Podcasts about tracheal intubation

During this episode, Dr. Dallen Mill joins us to share a few technologies that have been so beneficial to him that he would almost describe them as magic. We kick off our conversation with a brief overview of the history of anesthesia before we unpack how to address respiratory compromise and airway emergencies. Dr. Mill shares four studies on two options for laryngoscopies, discusses tips for negotiating the tube through the vocal cords, and offers some tech suggestions to support the process. We also talk about IV placement, the power of having a longer IV catheter, how to optimize the process with the use of an ultrasound device, and much more! For an informative review of some of the most helpful technology available in anesthesia today, don't miss this conversation with Dr. Dallen Mill. Key Points From This Episode:An overview of the history of anaesthesia. Respiratory compromise concerns and how airway emergencies can be managed.The appropriate time to apply direct laryngoscopy versus video laryngoscopy.Four studies on the relevance of these two approaches.Tips for negotiating the tube through the vocal cords.Different options for purchasing a video laryngoscope.Learning how to get the necessary view and practicing insertion.Other scenarios where video laryngoscopy can be useful.The role of an ultrasound in the process. IV placement and alleviating patient anxiety. Why a longer IV catheter can be beneficial for the ultrasound process.Linking the ultrasound device to your iPad. Using the BIS Monitor where relevant.Fine-tuning the wake-up process.A guide to practicing IV placement. Links Mentioned in Today's Episode:Dr. Dallen Mill on LinkedIn — https://www.linkedin.com/in/dallen-mill-055338/‘Video versus Direct Laryngoscopy for Tracheal Intubation of Critically Ill Adults' — https://pubmed.ncbi.nlm.nih.gov/37326325/‘First-attempt success rate of video laryngoscopy in small infants (VISI): A multicentre, randomised controlled trial' — https://pubmed.ncbi.nlm.nih.gov/33308472/King Vision Video Laryngoscope — https://www.ambu.com/airway-management-and-anaesthesia/clinical-evidence/king-vision-video-laryngoscopeGlideScope Video Laryngoscope — https://www.verathon.com/video-laryngoscopes/BESDATA Video Laryngoscope — https://besdatatech.com/video-laryngoscope/Sonoque — https://www.sonoque.com/Butterfly Network — https://www.butterflynetwork.com/ Dr. Sono — https://drsono.com/ Everyday Oral Surgery Website — https://www.everydayoralsurgery.com/ Everyday Oral Surgery on Instagram — https://www.instagram.com/everydayoralsurgery/ Everyday Oral Surgery on Facebook — https://www.facebook.com/EverydayOralSurgery/ Dr. Grant Stucki Email — grantstucki@gmail.com Dr. Grant Stucki Phone — 720-441-6059

In this two part podcast special Iain and Simon go through twenty of the top papers from the last year or so, as presented by Simon at the Big Sick Conference in Zermatt earlier this year. All the details and more discussion can be found on the blog site. In Part 1 they discuss all things airway, including where we should be intubating patients needing immediate haemorrhage control. VL vs DL, the effect of blade size on intubation success, whether small adult ventilation bags are better than larger versions, intubating comatose poisoned patients, and more.  Check out part 2 for papers about major haemorrhage, trauma, cardiac arrest and more. Papers Dunton Z, Seamon MJ, Subramanian M, Jopling J, Manukyan M, Kent A, Sakran JV, Stevens K, Haut E, Byrne JP. Emergency department versus operating room intubation of patients undergoing immediate hemorrhage control surgery. J Trauma Acute Care Surg. 2023 Jul 1;95(1):69-77. doi: 10.1097/TA.0000000000003907. Epub 2023 Feb 28. PMID: 36850033. Prekker et al: Video versus Direct Laryngoscopy for Tracheal Intubation of Critically Ill Adults August 3, 2023 N Engl J Med 2023; 389:418-429 DOI: 10.1056/NEJMoa2301601 Landefeld KR, Koike S, Ran R, Semler MW, Barnes C, Stempek SB, Janz DR, Rice TW, Russell DW, Self WH, Vonderhaar D, West JR, Casey JD, Khan A. Effect of Laryngoscope Blade Size on First Pass Success of Tracheal Intubation in Critically Ill Adults. Crit Care Explor. 2023 Mar 6;5(3):e0855. doi: 10.1097/CCE.0000000000000855. PMID: 36895888; PMCID: PMC9990830. Snyder BD, Van Dyke MR, Walker RG, Latimer AJ, Grabman BC, Maynard C, Rea TD, Johnson NJ, Sayre MR, Counts CR. Association of small adult ventilation bags with return of spontaneous circulation in out of hospital cardiac arrest. Resuscitation. 2023 Dec;193:109991. doi: 10.1016/j.resuscitation.2023.109991. Epub 2023 Oct 5. PMID: 37805062. Freund Y et al. Effect of Noninvasive Airway Management of Comatose Patients With Acute Poisoning: A Randomized Clinical Trial. JAMA. 2023 Dec 19;330(23):2267-2274. doi: 10.1001/jama.2023.24391. PMID: 38019968; PMCID: PMC10687712. Eastwood G et al, TAME Study Investigators. Mild Hypercapnia or Normocapnia after Out-of-Hospital Cardiac Arrest. N Engl J Med. 2023 Jul 6;389(1):45-57. doi: 10.1056/NEJMoa2214552. Epub 2023 Jun 15. PMID: 37318140. Downing J, et al. Prevalence of peri-intubation major adverse events among critically ill patients: A systematic review and meta analysis. Am J Emerg Med. 2023 Sep;71:200-216. doi: 10.1016/j.ajem.2023.06.046. Epub 2023 Jun 28. PMID: 37437438

