This was originally posted on my 2 day old Facebook community experiment: T Bay Air Based Rounds
This will be under construction to collect information on airway topicalization Continue reading “Airway Topicalized Anesthesia”
What are all the things that must be done to achieve optimal BVM?
Here are some ways to remember and various pearls. Continue reading “Optimal Bag Mask Valve Ventilation”
Collected tweets on managing persistent flooding of the airway with fluids (blood or gastric fluids)
Some time ago, in this galaxy, our good friend Jorge Cabrera was faced with managing respiratory failure in a 55’ish year old man with BMI of 92 (ht 6 feet, wt 675 lbs (307kg). This patient was initially admitted with an upper gastrointestinal bleed with congestive heart failure and a history of obstructive sleep apnea. He had required mechanical ventilation but was weaned off recently. His recent intubation involved 2 attempts by anesthesia with the first attempt being failed Mac 3 direct laryngoscopy and the second attempt being a successful glidescope intubation.
The patient was now in hypercapnic hypoxic respiratory failure despite all treatment including NIPPV. His arterial blood gas was not improving despite CPAP or BiPAP (EPAP of 12).
pH 7.1 PaCO2 90’s PaO2 60’s SaO2<90’s
In airway management, oxygenation and ventilation are the overriding priorities and fluids in the airway must be avoided and managed at all costs.
It’s not about plastic in the trachea
– Rich Levitan (@airwaycam)
When indirect control of the epiglottis and laryngeal exposure proves difficult by the traditional Mac blade approach of placing the blade tip in the valleculae, consider repositioning the blade like in Miller blade technique to directly lift the epiglottis.
The eventual dream is for this to be a collection of blogs/ podcasts/ airway stories and a multimedia encyclopedia/reference/teaching tool on all things airway that we AirwayNauts can think of. It is an Airway resource repository.