Podcasts about intubating

It's episode one of season 11 and Simon and Iain chat through the blog content from St Emlyn's from January 2024. There's discussion about New Year resolutions and how to make them habits, intubating poisoned patients with a decreased conscious level and what we can possibly do to improve the working conditions in our Emergency Departments. As ever, we hope you enjoy the podcast. Please do like and subscribe, and if you'd like to contribute to St Emlyn's in any way please get in touch. 

Contributor: Meghan Hurley MD Educational Pearls: What is ATLS? Advanced Trauma Life Support (ATLS) is a systematic and comprehensive approach to the evaluation and management of trauma patients It was developed by the American College of Surgeons (ACS) The key components include the Primary Survey ("ABCDE"), the Secondary Survey, Definitive Care, and Special Considerations What are the issues with ATLS? ATLS relies on many algorithms and rules-of-thumb, which might be helpful for individuals with basic skills and training but might actually present obstacles for those with higher levels of training. Dr. Hurley cites several examples. Example 1: ABC approach to trauma patients ABC stands for Airway, Breathing, and Circulation but focusing on the airway first is not always the best decision. Immediate attention may need to be applied to massive hemorrhage. Intubating a patient that is hemodynamically unstable may cause cardiac arrest. A more helpful phrase might be “Resuscitate before you intubate.” Example 2: C-spine precautions Cervical collars may impede the likelihood of first-pass success when intubating. The risk of complications from a failed airway may often outweigh the risk of causing a spinal cord injury. Example 3:Cutting clothes off. The E of ABCDE stands for exposure which means fully undressing the patient to look for missing injuries. This often involves cutting their clothes off. This practice might be too broadly applied and leave low-risk trauma patients without any clothes to wear when discharged home. Example 4: Digital rectal exam A rectal exam can be a useful tool in the evaluation of patients with abdominal or pelvic injuries. It can help screen for rectal bleeding, pelvic fractures, and neurological function However, the rectal exam is not a sensitive test. A retrospective study from the Indian Journal of Surgery found that a rectal exam missed 100% of urethra injuries, 92% of spinal cord injuries, 93% of small bowel injuries, 100% of colon injuries, and 67% of rectal injuries in trauma patients. Example 6: Pushing on pelvis for pelvic injuries Pushing on the pelvis to check for instability can cause further damage to an unstable pelvis. Imaging the pelvis is far more important than pressing on it if a pelvic fracture is suspected.  Example 7: FAST exam A FAST exam, which stands for "Focused Assessment with Sonography for Trauma," is a rapid ultrasound examination used to assess trauma patients for signs of internal bleeding or organ damage in the abdomen and chest. These can be very useful as an initial test to tell a trauma surgeon where to start looking for internal bleeding in an unstable blunt traumatic injury If a patient is stable and likely going to get a CT scan whether the FAST is positive or negative then the test is unnecessary References ATLS Subcommittee; American College of Surgeons' Committee on Trauma; International ATLS working group. Advanced trauma life support (ATLS®): the ninth edition. J Trauma Acute Care Surg. 2013 May;74(5):1363-6. doi: 10.1097/TA.0b013e31828b82f5. PMID: 23609291. Bloom BA, Gibbons RC. Focused Assessment With Sonography for Trauma. 2023 Jul 24. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 29261902. Brown R. Oxygenate and Resuscitate Before You Intubate. Common pitfalls to avoid when managing the crashing airway. EMS World. 2016 Jan;45(1):48-50, 52, 54-5. PMID: 26852546. Chrimes N, Marshall SD. Attempt XYZ: airway management at the opposite end of the alphabet. Anaesthesia. 2018 Dec;73(12):1464-1468. doi: 10.1111/anae.14361. Epub 2018 Jul 11. PMID: 29998563. Docimo S Jr, Diggs L, Crankshaw L, Lee Y, Vinces F. No Evidence Supporting the Routine Use of Digital Rectal Examinations in Trauma Patients. Indian J Surg. 2015 Aug;77(4):265-9. doi: 10.1007/s12262-015-1283-y. Epub 2015 May 19. PMID: 26702232; PMCID: PMC4688269. Groeneveld A, McKenzie ML, Williams D. Logrolling: establishing consistent practice. Orthop Nurs. 2001 Mar-Apr;20(2):45-9. doi: 10.1097/00006416-200103000-00011. PMID: 12024634. Morgenstern, J. The FAST exam: overused and overrated?, First10EM, August 30, 2021. Rodrigues IFDC. To log-roll or not to log-roll - That is the question! A review of the use of the log-roll for patients with pelvic fractures. Int J Orthop Trauma Nurs. 2017 Nov;27:36-40. doi: 10.1016/j.ijotn.2017.05.001. Epub 2017 May 10. PMID: 28797555. Sapsford W. Should the 'C' in 'ABCDE' be altered to reflect the trend towards hypotensive resuscitation? Scand J Surg. 2008;97(1):4-11; discussion 12-3. doi: 10.1177/145749690809700102. PMID: 18450202. Sundstrøm T, Asbjørnsen H, Habiba S, Sunde GA, Wester K. Prehospital use of cervical collars in trauma patients: a critical review. J Neurotrauma. 2014 Mar 15;31(6):531-40. doi: 10.1089/neu.2013.3094. Epub 2013 Nov 6. PMID: 23962031; PMCID: PMC3949434. Summarized by Jeffrey Olson MS2 | Edited by Meg Joyce & Jorge Chalit, OMSII  

