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Awake, and Paralysed: A Never Event

Don't Forget the Bubbles

Awake fiberoptic intubation where the patient consents, co-operative AND the airway is prepared with local anaesthesia. This could be due to paralysis of the muscles which protect the upper airway. Key take-home points While Ben’s case is tragic, we can learn important points about airway management.

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Fourteen Emergency Medicine Research Gems from 2023

ACEP Now

The PATCH-Trauma trial took a critical look at TXA in major trauma in the advanced trauma systems of Australia and found a mixed result: a slightly greater number of patients were still alive six months following TXA administration, but there was no difference in survival with a good functional outcome.

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REBEL Cast Ep122 – Delayed vs Rapid Sequence Intubation in Agitated Trauma Patients

RebelEM

Re-oxygenation with BMV can increase airway-related adverse events (i.e. What They Did: Prospective randomized clinical trial Patients randomized to: Delayed Sequence Intubation (DSI): IV ketamine 1.5mg/kg in 0.5

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How To Use SALAD To Manage Unstable Epistaxis and the Airway

ACEP Now

As with other entities, management of the airway must take precedence. While unusual, nosebleeds may present with life-threatening airway compromise. This is a discussion of a potentially disastrous airway outcome. The post How To Use SALAD To Manage Unstable Epistaxis and the Airway appeared first on ACEP Now.

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Airway Choices in the Era of Many Choices

EM Updates

The primary tool for emergency airway management then became the traditional laryngoscope , a device little improved since the 1940s, until the advent of video laryngoscopy in the early 2000s which changed everything. HAVL , which uses a blade that goes around the tongue, requires that the operator look at the screen.

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Impact of Emergency Department Crowding on Lung Protective Ventilation

RebelEM

However, that practice is long-outdated and patients managed on lower tidal volumes (6 ml/kg) were found to have decreased mortality. Ventilator-associated lung injury and inflammation can occur even during short-term mismanagement can worsen patient outcomes. Prior studies have used annual census or shift level crowding.

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Beyond Ketamine: When to use Facilitated Intubation in the ED

EMDocs

Still, there are those that believe that FPS is more of a physician-centered endpoint that does not fully reflect important patient-centric outcomes (16). Improved Visualization: Video laryngoscopes allow for the use of standard or hyperangulated geometry, essentially allowing the operator to “look around the corner” on an anterior airway.