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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 141
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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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Glasgow Coma Scale in Children

Pediatric EM Morsels

Motor Fingernail bed pressure with a pencil first If flexion outcome, then apply painful stimulus to neck or head (trapezius or supraorbital notch) to look for localization Spinal reflex can result in a falsely elevated score if lower extremity pain induced Verbal Orientated- Able to answer all questions. References : Teasdale G, Jennett B.

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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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Acute Esophageal Variceal Bleeding in Children

Pediatric EM Morsels

Multimodal management can help avoid variceal bleeding. Luoto, 2020 ] Acute Esophageal Variceal Bleeding: Management Guidelines on the management of acute variceal bleeding in children are limited and debated due to limited pediatric-specific evidence. Prepare airway management tools (hoping to avoid needing them).