Dr Christopher Flannigan talking about Intubating the Critically Unwell Infant. This talk is part of the Paediatric Emergencies 2022 event. To get your CME certificate for listening to this podcast please visit https://www.paediatricemergencies.com/conference/paediatric-emergencies-2022/

Access to video version of lecture & supplemental materials at: https://www.icuedu.org/acidbasecasedka

In this month's EM Quick Hits podcast: Justin Morgenstern on which patients to consider cerebral venous thrombosis in, Maria Ivankovic on diphenhydramine alternatives, Brit Long on abdominal compartment syndrome, Sarah Reid on neonatal "constipation" - when to worry, and Anand Swaminathan on intubating the patient with metabolic acidosis... The post EM Quick Hits 25 Cerebral Venous Thrombosis, Diphenhydramine Alternatives, Abdominal Compartment Syndrome, Neonatal Constipation, Intubating Metabolic Acidosis appeared first on Emergency Medicine Cases.

Back in April 2020, on REBEL Cast episode 79 we sat down to discuss COVID-19.  Specifically, we focused on not intubating patients early and why... The post REBEL Cast Ep93: COVID-19 – A Follow Up on Not Intubating Early and ARDSnet appeared first on REBEL EM - Emergency Medicine Blog.

In this episode, we are featuring a podcast from REBEL Cast hosted by Dr. Salim Rezaie. This episode features speakers, David Farcy, MD FAAEM FCCM; Cameron Kyle-Sidell, MD; and Evie Marcolini, MD FAAEM FACEP FCCM and is a follow up on the last episode regarding trying not to intubate early. View additional resources at: https://www.aaem.org/resources/publications/podcasts/critical-care-in-emergency-medicine/episode-20. Intro music by NICOCO, 'Quiberon,' from the album 'Nicoco,' powered by JAMENDO.

In this episode, we are featuring a podcast from REBEL Cast hosted by Dr. Salim Rezaie. This episode features speakers, David Farcy, MD FAAEM FCCM; Cameron Kyle-Sidell, MD; and Evie Marcolini, MD FAAEM FACEP FCCM and is a follow up on the last episode regarding trying not to intubate early. View additional resources at: https://www.aaem.org/resources/publications/podcasts/critical-care-in-emergency-medicine/episode-20. Intro music by NICOCO, 'Quiberon,' from the album 'Nicoco,' powered by JAMENDO.