Date: July 21, 2023 Reference: Prekker et al. Video versus Direct Laryngoscopy for Tracheal Intubation of Critically Ill Adults. NEJM 2023 Guest Skeptic: Dr. Jeff Jarvis is the Chief Medical Officer and System Medical Director for the Metropolitan Area EMS Authority in Fort Worth, Texas, also known as MedStar. He is board certified in both Emergency Medicine […] The post SGEM#410: Do You See What I See? Video Laryngoscope for Intubation first appeared on The Skeptics Guide to Emergency Medicine.

We've spoken a lot recently about intubation First Pass Success, including what the definition is. We've also discussed different papers about the impact the type of laryngoscope, video or direct, has on first pass success. There's a new paper out that directly compares video vs direct laryngoscopy. Join us to discuss the DEVICE trial.   Citations Prekker ME, Driver BE, Trent SA, et al. Video versus Direct Laryngoscopy for Tracheal Intubation of Critically Ill Adults. N Engl J Med. Published online June 16, 2023 Jarvis JL, McClure SF, Johns D. EMS Intubation Improves with King Vision Video Laryngoscopy. Prehosp Emerg Care. 2015 Ducharme S, Kramer B, Gelbart D, Colleran C, Risavi B, Carlson JN. A pilot, prospective, randomized trial of video versus direct laryngoscopy for paramedic endotracheal intubation. Resuscitation. 2017 Pourmand A, Terrebonne E, Gerber S, Shipley J, Tran QK. Efficacy of Video Laryngoscopy versus Direct Laryngoscopy in the Prehospital Setting: A Systematic Review and Meta-Analysis. Prehosp Disaster Med. 2023 Brown CA, Kaji AH, Fantegrossi A, et al. Video Laryngoscopy Compared to Augmented Direct Laryngoscopy in Adult Emergency Department Tracheal Intubations: A National Emergency Airway Registry (NEAR) Study. Acad Emerg Med. 2020 Hansel J, Rogers AM, Lewis SR, Cook TM, Smith AF. Videolaryngoscopy versus direct laryngoscopy for adults undergoing tracheal intubation: a Cochrane systematic review and meta-analysis update. British Journal of Anaesthesia. 2022See omnystudio.com/listener for privacy information.

Dr. Michael Lanspa chats with Dr. Kevin Seitz and Dr. Matthew Churpek about their article, "Individualized Treatment Effects of Bougie vs Stylet for Tracheal Intubation in Critical Illness."

In this podcast I break down the DEVICE trial looking at using video laryngoscopy (VL) or direct laryngoscopy (DL) for intubation. Show Notes: https://eddyjoemd.com/vl-dl-intubation/ This Video was Editing Using Descript: https://www.descript.com?lmref=BGOxjQ TrueLearn Link: ⁠⁠⁠https://truelearn.referralrock.com/l/EDDYJOEMD25/⁠⁠⁠ Discount code: EDDYJOEMD25 Citation: Prekker ME, Driver BE, Trent SA, Resnick-Ault D, Seitz KP, Russell DW, Gaillard JP, Latimer AJ, Ghamande SA, Gibbs KW, Vonderhaar DJ, Whitson MR, Barnes CR, Walco JP, Douglas IS, Krishnamoorthy V, Dagan A, Bastman JJ, Lloyd BD, Gandotra S, Goranson JK, Mitchell SH, White HD, Palakshappa JA, Espinera A, Page DB, Joffe A, Hansen SJ, Hughes CG, George T, Herbert JT, Shapiro NI, Schauer SG, Long BJ, Imhoff B, Wang L, Rhoads JP, Womack KN, Janz DR, Self WH, Rice TW, Ginde AA, Casey JD, Semler MW; DEVICE Investigators and the Pragmatic Critical Care Research Group. Video versus Direct Laryngoscopy for Tracheal Intubation of Critically Ill Adults. N Engl J Med. 2023 Jun 16. doi: 10.1056/NEJMoa2301601. Epub ahead of print. PMID: 37326325. My website: ⁠⁠⁠www.eddyjoemd.com⁠⁠⁠  Instagram: ⁠⁠⁠www.instagram.com/eddyjoemd⁠⁠⁠  Twitter: ⁠⁠⁠www.twitter.com/eddyjoemd⁠⁠⁠ Facebook: ⁠⁠⁠www.facebook.com/eddyjoemd⁠⁠⁠  Podcast: ⁠⁠⁠https://anchor.fm/eddyjoemd⁠ --- Support this podcast: https://podcasters.spotify.com/pod/show/eddyjoemd/support

This new meta-analysis from Hansel et al. is a must read for all. Join Associate Editor Susannah Patey as she speaks with the authors about the key findings and clinical conclusions. 

