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The NICO Trial: NIV in Comatose Patients with Acute Poisoning

RebelEM

These patients can be at risk of vomiting and aspiration and often prompts clinicians to pursue definitive airway management to avoid pneumonia and other complications. There has been no high level evidence to help guide practice until now…the Non-Invasive Airway Management of Comatose Poisoned Emergency Patients (NICO) trial.

Poisoning 137
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The Ducanto Catheter—It Sucks!

RebelEM

James DuCanto, developed the DuCanto catheter to enhance airway management in these high-stakes situations. The commonly used 14 Fr Yankauer catheter, with its smaller bore, may struggle to clear heavily contaminated airways effectively. 1 The head-to-head performance of these devices has not been previously studied.

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SGEM#462: Spooky Scary Access – IV or IO for OHCA

The Skeptics' Guide to EM

Missy has been teaching airway management for over a decade and is the creator of the Prehospital Emergency Airway Course which is taught throughout Washington State. With a survival rate to discharge often below 10% globally, rapid, effective interventions are needed to improve patient outcomes.

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Awake, and Paralysed: A Never Event

Don't Forget the Bubbles

This could be due to paralysis of the muscles which protect the upper airway. In studies including patients with trauma or Glasgow Coma Scale less than 8, intubation without sedation led to poorer neurological outcomes. Key take-home points While Ben’s case is tragic, we can learn important points about airway management.

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Journal Feed Weekly Wrap-Up

EMDocs

. #1: Epinephrine or Airway First in OHCA? Spoon Feed In adults presenting to EMS after OHCA, those receiving epinephrine prior to advanced airway management (AAM = supraglottic airway, SGA, or endotracheal tube) experienced better outcomes and prehospital ROSC than those receiving AAM before epinephrine.

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SGEM#438: Bone, Bone, Bone, Tell Me What Ya Gonna Do – for IO Access Location?

The Skeptics' Guide to EM

It was a secondary analysis of an observational study which showed an association between decreased favourable neurologic outcomes in the IO group compared to the IV group. This is because of the ease of finding anatomic landmarks and their location away from other procedures like defibrillation, CPR, and airway management.

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SGEM#450: Try Again – Andexanet for Factor Xa Inhibitor–Associated Acute Intracerebral Hemorrhage

The Skeptics' Guide to EM

Background: In hemorrhagic stroke, the ABCs for resuscitation remain the same, but can also be categorized as: Airway Management: This is an important aspect for patients with a poor neurologic exam or those who are not protecting their airways. However, the management of ICH in the setting of DOAC use remains complex.

Stroke 72