>News from the Difficult Airway Course

Thanks to Dr Jay Mekwan for this update from the Difficult Airway Course

  • The airway manual is being re-written with the paper copy available from Spring 2017. However the content that is currently being taught has all been updated. The App will be updated shortly.One of the big things from this is that the dosing of Roc is now suggested as Total body weight whereas before it was ideal body weight. This obviously makes dosing easier. 

 

  • Cricothyrotomy is still reducing in freq. Results from NEAR III, suggest a rate of about 0.3%. This is thought to be due to the increasing use of video laryngoscopy reducing the number of failed airways.

 

  • CMAC is thought to be the best tool for education. While glidescope offers a similar platform, the feel of the CMAC is closer to DL and thus teaching residents is better.

 

  • When positioning a child for intubation remember to align the external auditory canal with the anterior shoulder in a single horizontal line

 

  • Sick/compromised patients require RSI drug modification, if still proceeding down the RSI route.Even the most cardio stable drugs (like Etomidate and Ketamine) can cause hypotension. Hence 1/2 dose (or lower) sedative and double dose paralytic are ideal

 

  • When performing an “awake look”, ensure that time is taken to adequately topicalize the airway/oral or nasal passages. You should use glycopyrolate, Otrivin (Xylometazoline), atomized lidocaine & lidocaine paste. Sedation is not mandatory but may improve success.

 

Dr Jay Mekwan reminds us all to complete the Airway Audit Forms. Also please remember to record intubations using the C-MAC record button. Personally I have just got the hang of recording, after capturing a few selfies by mistake.  I will post a how to record using C-MAC soon.

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