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HWN Suggests

The Sphincter Series: A Scary Airway Review

We are expected to perform in the most adverse circumstances, artfully managing the dirty airway, the bloody airway, the mangled airway, the obstructed airway, the burned airway, the swollen airway, the airway in someone who can’t lie flat, the rapidly changing airway, the airway needed in 2 minutes or less. Our airways are grimy. They often aren’t the pretty, sterile, controlled intubations that so many of us trained on initially. By securing an airway, we ultimately can save a life.

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 Trach Travails: Need-to-Know ED Tricks for Airway Emergencies in Tracheostomy Patients

Differentiate simple tracheostomy versus total laryngectomy patients by ETCO2at the nose. Simple tracheostomy patients are (potentially) intubatable from the oropharynx. Total laryngectomy patients are not. Mucus plugging is common. Attempt suction and replace the tracheostomy tube’s inner cannula. Let down the cuff, if present, to reposition a tracheostomy tube. Use caution when replacing dislodged trach tubes in fresh tracheostomies. Consider orotracheal intubation instead. Bougie, Cook, and Aintree catheters can assist with tracheostomy tube exchange.

Previously Featured

Airway Obstruction

We present a challenging airway obstruction case, discuss the limitations of non-rebreather masks, using PEEP on bag-valve-masks, heliox, tips on awake intubation, and the differential for high peak inspiratory pressures in the post intubation period.

Coping with airway emergencies: Get, Set, Go!

Airway emergencies are among the life-threatening events that are encountered in the operating room, emergency department or intensive care unit. They are important causes of preventable morbidity and mortality where time is the essence. It can be extremely challenging to rapidly assess the airway for early diagnosis and perform appropriate interventions simultaneously.

Current Considerations in Emergency Airway Management

As emergency airway management evolves, it remains a significant task to maintain up to date on current trends, data, and new equipment

Emergency Department Management of Surgical Airway Complications

Tracheostomies can allow patients who require ongoing ventilatory support significant improvement in their quality of life; however, the devices and their placement may be prone to complications, such as dislodgment and obstruction, infection, and bleeding, leading to potentially life-threatening complications.

Management of Paediatric Airway Emergencies: A Systematic Review of Current Practice Guidelines and Clinical Outcomes

Paediatric airway emergencies can be life-threatening and require prompt and effective management to ensure optimal outcomes. The incidence of paediatric airway emergencies has been reported to be as high as 5.4% in the pre-hospital setting. These emergencies can be caused by a variety of factors including trauma, infection, foreign body aspiration, and congenital anomalies

Resources

EMS Airway

EMSAirway.com is a resource for best practices in airway management and education for EMS profession.

Thoracic Key

The recognition of a compromised airway is the crucial first step in managing an airway emergency. Clinical features of significant airway compromise often involve increased work of breathing, inspiratory stridor, obstructed breathing pattern, desaturation and agitation. Untreated, the rapid development of hypoxia, hypercapnia, acidosis and cardiovascular collapse may ensue.