INTUBATE THIS GUY FOR ME PLEASE?

The decision to anaesthetise and intubate is not always an easy one. When learning to anaesthetise and intubate we are often told that a GCS of 8 or less is when the patient scores a tube in trauma. Reality is … Continue reading

Posted in Airway management, Emergency Medicine, Neurology, Prehospital Medicine, Trauma | Leave a comment

PREHOSPITAL RSI AS SAFE AS HOSPITAL RSI

A study in EMJ shows us how safe prehospital RSI can be when really robust operating procedures are in place. In my view it is also more evidence of the superiority of the doctor-paramedic model in prehospital care. During a … Continue reading

Posted in Airway management, Prehospital Medicine, Uncategorized | 15 Comments

LONG TERM CRICS ARE SAFE

Cricothyroidotomy is the go-to option for emergency surgical airway at the end of a can’t intubate, can’t ventilate scenario. It feels like an extreme measure in a pressing situation, and we’ve also been loaded with the impressions that crics are … Continue reading

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TACTILE SURGICAL AIRWAY

This video of an emergency surgical airway clearly shows how locating the cricothyroid membrane is completely tactile – and your finger needs to be used for tactile navigation during several steps of the procedure. Many surgical airway training scenarios fails … Continue reading

Posted in Airway management, Emergency Medicine | Leave a comment

PERCUTANEOUS TRACKIES NOT SO SAFE AFTER ALL…

A literature review in crit care reminds me of how ICU percutaneous tracheostomies are potentially dangerous and is associated with significant mortality. This mortality needs to be weighed in when deciding wether to make the hole in the neck or … Continue reading

Posted in Airway management, Intensive Care | 2 Comments