Contributor: Dylan Luyten, MD Educational pearls: Clinical management of COVID-19 is rapidly evolving, relying on case reports and clinical experience In just a month, the consensus around management of COVID patients with severe hypoxia has shifted from an early intubation strategy to other, non-invasive means Intubating early can quickly consume ventilator resources, require increased intensive care monitoring, and likely leads to longer hospital stays and once COVID patients are intubated, extubation can take days to weeks. In Italy, ventilator supplies were depleted leading to the use of helmet CPAP machines, which appeared to be effective in management of respiratory distress in COVID, though not available for use in the US Non-invasive ventilation such as CPAP/BiPAP is thought to increase risk to staff for infection via aerosolization, and has often been avoided in COVID patients High flow nasal cannulas appear to pose less of a risk of aerosolization of viral particles (especially when a surgical mask is placed over the patient’s nose, mouth and apparatus) Anecdotal evidence from NYC has shown success allowing conscious patients to maintain hypoxia on HFN, where they will self prone to help with lung recruitment, and seemingly do well despite persistent saturations in the 80s or less Hospitals around the country are moving away from the intubate early methodology in favor of high flow oxygen therapy as long as they are not having issues with work of breathing or other complications The pathophysiology of respiratory distress and hypoxia in COVID patients is evolving as well, and some presentations appear similar to disease processes such as high altitude pulmonary edema (HAPE) rather than acute respiratory distress syndrome (ARDS), in that patients are quite well appearing despite phenomenally low oximetry readings.  These select patients appear to be excellent candidates for non-invasive means rather than an early intubation strategy   Editor’s note: do not take lightly that intubation is one of the highest risk aerosolization generating procedures, along with many peri-intubation procedures like suctioning, BVM, etc.   References [1]. Sorbello, M. et al. The Italian coronavirus disease 2019 outbreak: recommendations from clinical practice. Anaesthesia. 2020 Mar 27. [2]. Giwa, AL. Desai A. Duca A. Novel 2019 coronavirus SARS-CoV-2 (COVID-19): An updated overview for emergency clinicians. Emerg Med Pract. 2020 May 1;22(5):1-28.  [3]. Ather B, Edemekong PF. Airborne Precautions. [Updated 2020 Feb 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan. Summarized by Jackson Roos, MS3 | Edited by Erik Verzemnieks, MD  Photo Credit: New England Journal of Medicine https://www.nejm.org/doi/full/10.1056/NEJMc2007589?query=RP

On this episode of the Rotor Wash podcast, we take it back to CampECHO WV 2019 with this awesome talk by the legendary Dan Rauh. In Dan's signature style, he presents complex concepts in a brilliantly simple fashion. Sit back, relax, and enlighten yourself with some great education. Also, remember to check out the Sim Competition at ECHO Yacht Club in May! It is a fantastic opportunity to challenge yourself and bond with your peers.

Sam and I sit down and and chat with our new friend @ChillaPharmD about :   -Intubating the hypotensive patient. -Her perspective on the push dose pressor craze. -Long term sedation strategies. -The ONE thing that EMS does that drives her CRAZY!!   @ChillaPharmD is a board certified critical care pharmacist in California! 

Is there any benefit to reap from the obligatory "airway gauntlet" day of medic school. Remember this day? Intubating patients upside down, in the dark, and wedged by the toilet. Dr. Pickett believes so, and here is why.  

SMACCMini: The art of induction - how not lose them in the first 15 minutes / Intubating sick kids - small holes, big problems by Charles Larson and Andrew Beck.   Note on podcast: unfortunately this recording from #DasSMACC skips in a couple of places. It doesn't impact the exceptional quality of this talk, we just wanted to give you the heads up. SMACC Team.

