Another Case of Unrecognized Esophageal Intubation
Confirmation requires sustained waveform EtCO2.
In many cases of unrecognized esophageal intubation, providers report 👍🏻 lung sounds & other clinical signs of tracheal intubation.
They are not reliable. https://t.co/PAt8xfMDlJ
Tips for inserting balloon tamponade device (eg. Sengstaken) in ED or retrieval setting (ie pre-transport)
1. Videolaryngoscopy assisted insertion
2. Store a simple Quick Reference Guide with the device (like this one by @PeteLawrance2 )
3. Tape to a collar to provide traction
Cool study by the team from @UMNemergencymed!
Engaging the median hyoepiglottic ligament leads to improved laryngeal views.
@ErinKarl_MD @airwaycam @brian_driver#FOAMed#airway
https://t.co/lA80Uuczk1
Scroll down, article includes some cool airway videos of the technique.
Basic brainstem tip that will make you seem like a VL pro and make life easier, help your patient and keep you out of trouble:
Any time you insert any instrument, tube, bougie, introducer, catheter, yankauer, scope, blade etc into the airway ...
I’m not sure why awake intubation is so readily accepted as the safest option for patients with significant anatomic difficulties, but not for patients with significant physiologic difficulties
When VL view gets soiled your options.
1) keep advancing blindly, hope & pray not cause airway trauma and airway fluids will magically clean your optics, enough (it sometimes happens)
2) pull back and wipe optics with your gloved finger
3) pull out and wipe with alcohol prep wipe
Laryngoscope 101: how to hold it...
Don’t palm it!! Start with a light & low finger grip. It will give you better control for fine movements: identification of the epiglottis, and placement in the vallecula #protectedairway#insta#FOAMed
Intubation through SGA -> Failed VL
1) Can't ventilate with face mask
2) Failed intubation with VL
3) SEVERE hypoxia and/or apnea
💨 This is a rescue technique!
@jducanto#ResusX20#FOAMed
Fantastic 6 min overview of the multiple ways N95 masks act to protect the wearer from exposure to small particles from @minutephysics.
"N95s are much cleverer than strainers"
Worth a look.
https://t.co/r9Q9WeE55s
@blav81@MedicMatt17512@tacbarbie44 Yes, watch @jducanto explain the Yankaeur, designed in 1907. (around 8:50 in the video)
Airway decontamination - the dark side of airway management
https://t.co/ije2RqWYeo