Airway Procedures
The difficult airway is anticipated, the failed airway is experienced - Ron Walls
image by: EM:RAP
HWN Recommends
How to Make the Difficult Airway Less Difficult
As medical practitioners, the more clearly we understand why an airway is difficult, the less difficult it becomes to manage.
From Difficult to Everyday
Although there’s little you can do about your patient’s anatomy and physiologic condition, you still have to deal with it. I used to believe that I chose the laryngoscope blade for my patient. I was wrong; the patient picks the blade. I had to learn to perform a good patient assessment and really understand my patient’s needs. A good assessment only takes about a minute or so, but it’s a lot more than just glancing at the patient’s face. How far can you open the patient’s mouth? What’s the length of the…
Resources
Airway Choices in an Era of Many Choices
This is one of the best talks on Airway management in the ED I've heard. I feel that normally these talks were only available to those who attended the conference in person, but thanks to COVID the whole video is online for us to watch and re-watch. There are numerous videos in that conference that are very educational and I highly recommend watching the entire conference stream.
The Protected Airway Collaborative
The PAC concept is an “open source platform” and we are dedicated to encouraging and nurturing new ideas and young faculty interested in pursuing solutions to problems in emergency airway management and training and exploring their ideas with us. This space is dedicated to highlighting just some of the great innovations that have come from the PAC community.
Airway Avalanche
There are 4 major ‘options’ to effectively manage the Airway in an Emergency...
Emergency Airway Controversies
There are so many emergency airway controversies in emergency medicine! Dr. Jonathan Sherbino, Dr. Andrew Healy and Dr. Mark Mensour debate dozens of these controversies surrounding emergency airway management.
Own The Airway
This is a collection of my favourite online video resources to help even the greenest emergentologist ‘own the airway’. This post contains some truly awesome educational resources. Enjoy!
Take command of the airway
In general, for most adult patients, a DL or VL Mac 3 or 4 will easily intubate anyone. The majority of patients have airways that are classified as “not difficult”, however we cannot understate how critical it is to be proficient in both methods of intubation. We wholeheartedly believe that providers should regularly practice DL to maintain their airway skills. You never know when DL might be the only option to intubate someone.
The Airway Jedi
My goal is to share with you practical information: the things that you learn from experience, not just read from the book or the instruction manual. May the force be with us as we keep patients safe one airway at a time.
The Pediatric Airway: Pearls and Pitfalls
One cannot over-emphasize the importance of the appropriate equipment size for children. One size does not fit all. The pediatric age group represents a spectrum from neonates to infants, children, and adolescents.
Bougie
For that difficult airway.
Intubation
In the event you can’t intubate easily, stop after 30 – 60 seconds. Ventilate the patient briefly before your next attempt in order to maintain oxygenation. As long as you can ventilate the patient you have time. Time to alter your technique, change the position of the head, or use a different type of laryngoscope blade. Keep your suction handy and use it. Don’t be afraid to ask for help.
Cric
Think about it, prepare for it, feel confident doing it - Jonathan St. George MD
Glidescope
Despite an excellent view of the glottis, technical difficulties with endotracheal tube delivery remains in GlideScope intubation - Jeong Jin Min
LMA
Rescue airway in a failed intubation - Chris Nickson
Pediatric Intubation
Who hasn't struggled when it comes to pediatric intubation - HWN
Trach
My main goal is for people to see that the trach is no big deal. It's really no different than someone using an inhaler or a shot for diabetes - Your Curse is My Miracle
How to Make the Difficult Airway Less Difficult
As medical practitioners, the more clearly we understand why an airway is difficult, the less difficult it becomes to manage.
ASA Physical Status Classification System
The ASA Physical Status Classification System has been in use for over 60 years. The purpose of the system is to assess and communicate a patient’s pre-anesthesia medical co-morbidities. The classification system alone does not predict the perioperative risks, but used with other factors (eg, type of surgery, frailty, level of deconditioning), it can be helpful in predicting perioperative risks.
Mallampati Score
The Mallampati Score is a grading system based on the visualisation of the pharyngeal structures during laryngoscopy. A study of 210 patients confirmed the degree of difficulty in seeing three pharyngeal structures (uvula, soft palate and faucial pillars) as an accurate predictor of difficulty when using direct laryngoscopy.
Troop Elevation Pillow
Designed and developed by a practicing anesthesiologist to address the inherent problem of positioning when working with larger patients. The Troop Elevation Pillow is designed and intended to facilitate airway management for obese and large-framed patients. The pillow is for intra-op and post-op care.
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