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Current Extraglottic Airway Devices and Prehospital Practices

ACEP Now

Airway management remains a fundamental skill for all emergency physicians. Extraglottic airway devices (EGAs) have become a widely accepted means of airway management along with rescue airway devices. 9 LMAs use an inflatable mask expanded using a similar technique to the endotracheal tube cuff.

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Proning for ARDS

Northwestern EM Blog

In this study, they found that prone positioning resulted in significant improvement in oxygenation, as well as a 50% decrease in mortality at 28 days (Guerin et. Position arms in a comfortable position, avoiding any position that could cause a brachial plexus injury, and ensure they are well-supported to avoid pressure ulcers.

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Diagnostics and Therapeutics: Vascular Access in the Emergency Department

Taming the SRU

Establishing reliable vascular access is absolutely critical for ED patients requiring resuscitation, airway management, or medication administration. For laboratory testing, it is important to be aware that not all values obtained via an intraosseous line correlate well with peripheral venous samples (11). Li Y, editor.

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Impact of Emergency Department Crowding on Lung Protective Ventilation

RebelEM

2019 Aug; PMID: 30954692 Clinical Question: What is the impact of system factors in the implementation of standard-of-care LPV in critically ill ED patients admitted to the ICU? There may have very well been a policy where only RTs can make changes to a ventilator after an order was placed to ensure accurate documentation. J Crit Care.

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Glasgow Coma Scale in Children

Pediatric EM Morsels

cats and dogs have their own GCS scores [Lapsley 2019, Ash 2018] Moral of the Morsel Modified can make it Merrier! Consider other indicators of need for airway management, such as gag reflex. 2019 Jul;20(7):660-666. 2019 Sep;241:112-118. Epub 2019 Apr 22. 2019 Jul;20(7):682-683. A practical scale.

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Video beats direct laryngoscopy for intubation--even for experts

PulmCCM

Anesthesiology residents literally stop counting, generally performing well over a thousand intubations in a four-year residency (compared to pulmonary-critical care fellows’ mere nine months total in the ICU on a traditional research/clinical split), including extensive experience on difficult airways and advanced airway management.

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Beyond Ketamine: When to use Facilitated Intubation in the ED

EMDocs

They increase the risks of hypoxia and acidosis during the apneic period as well as hypotension and hypoperfusion caused by the abrupt transition from negative-pressure to positive-pressure ventilation (10). Incidence and factors associated with cardiac arrest complicating emergency airway management. 2019, 64:617-28.