Tag Archives: airway

VLVids: Dual endoscopy intubation with compressive thyroid mass

Here’s a great example of using a dual endoscopy technique not only to manage a potentially difficult airway, but also to give more insight into the pathology itself. This short video shows the intubation of a patient who presented for thyroid surgery with a large mass compressing the trachea, as well as some other predictors of difficult intubation: slightly limited mouth opening, a short neck, and potentially challenging dentition. We wanted to see the position and degree of tracheal compression present before advancing the tracheal tube, but also to place the modified tube with nerve monitoring sensor precisely at the right depth.

Video laryngoscopy with a Mackintosh-style blade provided good access to the airway, and allowed us to spray the vocal cords and trachea with local anaesthetic, avoiding neuromuscular blockers. We could then place the tip of the tube through the vocal cords and observe the trachea and subglottic space using the Bonfils optical stylet. Both images are displayed side-by-side to coordinate view. It’s a good tip to put the device in your left hand on the left side of the screen (and corresponding right-handed device on the right) to promote good orientation.

If you’ve tired dual endoscopy for a clinical case, pop a description or brief story in the comments!

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IAMM 2023

The International Airway Management Society’s (IAMS) 2023 annual meeting is going to be held on 5-7 August 2023 in hybrid format – both at the University of Pennsylvania in Philadelphia, USA, and online.

The main meeting runs over most of Saturday 5 and Sunday 6, with an in-person tour of the hospital and university facilities on Monday 7 August. Sessions include oxygenation strategies, innovation in airway management, paediatric and obstetric patients, ENT, battlefield, trauma, emergency and thoracic airway management, and diagnosis and management of the difficult airway. Look out for a link here to the final program when published!

Live broadcasting will be available from the Miller Voice of Anaesthesia during the meeting; in-person attendees will be able to engage in the Smilow Commons Auditorium, Smilow Center for Translational Research, 3400 Civic Centre Blvd, Philadelphia, PA 19104, USA.

DAS 2021 – Awake Video Laryngoscopy

Selected references can be accessed online via the links here. If you are unable to access a reference, or wish to download a larger set for furhter reading, please click the link for the archive at the bottom.

If you’re struggling access the articles above or would like an EndNote library and further references, you can access a share folder here.

A brief video describing a challenging case managed with awake VL using the CMAC Video Stylet is shown below. (Video prepared for the 2021 Virtual Guy’s Airway Management Course)

COVID Airways Podcast on Critical Care Scenarios

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:

http://icuscenarios.com/episode-37-airway-management-for-covid-19/

Nairobi Airway Course 2017: Photos

Some photos of the action at the Nairobi Surgical Skills Centre this week. Many thanks to the local faculty from the University of Nairobi and other institutions, the companies that supported use of the facilities and equipment, and the enthusiastic delegates!



Resources and notes from the course are available on the course page here

Airway Abbreviations

Herewith a collaborative effort from the airway Twitterati to establish a list of common airway abbreviations:

  • AFOI  –  Awake fibre-optic (or flexible optic) intubation
  • ApOX  –  Apnoeic Oxygenation
  • BB  –  Bronchial blocker
  • BVM  –  Bag/Valve/Mask device (see BVMR)
  • BVMR  –  Bag/Valve/Mask/Reservoir device (see BVM)
  • CICO  –  Can’t intubate, can’t oxygenate  (see CICV)
  • CICV  –  Can’t intubate, can’t ventilation (CICO now in use)
  • CL  –  Cormack-Lehane grade
  • DL  –  Direct laryngoscopy
  • DLT  –  Double-lumen endobronchial tube
  • DSI  –  Delayed sequence induction
  • ESA  –  Emegency Surgical Airway (see FONA)
  • ETI  –  Endotracheal intubation
  • ETT  –  Endotracheal tube
  • EtCO2  –  End-tital carbon dioxide
  • EXIT  –  EX-utero Intrapartum Treatment
  • FB  –  Foreign body
  • FETO  –  Fetal Endoscopic Tracheal Occlusion (or Fetoscopic EndoTracheal Occlusion)
  • FiO2  –  Fraction of inspired oxygen
  • FOI  –  Fibre-optic intubation
  • FONA  –  Front-of-neck access (see ESA)
  • LA  –  Local anaesthetic
  • LMA  –  Laryngeal Mask Airway (trade name, see SGA etc)
  • MAD  –  Mucosal Atomisation Device
  • MP  –  Mallampati grade
  • NPA  –  Nasopharyngeal airway
  • NODESAT – Nasal Oxygenation During Efforts at Secuing A Tube
  • OPA  –  Oropharyngeal airway
  • PLA  –  Perilayngeal airway
  • RSI  –  Rapid sequence induction
  • SAD  –  Supraglottic airway device (see SGA, EGA, XGA)
  • SGA  –  Supraglottic airway (see SAD, EGA, XGA)
  • THRIVE  –  Transnasal, Humidified, Rapid-Insufflatory Ventilatory Exchange
  • VL  –  Video layngoscopy
  • XGA  –  Extraglottic airway (see EGA, SAD, SGA)

Contributions/comments?  DM @openaiwayorg or @rosshofmeyr

Thanks to @AirwayMxAcademy for initiating the idea!

FCA2 Airway Update Dec’16

A short presentation on a selection of airway  themes and some of the papers from 2016 for our FCA Part 2 candidates.  Definitely not intended to be a systematic or exhaustive review!  Click the image to download a PDF of the slides, or the link below for the resources.

2016 Airway Update Resources

You can watch a 9-minute video of the slides and attendant video clips below.  Please note that this is not narrated.

Basic fibreoptic/flexible scope skills video

Another quick training video, on the basic techniques of driving a flexible scope (fibreoptic or video) for intubation.  This was made specifically as a primer for people in our own department taking part in a training study, but hopefully it is useful to a larger audience!

Please put your comments and (hopefully constructive) critique below.   As always, you’re welcome to use with attribution!

The permanent page for this video can be found here.

Why is my C-MAC Pocket Monitor not working (again)?

Despite making a previous post and video to explain the way to make sure the device switches on, I regularly get told that the Pocket Monitor (PM) for our C-MAC video laryngoscope is not working/charging/switching on. This is in fact a design feature to prevent accidental activation or discharge. Watch here to find out more:

Thanks to the lovely Sam Adams for playing along…good career in acting if anaesthesia were to ever become boring!