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?
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.
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.
To “cuff or not to cuff”?… much ink has been used to attempt to answer this question
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.
Once again let us discuss the issue of SGA use and aspiration
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.
RSA… I do not know if I like this one
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).
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
D.A. Algorithm @ UF. Survey 10-09
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)
The LMA “classic” is it a secure airway
I read this somewhat interesting letter to the editor in the latest issue of Acta Anaesthesiologica Scandinavica, and it caught my attention. I believe this has to do with the fact that in airway management topics, there are more “factoids” than actual “facts”. Believe it or not I posted this question to some of the most prestigious minds in the airway related community, and most sidestepped an answer. And so my question goes for you: Is the LMA classic a secure airway? If “yes”, only for certain procedures, or only for certain patients? And if “No” is it because it does not a gastric aspiration port? Which then leads to the next obligatory question: Are the ProSeal and/or Supreme LMA’s, secure airways?
Controlled RSI in Peds?
It would be very interesting to hear comments from our fellow members of the Peds. group regarding this never ending controversy of RSI. Does this simulation study give us the answer?
Associate Professor of Anesthesiology at the University of Florida; I did my residency then fellowship in Cardiothoracic anesthesia, completed a Masters In Education at UF in 2012 and have been a UF/VA staff anesthesiologist since 2000. I was also the Director of the Master of Education Fellowship from the C.O.M. until the course was terminated. I am responsible for the Difficult Airway Rotation at the UF and Airway Management Services at the NFSGVHS. My interests include: 1-Airway related topics 2-Education about Airway management 3- Resident training in Airway management 4-Non-Anesthesia providers airway training and education 5-Education in general and specifically technology in education.