Doctor Jarrod Mosier is a bit of a polymath, and we were delighted he could squeeze us into his busy life. His day jobs include Intensive Care Medicine and Emergency medicine in Tucson, where he is a professor (at the other UofA: Arizona).He is an expert in all aspects of airway management, ranging from the physiologically difficult airway, through the importance of first pass success, including how to optimize for intubation, the roles of ultrasound and extracorporeal support, and all the way to safe extubation. This was the focus of our wide-ranging entertaining conversation. When away from work Jarrod throws a mean football, dotes on his two kids, and loves getting up into the mountains to snap superb nature photographs. Further reading: 1. Mosier JM, Sakles JC, Law JA, Brown CA 3rd, Brindley PG. Tracheal Intubation in the Critically Ill. Where We Came from and Where We Should Go. Am J Respir Crit Care Med. 2020;201(7):775-788. doi:10.1164/rccm.201908-1636CI 2. Mosier JM. Physiologically difficult airway in critically ill patients: winning the race between haemoglobin desaturation and tracheal intubation. Br J Anaesth. 2020;125(1):e1-e4. doi:10.1016/j.bja.2019.12.001

CHEST February 2023, Volume 163, Issue 2 Brian Driver, MD, joins CHEST Podcast Moderator, Alice Gallo de Moraes, MD, to discuss the prevalence of recalled awareness during paralysis in patients who underwent emergency tracheal intubation and mechanical ventilation. DOI: https://doi.org/10.1016/j.chest.2022.08.2232   Disclaimer: The purpose of this activity is to expand the reach of CHEST content through awareness, critique, and discussion. All articles have undergone peer review for methodologic rigor and audience relevance. Any views asserted are those of the speakers and are not endorsed by CHEST. Listeners should be aware that speakers' opinions may vary and are advised to read the full corresponding journal article(s) for complete context. This content should not be used as a basis for medical advice or treatment, nor should it substitute the judgment used by clinicians in the practice of evidence-based medicine.

This new paper from the AERATOR group examines the science around aerosol generation and awake tracheal intubation (ATI). Their study was performed on a single day during an ATI course on 12 anaesthetic trainees. They show that ATI without sedation generates high concentrations of respiratory aerosol. Professor Ross Hofmeyr talks to the authors about their study, its clinical implications and what the future holds for research in this area. 

Dr. Ben Sandefur, Emergency Medicine attending at Mayo Clinic, joins Alex and Venk on the podcast to talk about angioedema and awake tracheal intubation. He reviews the different types of angioedema in a format designed to assist the emergency department practitioner with decision making and prognostication. This is followed by a description of how to prepare for and lead a team and patient through awake tracheal intubation using fiberoptic and video laryngoscopy techniques.   Contacts TWITTER - @AlwaysOnEM; @VenkBellamkonda INSTAGRAM – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch EMAIL - AlwaysOnEM@gmail.com References Rosenbaum S, Wilkerson RG, Winters ME, Vilke GM, Wu MYC. Clinical Practice Statement: What is the Emergency Department Management of Patients with Angioedema Secondary to an ACE-Inhibitor? J Emerg Med. 2021 Jul;61(1):105-112 [from the American Academy of Emergency Medicine] https://pubmed.ncbi.nlm.nih.gov/34006418/ Moellman JJ, Bernstein JA, et al. A consensus parameter for the evaluation and management of angioedema in the emergency department. Acad Emerg Med. 2014 Apr;21(4):469-84 [from the American College of Allergy, Asthma & Immunology (ACAAI) and the Society for Academic Emergency Medicine (SAEM)] https://pubmed.ncbi.nlm.nih.gov/24730413/ Carrillo-Martin I, Gonzalez-Estrada A, Funni SA, Sandefur BJ, Jeffery MM, Campbell RL. Angioedema - related emergency department visits in the United States: Epidemiology and time trends, 2006-2015. J Allergy Clin Immunol Pract. 2020 Jul-Aug;8(7):2442-2444. https://pubmed.ncbi.nlm.nih.gov/32302784/ Ishoo E, Shah UK, Grillone GA, Stram JR, Fuleihan NS. Predicting airway risk in angioedema: staging system based on presentation. Otolaryngol Head Neck Surg. 1999 Sep;121(3):263-8 https://pubmed.ncbi.nlm.nih.gov/10471868/ Arthur J, Caro D, Topp S, Chadwick S, Driver B, Henson M, Norse A, Spencer H, Godwin SA, Guirgis F. Clinical predictors of endotracheal intubation in patients presenting to the emergency department with angioedema. Am J Emerg Med. 2022 Oct 19;63:44-49 https://pubmed.ncbi.nlm.nih.gov/36327748/ Sandefur BJ, Liu XW, Kaji AH, Campbell RL, Driver BE, Walls RM, Carlson JN, Brown CA. Emergency Department Intubations in Patients with Angioedema: A Report from the National Emergency Airway Registry. J Emerg Med. 2021 Nov;61(5):481-488 https://pubmed.ncbi.nlm.nih.gov/34479750/ Sandefur BJ, Oliveira Silva L, Lohse CM, Goyal KA, Barbara DW, Castaneda-Guarderas A, Liu XW, Campbell RL. Clinical features and outcomes associated with angioedema in the emergency department. West J Emerg Med. 2019 Aug 6;20(5):760-769 https://pubmed.ncbi.nlm.nih.gov/31539333/ Additional Resources Wilkerson RG, Moellman JJ. Hereditary Angioedema. Emerg Med Clin North Am. 2022 Feb;40(1):99-118 https://pubmed.ncbi.nlm.nih.gov/34782094/ Wilkerson RG, Winters ME. Angiotensin-Converting Enzyme Inhibitor-Induced Angioedema. Emerg Med Clin North Am. 2022 Feb;40(1):79-98 https://pubmed.ncbi.nlm.nih.gov/34782093/  

