#AnSky #AirwaySky
Je vois encore trop de médecins/internes (AR, MIR, MU) complètement perdus devant un patient trachéotomisé.
Aussi je vous invite à lire cette petite revue sur la gestion des complications chez le trachéo(S)tomisé : journals.lww.com/anesthesiolo...
Definitely time to retire clinical signs, but we are lagging behind. I still observe etCO2 comes second to auscultation. "The capnograph should be first, front and center as the tool to exclude oesophageal intubation." #AnSky #AirwaySky
Here is the first consensus-based core outcome set for airway management research, with agreed definitions and measurement instruments.
This will harmonise evidence synthesis and improve the translatability of findings to improve clinical care.
#AnSky #AirwaySky
doi.org/10.1111/anae...
Through and through the airway: optimising airway introducer use with videolaryngoscopy
@doctimcook.bsky.social @janhansel.bsky.social
#AnSky #AirwaySky #MedSky
doi.org/10.1111/anae...
How do you master HAVL?
• a thorough understanding of the ergonomic principles
• delivery of high-quality teaching
• the process of deliberate practice with immediate feedback
#AnSky #MedSky #AirwaySky
doi.org/10.1111/anae...
Airway POCUS
POCUS was associated with higher odds of first-pass success rates during percutaneous tracheostomy when compared with landmark techniques.
#AnSky #AirwaySky #MedSky
doi.org/10.1111/anae...
Using the hybrid technique of simultaneous VL and flexible bronchoscopy in children
First-attempt tracheal intubation success was highest with the hybrid technique (74.5%) compared with VL (60.9%, p = 0.020) and DL (10.0%, p < 0.001)
#AnSky #PaedsAnSky #AirwaySky
doi.org/10.1111/anae...
❗ Airway POCUS❗
Are you interested in the POCUS parameters for the prediction and management of a difficult airway?
Here they are!
#AnSky #MedSky #AirwaySky
doi.org/10.1111/anae...
Point-of-care-ultrasound in airway assessment & management - can POCUS be used to predict difficult laryngoscopy?
#AnSky #AirwaySky #MedSky #POCUS
doi.org/10.1111/anae...
Bougie or stylet: what to use when the chips are down?
Is it truly possible to consistently and deliberately shape a bougie to fit a hyperangulated blade?
@doctimcook.bsky.social @janhansel.bsky.social
#AnSky #AirwaySky #MedSky
doi.org/10.1111/anae...
The VIDIAC score – standard of care for classifying videolaryngoscopy in health records?
#AnSky #AirwaySky #MedSky
doi.org/10.1111/anae...
What intubation rescue techniques are operators using in children?
Have you got your Plan B prepared?
#AnSky #PedsAnSky #AirwaySky #MedSky
doi.org/10.1111/anae...
Combined videolaryngoscopy and flexible bronchoscopy for difficult tracheal intubation in children: a retrospective observational cohort study
#AnSky #PedsAnSky #AirwaySky #MedSky
doi.org/10.1111/anae...
What technique do you use in children with difficult tracheal intubation?
The hybrid technique of simultaneous VL and flexible bronchoscopy was associated with a higher first-attempt success rate compared with VL alone or DL.
#AnSky #PedsAnSky #AirwaySky #MedSky
doi.org/10.1111/anae...
Some more commentary on the VIDIAC score..
• it does not explicitly include predictors for tracheal tube delivery
• do the findings apply to VLs other than the Storz CMAC?
• it does not provide a prospective prediction of difficulty
#AnSky #AirwaySky #MedSky
doi.org/10.1111/anae...
Correspondence: Universal videolaryngoscopy: supporting evidence from real-world data and recent trials
#AnSky #AirwaySky #MedSky
doi.org/10.1111/anae...
What does your difficult airway alert form look like?
Here's a standardised communication tool from Queensland.
Thoughts? Similarities/differences from your institution?
#AnSky #AirwaySky
doi.org/10.1111/anae...
Correspondence: Distinguishing prophylactic and therapeutic cricoid force
#AnSky #AirwaySky #MedSky
doi.org/10.1111/anae...
Science Letter: Data analysis of the Queensland Difficult Airway Alert Project
#AnSky #AirwaySky
doi.org/10.1111/anae...
Let's talk about therapeutic vs prophylactic cricoid force.
If gastric contents (or other materials) are actually detected around the larynx or when real-time regurgitation and/or aspiration occurs, should we use 'therapeutic' cricoid force?
#AnSky #AirwaySky #MedSky
doi.org/10.1111/anae...
The Queensland Difficult Airway Alert Project commenced in response to two critical airway incidents. The aim - to ⬇️ complications in patients with an unanticipated difficult airway by improving communication/documentation statewide.
#AnSky #AirwaySky
doi.org/10.1111/anae...
What is the most efficacious introducer when performing hyperangulated videolaryngoscopy?
Stylets were most efficacious and a static bougie least.
#AnSky #AirwaySky
doi.org/10.1111/anae...
In adult patients undergoing tracheal intubation in real-world operating theatre settings, universal VL showed clear advantages over direct laryngoscopy.
This is the largest comparative analysis conducted to date!
#AnSky #AirwaySky #MedSky
doi.org/10.1111/anae...
Should we use universal videolaryngoscopy in real-world operating theatre settings?
YES!
↑ rate of easy intubation
↑ rate successful first-attempt intubation
↓ incidence of difficult laryngoscopy
↓ complications related to intubation
#AnSky #AirwaySky #MedSky
doi.org/10.1111/anae...
Editorial: Rapid sequence induction: a modern-day example of Theseus' Paradox?
Stept and Safar described ‘rapid induction/intubation’ in 1970.
PUMA recently issued a consensus statement on RSI.
Let's compare.
@sthjournalclub.bsky.social
#AnSky #AirwaySky
doi.org/10.1111/anae...
In children with difficult tracheal intubation, the hybrid technique was associated with a higher first-attempt success rate compared with videolaryngoscopy alone or direct laryngoscopy.
#AnSky #AirwaySky #PedsAnesSky
doi.org/10.1111/anae...
When using a hyperangulated videolaryngoscope have you tried "reverse loading" a tracheal tube on to a preformed stylet?
The stylet & tracheal tube are shaped forcibly in the opposite direction to the normal curvature and to match the shape of the blade.
#AnSky #AirwaySky
doi.org/10.1111/anae...
Correspondence: Stylet vs. flexible-tip bougie: interpreting intubation outcomes with hyperangulated videolaryngoscopy in the ICU
#AnSky #MedSky #AirwaySky #ICUSky
doi.org/10.1111/anae...
Using three-dimensional computer simulation to analyse the three axes of tracheal tube orientation - what can we learn?
#AnSky #AirwaySky #MedSky
doi.org/10.1111/anae...
Correspondence: Rescuing the stylet: how technique can close the gap in hyperangulated videolaryngoscopy
#AnSky #AirwaySky #MedSky
doi.org/10.1111/anae...
