Airway Educational Project

Medinfo Sites weblog
16
Jan


Requiem for the reusable Eschman Bougie?

By •• Posted in Devices, Techniques

At the end of every year a tradition from the networks and news organizations is to show us whom among celebrities and famous people died during the year. I must admit I do not pay close attention to it and rather think of whom or what  I would add to the list. This year something stood out for me. With new regulations at VA hospitals we are no longer allowed to re-use certain pieces of equipment and they are mandating instead the use of disposables. This means I had to forcefully retire a dear friend and ally of many battles (that saved me countless times) and that I used to carry with me in my pocket every day: the reusable Eschman bougie. I am still in mourning. I still think this was not a wise move. Read these articles and tell me what you think.

Frova vs Eshman vs Portex

Portex Single use

 
 
12
Jan


Randomized controlled studies in airway topics… how common are they?

Despite some considering the airway as “the cornerstone of anesthesia” if one looks closely, the amount of RCS on the subject, actually are very, very rare. Doing studies on the airway is perhaps inherently difficult because the stakes of things going the wrong way are basically too high. The majority of the literature or information we have on the subject is anecdotal, or retrospective, but RCS are a dime a dozen. Take a look at this letter criticizing  some researches for what they did in their research (I am including the original article as well) and tell me what you think. I look forward for a lively discussion.

Can J AnesthJ Can Anesth 2009 Adnet

Manual In-line stabilization

 
 
5
Jan


Can’t intubate, can’t ventilate… are you and your institution ready?

By •• Posted in Education, Techniques

Take a look at this interesting article from the U.K. They identified a problem and saw an opportunity to improve. Imagine if you will this study was done in Gainesville; wherever you worked today,last week, last month, do you know the location of the D.A cart? Do people that would be in charge of assisting you in case of a problem know the location and contents of this cart? If you choose jet ventilation as an alternative therapeutic option, do you know how to connect the O2 outlet in the anesthesia machine?

EJA 2009

 
 
22
Dec


Interesting and Timely topic

The judge gave the verdict of… guilty. We are not currently doing this and I somewhat agree with the author. It would be interesting to see if you think we should and the issue of how, naturally comes to mind.

Look forward to your comments.

Glidescope letter

 
 
15
Dec


Handling the patient with potential or with known cervical spine issues

The issue of elective/urgent/emergency airway management of patients with cervical spine issues is always a challenge and often comes out during oral boards questions. The bad thing is that there are multiple theories, methods, controversies and dangers etc… associated with this issue (reason why they love to ask these kind of questions)…..and those remain; the good thing is that we have made some progress and there are fortunately newer alternative methods available to handle the airway that are being used more commonly. The present post (requested by Adam Fier) is designed to give you some recent articles to show some relatively new alternatives of handling the airway in patients with or potential cervical spine conditions. I look forward to your comments.

Airtraq vs. CTrach

EMS and VL

Glidescope and Cervical Collar

Mac vs Airtraq

 
 
17
Nov


To “cuff or not to cuff”?… much ink has been used to attempt to answer this question

By •• Posted in Education, Pediatric

I am hungry for your participation and contributions. I am specially seeking the wisdom of our Pediatric colleagues regarding this eternal question/debate/feud of whether pediatric patients should get cuffed vs. uncuffed ETT’s.

Peds Cuff vs. Uncuffed ETT’s

cuff vs no cuff

 
 
7
Nov


Once again let us discuss the issue of SGA use and aspiration

By •• Posted in SGA

As discussed here before, we are fairly conservative with regards to SGA use and surgery for a variety of reasons, but mainly due to fear of the risk of aspiration of gastric contents. At the VA for example who does not report that has GERD? The question is do we really know if an SGA is contraindicated in such patients and also do we really know whether they should  be used in certain surgical procedures such as laparoscopic surgery? The article I am posting today deals with some of these issues. Look forward to your comments.

sga and aspiration

 
 
26
Oct


RSA… I do not know if I like this one

By •• Posted in SGA, Techniques, Trauma

Several posts in this site have dealt with controversies surrounding RSI. There are many unsolved issues (cric vs. no cric, ventilate vs. not ventilate, to use N.M relaxants outside the O.R vs. not use them, etc…) the truth is that more questions than answers exist. But how about this new concept coined in 2007 by E.D’s and paramedics during rescue operations. I hope to hear your comments (any comments).

Prehospital Airway (RSA)

 
 
22
Oct


To further add to the complexity of airway management in OB patients

The difficulties, morbidity and mortality associated with airway management and obstetrics, lead to a culture shift, and regional anesthesia and specifically neuro-axial blocks are very often used to provide anesthesia in this patient population. This brings an interesting question.How to maintain skills, gain experience and train residents in the dying art of GA in obstetrics? How to assure greater success rates and safety in those rare GA cases? Read on

GA and C-section

 
 
13
Oct


D.A. Algorithm @ UF. Survey 10-09

By •• Posted in Education

Survey attitude towards the ASA D.A algorithm @UF  (Actually realistically the response was not that great, so in truth I could have taken the “UF” out)