Moderator: BobbieJean Sweitzer, M.D. Participants: John Fiadjoe, M.D. and Allan Simpao, M.D., M.B.I. Articles Discussed: Sedation versus General Anesthesia for Tracheal Intubation in Children with Difficult Airways: A Cohort Study from the Pediatric Difficult Intubation Registry Walk a Tightrope or Burn a Bridge?: Sedation versus General Anesthesia for Intubation of a Pediatric Difficult Airway Transcript

A very Happy Doctors' Day to you all! In this episode I discuss some salient points regarding the physiologically difficult airway. There are many physicians I know who are still not aware regarding this concept that can kill patients as soon as we try and save them. Also - EZECON is being organised in Kolkata from 16-17th July,22 and it is going to be an academic feast for the residents. So do register for it. The references for reading up more on the physiologically difficult airways are as follows - 1. Mosier JM, Joshi R, Hypes C, Pacheco G, Valenzuela T, Sakles JC. The Physiologically Difficult Airway. West J Emerg Med. 2015 Dec;16(7):1109-17. doi: 10.5811/westjem.2015.8.27467. Epub 2015 Dec 8. PMID: 26759664; PMCID: PMC4703154. 2. Weingart SD, Trueger NS, Wong N, Scofi J, Singh N, Rudolph SS. Delayed sequence intubation: a prospective observational study. Ann Emerg Med. 2015 Apr;65(4):349-55. doi: 10.1016/j.annemergmed.2014.09.025. Epub 2014 Oct 23. PMID: 25447559. 3. https://www.acepnow.com/article/crash-a-mnemonic-for-the-physiological-difficult-airway/ 4. Myatra SN, Divatia JV, Brewster DJ. The physiologically difficult airway: an emerging concept. Curr Opin Anaesthesiol. 2022 Apr 1;35(2):115-121. doi: 10.1097/ACO.0000000000001102. PMID: 35165233. 5. Cai SR, Sandhu MRS, Gruenbaum SE, Rosenblatt WH, Gruenbaum BF. Airway Management in an Anatomically and Physiologically Difficult Airway. Cureus. 2020 Sep 24;12(9):e10638. doi: 10.7759/cureus.10638. PMID: 33123451; PMCID: PMC7584327. 6. Kornas RL, Owyang CG, Sakles JC, Foley LJ, Mosier JM; Society for Airway Management's Special Projects Committee. Evaluation and Management of the Physiologically Difficult Airway: Consensus Recommendations From Society for Airway Management. Anesth Analg. 2021 Feb 1;132(2):395-405. doi: 10.1213/ANE.0000000000005233. PMID: 33060492. 7. Mosier, Jarrod M. “Physiologically Difficult Airway in Critically Ill Patients: Winning the Race between Haemoglobin Desaturation and Tracheal Intubation.” British Journal of Anaesthesia 125, no. 1 (July 2020): e1–4. https://doi.org/10.1016/j.bja.2019.12.001. 8. Scott Weingart, MD FCCM. EMCrit 325 – The Hypoxemic Difficult Airway and Preox Discussion with Jarrod Mosier. EMCrit Blog. Published on June 5, 2022. Accessed on June 30th 2022. Available at [https://emcrit.org/emcrit/hypoxemic-difficult-airway/ ]. 9. Salim Rezaie, "An Emergency Difficult Airway Predictor Would be From HEAVEN", REBEL EM blog, January 31, 2018. Available at: https://rebelem.com/emergency-difficult-airway-predictor-heaven/. 10. Salim Rezaie, "Critical Care Updates: Resuscitation Sequence Intubation – Hypotension Kills (Part 1 of 3)", REBEL EM blog, September 26, 2016. Available at: https://rebelem.com/critical-care-updates-resuscitation-sequence-intubation-hypotension-kills-part-1-of-3/. 11. Salim Rezaie, "Critical Care Updates: Resuscitation Sequence Intubation – pH Kills (Part 3 of 3)", REBEL EM blog, October 3, 2016. Available at: https://rebelem.com/critical-care-updates-resuscitation-sequence-intubation-ph-kills-part-3-of-3/.

Listen to the Q&A between Prof. Souhayl Dahmani and author Dr Tom Hansen as they discuss his article “Neonatal Tracheal Intubation: From Art to Evidence” found in the November 2021 issue of the EJA.

