The ResusEM conference is coming back this August! This is a summary of a portion of Dr. Byrne's talk on airway management presented at the August 2017 ResusEM conference at Cooper Medical School of Rowan University. Check out some of the literature looking at the performance of video largyngoscopy versus direct laryngoscopy in various hospital settings.
Intubation is a potentially dangerous procedure which may result in rapid hemodynamic collapse and cardiac arrest in the critically ill. This week we summarize the results of a large retrospective study to determine the clinical factors associated with cardiac arrest after intubation.
Whereas the dosing of sedative medications is usually unaffected, the chief concern is whether there should be changes for neuromuscular blockade – will your patient with myasthenia gravis require a higher or lower dose of your selected paralytic?
“Airway cart to 9A. Intern, this tube is yours. What meds do you want?”
After the initial self-pulse check and change of scrub pants, two words come to mind: SOAP ME. Not in the literal sense, which may or may not be necessary depending on how nervous one is, but in the handy-dandy-easy-to-remember-in-high-pressure-situations-mnemonic sense. The deer-in-headlights (AKA intern-in-headlights look aside), this edition aims to take a look into an expected adverse reaction with a commonly used rapid sequence intubation (RSI) medication: hyperkalemia associated with succinylcholine administration.
This post is a a summary of a portion of Dr Byrne's airway talk from last month's ResusEM conference at the Cooper Medical School of Rowan University. New techniques for preoxygenation before intubation can help to prolong time to desaturation and make this potentially dangerous procedure safer than ever!
Intubation has traditionally been performed with patients in the full supine position. Recent data suggests that elevation of the head of the bed may be more effective during preoxygenation before intubation. Check out this summary of a paper from Anesthesia that put this idea to the test!
You are intubating a sick patient in the ED via direct laryngoscopy. After opening the airway, sweeping the tongue with your blade, inserting into the vallecula, and lifting at the precisely correct angle your eyes behold....well...not the vocal cords! Maybe the arytenoid cartilages if you're lucky (aka Cormack Lehane 3 or 4 view). But wait, you aren't finished yet! You reach into your back pocket and remove your trusty bougie...