In the process of collating material for the Airway Ultrasound resources here on OpenAirway, the great free e-learning courses on usabcd have come to light. After registering with the service, you can access the following freecourses (and even take the tests, generating a course certificate):
You’ll need to register, add the courses to your cart and then check out
(total fee 0.00) to gain access to the material. There are plenty of other modules, including FATE, FAST, lung ultrasound and TEE which can be accessed for a fee. Check it out!
Over the past two weeks, I have been involved in three cases where all means of laryngoscopic intubation failed – including multiple different blades, introducers and highly skilled hands – and the airway could only be intubated with a flexible fibreoptic ‘scope. These three cases illustrate the type of pathology that can make even video laryngoscopy (VL) difficult or impossible:
- A morbidly obese patient in traction with a high spinal injury
- A patient presenting with late-stage, advanced laryngeal carcinoma with both supra- and infraglottic involvement and masses
- A child with Pierre-Robin Sequence presenting for mandibular distraction surgery.
In an article on the Airway E-Learning site, Dr Matthew Wiles details why he thinks fibreoptic intubation (FOI) is becoming a rare beast, and why we should work hard to maintain excellence in this important skill.
Despite being a huge fan and daily user of VLs, I am completely in agreement with his sentiments.
The well-known thoracic anaesthesia guru, Prof Jay Brodsky, has written a succinct and simple overview of the use of fibreoptic bronchoscopy (FOB) in thoracic anaestheisa, which is equally applicable to the modern flexible video endoscopes. If you are looking for a brief primer (including the appropriate use for placement of bronchial blockers and double-lumen ETTs), read the article on the Airway E-Learning site here.
Importantly, he elucidates the reasons for becoming proficient in the clinical placement and confirmation of DLTs without the use of a FOB, which is of particular relevance here in the developing world.