You're asked to see a 22 year old female with a past medical history of asthma who presents to the emergency room with increasing shortness of breath, chest tightness, and wheezing. Over the past 24 hours she's been non-responsive to her home nebulizer treatment every 4 hours.  A quick chart review allows you to see the patient has required ICU admission and mechanical ventilation last year due to an asthma exacerbation. As you walk into the room, you notice the patient can only speak one word at a time before taking deep breaths. She's in respiratory distress with an O2 sat of 88% on 2L NC. What would you do next?  Today, we'll show you the next best steps! - Subscribe to our YouTube here: http://www.youtube.com/subscription_center?add_user=medgeeks - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Ace your exams: https://learn.medgeeks.co - Have questions? Email team@medgeeks.co - This video should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

Friend to the show, Jim DuCanto has been obsessed with SALAD. Not the leafy greens delicately touched with a tart emulsion, but with Suction Assisted Laryngoscopy and Airway Decontamination (SALAD). Jim DuCanto, MD  is an anesthesiologist extraordinaire with a constant drive to perfect new airway techniques and document them on video along the way. COI Statement Dr. DuCanto invented and receives royalties on the DuCanto Catheter from SSCOR and the Nasco SALAD mannequin Read More about SALAD from Taming the Sru TtS Post Esophageal Diversion Maneuver (Intentional Esophageal Intubation) deliberately insert the ETT down the esophagus and gently inflate the balloon There is lit for this [cite source='pubmed']25943615[/cite] SALAD Park Maneuver Keep tip of suction catheter in the esophagus on the left side of the mouth SALAD Techniques Meconium Suction Set-Up Here was our original letter (J Clin Anesth, 23 (2011), pp. 518–519) (fulltext) It was recently validated (The Journal of Emergency Medicine Volume 52, Issue 4, April 2017, Pages 433–437) Large Bore Suction Surrogate Wanted to run something by you. I'm an EM-3 in Cleveland at University Hospitals rotating up in the CT-ICU at my institution with a CA-2. We were just fooling around with mechanisms to make large bore suction improvisation kits, and stumbled upon a VERY good one I didn't see on your site. 7.0 ETT with the adapter pulled off. Hook that up to suction EXTENSION tubing with the little white plastic adapter that comes with the extension tubing. Connect that tubing adapter directly to the 7.0 ETT on one end, and the tubing it is meant for on the other. Should have a small gap of that adapter bridging between the tubing end (traditionally a blue end I believe) and the ETT. Doesn't work with larger bores we found out. Easy as that. Drained 750cc of fluid in less than 3 seconds on repeat testing with continuous suction. No meconium aspirator needed (for those working in the community), and because it is an ETT, there is the built in hole at the end of the tube to prevent suck down events onto tissue in the oropharynx. -Chris Peluso ( cfpeluso10@gmail.com ) SALAD Comic More Stuff SALAD Facebook Page SSCOR Site Taming the SRU write-up of SALAD DuCanto Suction Catheter General Description of system and demonstration by Jeff Hill of the University of Cincinnati’s EM Program Product page of SALAD Mannequin University of Wisconsin HEMS Fellow with the “Static” Excercise University of Wisconsin HEMS Fellow with the “Dynamic” Excercise University of Wisconsin HEMS Attending takes on the SALAD Simulator Check out the next level of SALAD—SALAD 2.0 Listen to the JellyBean with Jim More from Jim DuCanto on EMCrit Podcast 73 – Airway Tips and Tricks A New Bougie for your Pocket by Jim DuCanto A Guide to Intubating through the Intubating Laryngeal Airway Two New Videos from Jim DuCanto The Oxylator More DuCanto and Pocket Bougie Videos Two OR Intubation Videos How to Custom Bend a Video Stylet for use with the Cookgas AirQ ILA image at the top from J Downham Now on to the Podcast...

“Airway” does not necessarily mean “Intubation” Introduction In emergency medicine we are taught “A-B-Cs” These are actions that can be accomplished in first 60 seconds of patient encounter Intubation takes several minutes to accomplish Intubating a crashing patient might even KILL them! Resuscitate THEN intubate Step 1: Suction Immediately suction if patient is… Altered and […]

Here is a 15 minute "Broome style" intubation simulation video. One way to skin a cat!

Talks on non-invasive ventilation, intubating the child and intubating the adult. This podcast does not reflect the views of John Stroger Hospital, Cook County Human Health Services or the Stroger Emergency Medicine Residency.