As always, feel free to send us questions, comments or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through instagram or twitter, @nicupodcast. Or contact Ben and Daphna directly via their twitter profiles: @drnicu and @doctordaphnamd. Papers discussed in today's episode are listed and timestamped below.enjoy!________________________________________________________________________________________04:10 - Qualitative indications for tracheostomy and chronic mechanical ventilation in patients with severe bronchopulmonary dysplasia. https://www.nature.com/articles/s41372-021-01165-915:40 - Association between Term Equivalent Brain MRI and 2 Year Outcomes in Extremely Preterm Infants: A Report from the PENUT Trial Cohort. https://jpeds.com/retrieve/pii/S002234762100825822:46 - Association of Blood Donor Sex and Age With Outcomes in Very Low-Birth-Weight Infants Receiving Blood Transfusion. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/278371529:30 - Slow advancement of enteral feed volumes to prevent necrotising enterocolitis in very low birth weight infants. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001241.pub838:29 - Neurodevelopmental outcome of preterm infants enrolled in myo-inositol randomized controlled trial. https://www.nature.com/articles/s41372-021-01018-5.41:20 - Adverse Events and Associated Factors During Intra-hospital Transport of Newborn Infants. https://www.jpeds.com/article/S0022-3476(21)00859-3/fulltext46:17 - Digital tracheal intubation and finger palpation to confirm endotracheal tube tip position in neonates: A systematic review and meta‐analysis. https://onlinelibrary.wiley.com/doi/10.1002/ppul.2555152:41 - The DELUX study: development of lung volumes during extubation of preterm infants. https://www.nature.com/articles/s41390-021-01699-w

In this month's podcast Anthony speaks with Professor Brendan McGrath and Sarah Wallace OBE about their article on tracheal complications. Hear about the risk factors, common presenting features, and optimal multidisciplinary management of these problems, which often present in patients who are admitted to intensive care.

Welcome to the first ever Anaesthesia Reports live broadcast – what will hopefully be the first of many - where we chat with the authors of their reports about the interesting scenarios they have encountered in their own clinical practice. This session was chaired by Dr Maryann Turner, who is an editor of Anaesthesia Reports and a paediatric anaesthetist based in Sydney. Dealing with a predicted difficult airway is a common challenge in anaesthesia. There are several different devices on the market that are designed to facilitate tracheal intubation in these patients and traditionally, a bronchoscope or a video laryngoscope would be used. But today, we are going to discuss the use of the ProVu™ video stylet as an alternative device for use in these patients. We were joined by Dr Imran Ahmad and Dr Siew-Ling Harrison, who are the authors the paper. Imran is a consultant anaesthetist at Guy's and St Thomas' and the director of the Guy's Airway Management Course, as well as the honorary secretary of the Difficult Airway Society. Siew-ling is a senior trainee in the south east of London who is the outgoing airway fellow under Imran and the current thoracic fellow at Guys Hospital.

In the third installment of our Johns Hopkins series, hosts Dr. Steven Taback and Bill Curtis are joined by Dr. Martin Brodsky, Speech Pathologist, Associate Professor of Physical Medicine and Rehabilitation, and a Fellow of the American Speech-Language-Hearing Association. Dr. Brodsky shares his insight on Speech Pathology in the ICU, dealing with dysphagia (swallowing problems), and physical therapy for vocal cord damage. In this dedicated series, we're showcasing the medical breakthroughs & innovations from one of the world's most preeminent hospitals: Johns Hopkins Medicine. Johns Hopkins Medicine is dedicated to improving the health of the community and the world by setting the standard of excellence in medical education, research, and clinical care. Timestamps: 2:23 What is dysphagia? 3:00 Why did Dr. Brodsky first start his career in speech pathology? 4:00 What is different if speech pathology from the past and present? 5:16 What do speech pathologist do inside the ICU? 6:30 Communicating to patients during intubation 8:55 Why not use a tracheotomy when intubation poses risks and rehabilitation? 12:40 Is there a risk of vocal cords never returning to full function? 13:47 What can an Intensivist do to minimize the damages caused by intubation? 18:21 What happens when a patient feels they’re having swallowing problems? 21:35 What is actually creating the problem of swallowing in the ICU? 23:58 What sort of circumstances lead to swallowing issues outside the hospital? 26:00 Physical therapy for swallowing 27:40 What should you be watching out for that can indicate a family member may need to seek help with swallowing? ----------------- Learn More: Medicine, We’re Still Practicing Follow Us: Twitter | Facebook | Instagram Hosted by: Dr. Steven Taback & Bill Curtis Produced and Edited by: AJ Moseley Sound Engineering by: Steve Reickeberg Theme Music by: Celleste and Eric Dick A CurtCo Media Production See omnystudio.com/listener for privacy information.

In this “Breathe Easy Critical Perspective” podcast, Dr. Dominique Pepper interviews Dr. Jarrod Mosier. They discuss tracheal intubation in critically ill adults in the era of COVID-19. Dr. Mosier is an Associate Professor in Emergency Medicine at the University of Arizona College of Medicine and the National Director of the Difficult Airway Course.

Dr. Calvin Brown reviews the recently published Difficult Airway Society guidelines on awake tracheal intubation (ATI) in adults.  The guidelines cover indication, set up, checklists, oxygenation, topicalization & sedation, and tube confirmation.  General recommendations are also discussed.  

Calvin Brown III, MD presents four nominees for the "2019 Airway Article of the Year."  The nominated articles were chosen from among those featured in 2019 Quarterly Airway Research Updates.  Dr. Brown discusses the content and merits of each article and the audience votes for the "Airway Article of the Year."

