Tag Archives: intubation

Is fibreoptic intubation a dying art?

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.

Aeromedical management of tracheal tube cuffs

My friends over at #badEM are doing some sterling work to put Africa on the #FOAM map.  This latest post, with some practical investigation by flight medic Jo Park-Ross deserves a good hard look and some introspection.  She makes an impassioned plea for the use of cuff pressure manometers in the aeromedical environment (as they should be used wherever patients are intubated) with the practical demonstration of why it is so important.  Please go and check it out on #badEM.

Cincik on the image to read the post on #bad EM
Click on the image to read the post on #bad EM