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?
RSI…How
In 1951 Morton and Wylie described the technique of rapid IV administration of a barbiturate and a muscle relaxant almost simultaneously followed by intubation with a cuffed endotracheal tube “to prevent regurgitation or vomiting of gastric contents”. Later in 1971 Stept and Safar reported a fifteen-step technique to prevent “regurgitation, vomiting and aspiration during Induction of anesthesia and resuscitation” and use the term “rapid sequence induction” still in vogue today. A lot has been written on the subject and considerable controversy persists: a)is it effective or not? b)should crycoid pressure be used and if so, how should it be performed? c)Should BMV be withheld or not.?
I expect a lot of controversy and participation (do not make me think this is wishful thinking) .
But the patient has GERD… Can and should you even consider a SGA?
If you have followed the blog, perhaps you have read the articles that deal with the issues of GERD and airway instrumentation. This article deals with this issue again. I suspect that it will lead to controversy… bring it on!
Expanding Role and importance of SGA’s (LMA in particular) for Airway Management
As discussed with some of you, we live, work and train at a place that is ultra conservative in the use of SGA’s for airway management. In the “real world” the role of SGA’s and the LMA is different and expanding. We have to learn from these people and their experiences. Be open minded. Look forward to your comments.
Relevant and timely articles
What if you are called to handle the airway of a patient with suspected swine flu virus infection? Do you know what to do and what precautions to take for yourself? We can only learn from the most recent past and the SARS epidemic.
History
Well, hello again, I decided to post a historical article, so as to not expect any comments or replies for this effort. I believe the blog is dying because of lack of participation.
The importance of timely and adequate intubation
This is one of the best articles regarding the importance of adequate and timely intubation; it also deals with concerns about repetitive unsuccessful attempts. Read on, and send me your comments.
I hope this clip hits home
What can I say, but say that I strongly believe that what we do when we take care of patients and specifically take care of handling their airways, is extremely important. With the risk of sounding like a broken record, I will continue to make airway management teaching, my priority.
Take a look at this clip; if it sends chills to your spine, let me know.