Kontakt: ivajuntan@gmail.com    Musik: Blind Love Dub by Jeris (c) copyright 2017 Licensed under a Creative Commons Attribution (3.0) license. http://dig.ccmixter.org/files/VJ_Memes/55416 Ft: Kara Square (mindmapthat)    Om du gillar du det vi gör - stöd Life Support Foundation! www.lifesupportfoundation.org     Bli månadsgivare eller används Swish: 1234610804 Ahmed A, Azim A. Difficult tracheal intubation in critically ill. J Intensive Care. 2018;6:49. Umobong EU, Mayo PH. Critical Care Airway Management. Crit Care Clin. 2018;34(3):313-24. Casey JD, Semler MW, High K, Self WH. How I manage a difficult intubation. Crit Care. 2019;23(1):177. Casey JD, Janz DR, Russell DW, Vonderhaar DJ, Joffe AM, Dischert KM, et al. Bag-Mask Ventilation during Tracheal Intubation of Critically Ill Adults. N Engl J Med. 2019;380(9):811-21.  

n this episode of Critical Matters, we provide a quick recap on five things we learned after attending the annual Society of Critical Care Medicine Critical Care Congress. Four recent clinical studies released ahead of print during the congress are briefly discussed in addition to some thoughts on ECMO. Additional Resources: Bag-Mask Ventilation during Tracheal Intubation of Critically Ill Adults: https://bit.ly/2GRFbEH Effect of Titrating Positive End-Expiratory Pressure (PEEP) with Esophageal Pressure-Guided Strategy vs. an Empirical High PEEP-FiO2 Strategy on Death and Days Free From Mechanical Ventilation Among Patients with Acute Respiratory Distress Syndrome: https://bit.ly/2T38pqV Effect of a Resuscitation Strategy Targeting Peripheral Perfusion Status vs Serum Lactate Levels on 28-Day Mortality Among Patients With Septic Shock: https://bit.ly/2UcyoJ3 Adjunctive Intermittent Pneumatic Compression for Venous Thromboprophylaxis: https://bit.ly/2Xx4O35 Books Mentioned in This Episode: The Art of Living: The Classical Manual on Virtue, Happiness, and Effectiveness. Epictetus by Sharon Lebell: https://amzn.to/2ECiYIp

Torsdag den 2. maj blev der afholdt Copenhagen Critical Care symposium. Vi deltog, bla. med en podcast hvor vi tog en snak med næsten alle talerne. Her får du deres 3-4 take homes points fra netop deres tale. Vi snakker om ledelse, opbygning af kultur, brandsårsbehandling og meget mere. Hør podcasten hvor de nyeste anbefalinger om brandsårsbehandling gennemgås, behandling for Rhabdomyolyse analyseres. Akronymet MONA aflives af Kardiolog Jens Rosenberg. En fantastisk session om lederskab og meget mere. Se tiderne for de forskellige emner her under 02:00 Lederskab med Thomas Bøllingtoft Knudsen,Randi Beier & Ture Larsen, Roger Harris14:50 Massetilskadekomst med Christina Hernon (US), Dan Lou Isbye og Kristian Andersen29:50 Critical care er ikke ét speciale med Monika Afzali Rubin og Karl Høeg40:15 Toxikologi - Christina Hernon (US), 45:21 Brandsår - Rikke Holmgaard, Christian Overgaard Steensen & Martin Risom Vestergaard51:50 Mythbusters - Jens Rosenberg, Jens Michelsen, Thomas Bøllingtoft Knudsen01:01:11 Critical Care litteratur update 2019 - Thomas Strøm ogLars Simon Rasmussen Abonner eller hent via iTunes for iOS og for android via Podbean. Nu også via TUNE IN Se vores egen Karl Høeg som vært på FOAMmedic Talk hvor han interviewer Læge Monika Afzali Rubin https://www.youtube.com/watch?v=WnrmbQCqPTg Links og referencer: Se hele cphcc2019 på vores søster blog scanFOAM https://www.youtube.com/watch?v=WLYujtTXfLQ Paper battle mellem Thomas Strøm og Lars S. Rasmussen, her er de fire artikler som blev debatteret, hør vores snak ved 01:01:11 i podcasten: Timing of Renal-Replacement Therapy in Acute Kidney Injury and Sepsis.Barbar SD, Dargent A, Quenot JP. N Engl J Med. 2019 Jan 24;380(4):399. Bag-Mask Ventilation during Tracheal Intubation of Critically Ill Adults. Casey JD, Janz DR, Russell DW, Vonderhaar DJ, Joffe AM, Dischert KM, Brown RM, Zouk AN, Gulati S, Heideman BE, Lester MG, Toporek AH, Bentov I, Self WH, Rice TW, Semler MW; PreVent Investigators and the Pragmatic Critical Care Research Group. N Engl J Med. 2019 Feb 28;380(9):811-821 Effect of Cricoid Pressure Compared With a Sham Procedure in the Rapid Sequence Induction of Anesthesia: The IRIS Randomized Clinical Trial. Birenbaum A, Hajage D, Roche S, Ntouba A, Eurin M, Cuvillon P, Rohn A, Compere V, Benhamou D, Biais M, Menut R, Benachi S, Lenfant F, Riou B; IRIS Investigators Group. JAMA Surg. 2019 Jan 1;154(1):9-17 Sodium bicarbonate therapy for patients with severe metabolic acidaemia in the intensive care unit (BICAR-ICU): a multicentre, open-label, randomised controlled, phase 3 trial. Jaber S, Paugam C, Futier E, Lefrant JY, Lasocki S, Lescot T, Pottecher J, Demoule A, Ferrandière M, Asehnoune K, Dellamonica J, Velly L, Abback PS, de Jong A, Brunot V, Belafia F, Roquilly A, Chanques G, Muller L, Constantin JM, Bertet H, Klouche K, Molinari N, Jung B; BICAR-ICU Study Group. Lancet. 2018 Jul 7;392(10141):31-40 Støt FOAMmedics arbejde med 5 eller 10 kr pr. podcast. Hvis du har lyst til at støtte vores arbejde med at lave lækker lyd og skrift så klik ind på 10er.dk og støt os med 5, 10 eller 15 pr. podcast episode, så bliver vi så sindsygt stolte og glade. Eller klik på 10'er logo her under og en pop-up løsning kommer frem.

