This is a distillation of 10 key tips to help folks who are learning airway management improve their skills. This show gets straight to the point: 10 tips for airway management in 10 minutes.
10 Tips for Airway Management
1. Develop a growth mindset and practice deliberately
2. Do a good airway assessment
3. Develop and follow a plan
4. Control your environment
5. Position the patient and yourself for success
6. Preoxygenate adequately
7. Communicate effectively
8. Choose meds appropriately and let them work
9. Take your time with laryngoscopy
10. Recognize when you need to change your plan and do so deliberately
Resources:
Achar, S. K., Pai, A. J., & Shenoy, U. K. (2014). Apneic oxygenation during simulated prolonged difficult laryngoscopy: comparison of nasal prongs versus nasopharyngeal catheter: a prospective randomized controlled study. Anesthesia, essays and researches, 8(1), 63.
Booth, A. W. G., Vidhani, K., Lee, P. K., & Thomsett, C. M. (2017). SponTaneous Respiration using IntraVEnous anaesthesia and Hi-flow nasal oxygen (STRIVE Hi) maintains oxygenation and airway patency during management of the obstructed airway: an observational study. BJA: British Journal of Anaesthesia, 118(3), 444-451
Caputo, N., Azan, B., Domingues, R., Donner, L., Fenig, M., Fields, D., … & McCarty, M. (2017). Emergency Department use of Apneic Oxygenation versus usual care during rapid sequence intubation: A randomized controlled trial (The ENDAO Trial). Academic Emergency Medicine, 24(11), 1387-1394.
Chong, J. (2016). Airway management in obese patients. EMNote. Retrieved from http://www.emnote.org/emnotes/airway-management-in-obese-patients
Dearani, J. A., Gold, M., Leibovich, B. C., Ericsson, K. A., Khabbaz, K. R., Foley, T. A., … & Daly, R. C. (2017). The role of imaging, deliberate practice, structure, and improvisation in approaching surgical perfection. The Journal of thoracic and cardiovascular surgery, 154(4), 1329-1336.
Ericsson, K. A. (2015). Acquisition and Maintenance of Medical Expertise: A Perspective From the Expert – Performance Approach With Deliberate Practice. Academic Medicine, 90(11), 1471. doi:10.1097/ACM.0000000000000939
Ericsson, A., & Pool, R. (2016). Peak: Secrets from the new science of expertise. Houghton Mifflin Harcourt.
Ericsson, K. A. (2004). Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains. Academic medicine, 79(10), S70-S81.
e Silva, L. O. J., Cabrera, D., Barrionuevo, P., Johnson, R. L., Erwin, P. J., Murad, M. H., & Bellolio, M. F. (2017). Effectiveness of apneic oxygenation during intubation: a systematic review and meta-analysis. Annals of emergency medicine, 70(4), 483-494.
Heard, A., Toner, A. J., Evans, J. R., Palacios, A. M. A., & Lauer, S. (2017). Apneic oxygenation during prolonged laryngoscopy in obese patients: a randomized, controlled trial of buccal RAE tube oxygen administration. Anesthesia & Analgesia, 124(4), 1162-1167.
Kahneman, D. (2011). Thinking, fast and slow. New York: Farrar, Straus and Giroux.
Lee, P. K., Booth, A. W. G., Vidhani, K., & Bath, J. M. (2017). Spontaneous Breathing For the Difficult Airway: STRIVE Hi Demonstrates Its Versatility. Anesthesiology News.
Moulton, C. E., Regehr, G., Mylopoulos, M., & MacRae, H. M. (2007). Slowing down when you should: a new model of expert judgment. Academic Medicine: Journal Of The Association Of American Medical Colleges, 82(10 Suppl), S109-S116.
Myatra, S. N., Kalkundre, R. S., & Divatia, J. V. (2017). Optimizing education in difficult airway management: meeting the challenge. Current Opinion in Anesthesiology, 30(6), 748-754.
Nørskov, A. K., Rosenstock, C. V., Wetterslev, J., Astrup, G., Afshari, A., & Lundstrøm, L. H. (2015). Diagnostic accuracy of anaesthesiologists’ prediction of difficult airway management in daily clinical practice: a cohort study of 188 064 patients registered in the Danish Anaesthesia Database. Anaesthesia, 70(3), 272-281. [THIS IS THE STUDY SHOWING 93% OF DIFFICULT INTUBATIONS AND 94% OF DIFFICULT MASK VENTILATION CASES WERE NOT ANTICIPATED.]
Patel, A., & Nouraei, S. A. R. (2015). Transnasal Humidified Rapid‐Insufflation Ventilatory Exchange (THRIVE): a physiological method of increasing apnoea time in patients with difficult airways. Anaesthesia, 70(3), 323-329.
Patel, A., & Nouraei, S. A. R. (2016) Nasal ventilation: oxygenation, no desat, and thrive. Anesthesiology News. Retrieved from http://www.anesthesiologynews.com/Review-Articles/Article/08-16/Nasal-Ventilation-Oxygenation-NO-DESAT-and-THRIVE/37294/ses=ogst
Pratt, M. (2017). A Practical Approach to Apneic Oxygenation during Endotracheal Intubation. J Anesth Clin Res, 8(696), 2.
Pratt, M., & Miller, A. B. (2016). Apneic Oxygenation: A Method to Prolong the Period of Safe Apnea. AANA Journal, 84(5), 322-328.
Ramachandran, S. K., Cosnowski, A., Shanks, A., & Turner, C. R. (2010). Apneic oxygenation during prolonged laryngoscopy in obese patients: a randomized, controlled trial of nasal oxygen administration. Journal of clinical anesthesia, 22(3), 164-168.
Weingart, S. D., & Levitan, R. M. (2012). Preoxygenation and prevention of desaturation during emergency airway management. Annals of emergency medicine, 59(3), 165-175.
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