HWN Suggests

So You Want to Tomahawk Somebody?

For fiberoptic intubations when you are intubating facing the patient, it is best to position their head at the level of your own head. That is not necessarily the case with the tomahawk intubation. If you position their head at the level of your head, you will not have as good of control of the ET tube as you try to pass it. When the patient is lower than you you may potentially be better able to finely manipulate the ET tube into and through the glottic opening.

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Articles of Interest

The Tomahawk View - A Lifesaver in an Awake Intubation

The entire ordeal that transpired was fascinating and thought provoking - one of those experiences that will implant a medical student with awe, fear, and love of the airway.

The “Reverse C-Mac Tomahawk”: A Novel Approach to the Difficult Airway and Sedation in Patients Unable to Lie Supine

The management of the difficult airway is an extremely stressful situation for both the patient and the anesthesiologist, for several different reasons. For the patient, this situation can be an uncomfortable and unpleasant ordeal to experience, coupled with the fact that a lost airway can result in death. At the same time, the patient must surrender control and trust that the anesthesiologist will be successful in securing the airway. For the anesthesiologist, the knowledge that he or she may get only one attempt at the procedure, and that the patient could suffer imminent death if our efforts should fail, can be extremely anxiety-provoking.