We've got a broad array of topics and papers for you this month! First up we look at a paper from the NEJM assessing the potential benefits in providing ventilations to patients undergoing an RSI. Next we look at patients presenting with both syncope and pre-syncope to the emergency department, this paper quantifies the risk that we should be apportioning to these two different presentations. Finally, we look at a paper that suggests the manual pulse check in CPR is dead, and that the time has come for doppler and ultrasound to replace it! As always make sure you take a look at the papers yourselves and draw you own conclusions, we'd love to hear your thoughts. Enjoy! Simon & Rob References & Further Reading Bag-Mask Ventilation during Tracheal Intubation of Critically Ill Adults. Casey JD. N Engl J Med.2019  Comparison of 30-Day Serious Adverse Clinical Events for Elderly Patients Presenting to the Emergency Department With Near-Syncope Versus Syncope. Bastani A. Ann Emerg Med.2019 Comparison of manual pulse palpation, cardiac ultrasonography and Doppler ultrasonography to check the pulse in cardiopulmonary arrest patients. Zengin S. Resuscitation.2018  

Critical Perspective: The PreVent trial, assessing the role of bag-mask ventilation during tracheal intubation in critically ill adults

Jerry is a consultant in anaesthesia and intensive care medicine at the Royal United Hospital, Bath and Honorary Professor of Resuscitation Medicine at the University of Bristol. He trained at Bristol Medical School (MB ChB 1983) and undertook anaesthesia and critical care training in Plymouth, Bristol, Bath and Southampton, and at the Shock Trauma Center, Baltimore in the United States. Jerry is Chair of the European Resuscitation Council (ERC), past Chair of the Resuscitation Council (UK), and the immediate past Co-Chair of the International Liaison Committee on Resuscitation (ILCOR). He received a Lifetime Achievement Award in Cardiac Resuscitation Science from the American Heart Association in 2016. Jerry is Editor-in-Chief of the journal Resuscitation. Jerry’s research interests are in cardiopulmonary resuscitation, airway management, and post-cardiac arrest treatment – he has authored over 300 original papers, reviews and editorials on these topics. 

The Intensive Care Society, Faculty of Intensive Care Medicine, Difficult Airway Society and the Royal College of Anaesthetists have combined to provide the ‘Guidelines for the management of tracheal intubation in critically ill adults‘. The main part of the document covers Plan A to Plan D when performing this procedure. This is well worth a read […]

The Intensive Care Society, Faculty of Intensive Care Medicine, Difficult Airway Society and the Royal College of Anaesthetists have combined to provide the ‘Guidelines for the management of tracheal intubation in critically ill adults‘. The main part of the document covers Plan A to Plan D when performing this procedure. This is well worth a read […] The post CCP Podcast 083: Guidelines for Tracheal Intubation in Critically Ill Adults 2017 appeared first on Critical Care Practitioner.

