Some new devices/monitors such as the Glidescope Core or Storz CMAC 8404 now allow viewing two video feeds on one display, either as a “picture-in-picture” or side-by-side display. Here is a demo of split-screen dual endoscopy with Macintosh-blade VL and optical stylet:
I was honoured to be invited back on the Critical Care Scenarios (@icuscenarios) podcast, to chat this time about airway management in COVID-19, but also talking about how it’s helping to focus improving our emergency airway management in general. Check it out at this link:
Have you shared your preferences, practice and experience with managing the airway in patients with unstable cervical spine injuries? We have representation from around the world but would still like to expand our sample! If your country is not dark blue or green in the map above, please add your voice:
While many of us would think this is a daft question, when we went hunting for high-quality evidence, it was not very forthcoming. Hence: science to the rescue! Watch a brief (<120 second) overview of the study:
Kirsten Kingma and Ross Hofmeyr give a #litbit overview of their paper published open-access in Emergency Medicine Australasia comparing intubation with different introducers in a simulated easy and difficult airway.
What’s the bottom line? We should always be using and introducer (bougie or stylet) when approaching a predicted difficult airway, and possibly for any emergency or rapid-sequence intubation… at least in manikins! What’s needed next? A robust RCT…
All hosted on the permanent page here!
Clinical video demonstrating a collection of techniques to facilitate elective intubation for a patient with an unstable cervical spinal injury in caliper traction. Note the sideways introduction of the VL blade due to limited space for the VL handle, optimisation of the view (‘Rule of 3’), use of a coude-tipped bougie (introducer), and the 3-part technique to advance the endotracheal tube when it catches on the arytenoid cartilage (pull tube back to disengage, rotate 90 degrees counterclockwise, advance tube).
Demonstration of an unhurried intubation using a bougie preloaded in the reinforced endotracheal tube in an Airtraq optical laryngoscope with Airtraq Cam video adapter. You can note ideal positioning of the Airtraq (“Rule of 3”) and the steering ability of a coude-tipped bougie.
As promised, my presentation from the 9th National Assembly on Paediatric Emergency Medicine currently being held at the Apollo Institute of Medical Sciences & Research in Hyderabad, India. There is much more content in the audio, which I will try to add to the post later when it is available.Thoughts? Comments? Post them below!
As promised/per usual, here’s my presentation from the current National Assembly on Paediatric Emergency Medicine, being held now (16-19 Feb 2017) at the Apollo Institute of Medical Sciences & Research, Hyderabad, India. Much of the content is in the audio, of course…which I will post if/when available.
Comments welcome below as usual!