Dr. Eric Vicaut and Dr. Rim Halaby Discuss

When you give only after you're asked, you've waited too long. – John Mason First, learn to bag Place a towel roll under the scapulae to align oral, pharyngeal, and tracheal axes: Karsli C. Can J Anesth. 2015. Use airway adjuncts such as the oropharyngeal airway or a nasal trumpet. Use the two-hand ventilation technique whenever possible:   (See Adventures in RSI for more)     Supraglottic Airways: for difficult bag-valve-mask ventilation or a difficult airway (details in audio) LMA Classic Pros: Best studied; sizes for all ages Cons: Cannot intubate through aperture   LMA Supreme Pros: Better ergonomics with updated design; bite bloc; port for decompression Cons: Cannot pass appropriate-sized ETT through tube   King Laryngeal Tube Pros: Little training needed; high success rate; single inflation port Cons: Flexion of tube can impede ventilation or cause leaks; only sized down to 12 kg (not for infants and most toddlers)   Air-Q Pros: Easy to place; can intubate through aperture Cons: Not for neonates less than 4 kg   iGel Pros: Molds more accurately to supraglottis; no need to inflate; good seal pressures Cons: Cannot intubate through (without fiberoscopy)   Summary • If you can bag the patient, you're winning. • If you have difficulty bagging, or anticipate or encounter a difficult airway, then don't forget your friend the supraglottic airway (SGA). • Ego is the enemy of safety: SGAs are simple, fast, and reliable. • Just do it.   References Ahn EJ et al. Comparative Efficacy of the Air-Q Intubating Laryngeal Airway during General Anesthesia in Pediatric Patients: A Systematic Review and Meta-Analysis. Biomed Res Int. 2016;2016:6406391. Black AE, Flynn PE, Smith HL, Thomas ML, Wilkinson KA; Association of Pediatric Anaesthetists of Great Britain and Ireland. Development of a guideline for the management of the unanticipated difficult airway in pediatric practice. Paediatr Anaesth. 2015 Apr;25(4):346-62. Byars DV et al. Comparison of direct laryngoscopy to Pediatric King LT-D in simulated airways. Pediatr Emerg Care. 2012 Aug;28(8):750-2.  Carlson JN, Mayrose J, Wang HE. How much force is required to dislodge an alternate airway? Prehosp Emerg Care. 2010 Jan-Mar;14(1):31-5. Diggs LA, Yusuf JE, De Leo G. An update on out-of-hospital airway management practices in the United States. Resuscitation. 2014 Jul;85(7):885-92. Ehrlich PF et al. Endotracheal intubations in rural pediatric trauma patients. J Pediatr Surg. 2004 Sep;39(9):1376-80. Hernandez MR, Klock PA Jr, Ovassapian A. Evolution of the extraglottic airway: a review of its history, applications, and practical tips for success. Anesth Analg. 2012 Feb;114(2):349-68.  Huang AS, Hajduk J, Jagannathan N. Advances in supraglottic airway devices for the management of difficult airways in children. Expert Rev Med Devices. 2016;13(2):157-69. Jagannathan N, Wong DT. Successful tracheal intubation through an intubating laryngeal airway in pediatric patients with airway hemorrhage. J Emerg Med. 2011 Oct;41(4):369-73.  Jagannathan N et al. Elective use of supraglottic airway devices for primary airway management in children with difficult airways. Br J Anaesth. 2014 Apr;112(4):742-8. Jagannathan N, Ramsey MA, White MC, Sohn L. An update on newer pediatric supraglottic airways with recommendations for clinical use. Paediatr Anaesth. 2015 Apr;25(4):334-45. Karsli C. Managing the challenging pediatric airway: Continuing Professional Development. Can J Anaesth. 2015 Sep;62(9):1000-16. Luce V et al. Supraglottic Airway Devices vs Tracheal Intubation in Children: A Quantitative Meta-Analysis of Respiratory Complications. Paediatr Anaesth 24 (10), 1088-1098. Nicholson A et al. Supraglottic airway devices versus tracheal intubation for airway management during general anaesthesia in obese patients. Cochrane Database Syst Rev. 2013 Sep 9;(9):CD010105. Ostermayer DG, Gausche-Hill M. Supraglottic airways: the history and current state of prehospital airway adjuncts. Prehosp Emerg Care. 2014 Jan-Mar;18(1):106-15.  Rosenberg MB, Phero JC, Becker DE. Essentials of airway management, oxygenation, and ventilation: part 2: advanced airway devices: supraglottic airways. Anesth Prog. 2014 Fall;61(3):113-8.  Schmölzer GM, Agarwal M, Kamlin CO, Davis PG. Supraglottic airway devices during neonatal resuscitation: an historical perspective, systematic review and meta-analysis of available clinical trials. Resuscitation. 2013 Jun;84(6):722-30. Sinha R, Chandralekha, Ray BR. Evaluation of air-Q™ intubating laryngeal airway as a conduit for tracheal intubation in infants--a pilot study. Paediatr Anaesth. 2012 Feb;22(2):156-60. Timmermann A. Supraglottic airways in difficult airway management: successes, failures, use and misuse. Anaesthesia. 2011 Dec;66 Suppl 2:45-56. Timmermann A, Bergner UA, Russo SG. Laryngeal mask airway indications: new frontiers for second-generation supraglottic airways. Curr Opin Anaesthesiol. 2015 Dec;28(6):717-26.   Supraglottic Airway on WikEM   This post and podcast are dedicated to Tim Leeuwenburg, MBBS FRACGP FACRRM DRANZCOG DipANAES and Rich Levitan, MD, FACEP for keeping our minds and our patients' airways -- open.  You make us better doctors.  Thank you. Powered by #FOAMed — Tim Horeczko, MD, MSCR, FACEP, FAAP Pediatric; Emergency Medicine; Pediatric Emergency Medicine; Podcast; Pediatric Podcast; Emergency Medicine Podcast; Horeczko; Harbor-UCLA; Presentation Skills; #FOAMed #FOAMped #MedEd

Editor's Audio Summary by Howard Bauchner, MD, Editor in Chief of JAMA, the Journal of the American Medical Association, for the February 07, 2016 issue

INSP Johnston, L Neonatal Tracheal Intubation Podcast 112116 by OPENPediatrics

Dr A. Quinn, from Leeds General Infirmary in the UK, lead author of a recent BJA paper on failed tracheal intubation in obstetric anaesthesia talks us through this important UK national prospective survey. Using the UK Obstetric Surveillance System (UKOSS) of data collection, Dr Quinn and colleagues confirm the expected incidence of failed tracheal intubation in obstetrics at one in 224, and that the incidence of failed intubations hasn't decreased in the last 20 years, despite advances in airway techniques. Age, BMI, and a recorded Mallampati score were signi?cant independent predictors of failed tracheal intubation.