My favourite position always works…

Positioning is FREE! 

Our goal is to maximize first-pass success with intubation, and not settle for mere success after multiple attempts.  Achieving proper position is easy…just do whatever it takes line up the ear hole with either the front of the shoulder or the jugular notch.

Proper positioning is absolutely guaranteed to improve your intubation success rate.

 

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Heroic Medical Measures in the Crashing Asthmatic

  1. Pre-oxygenate your patient with high flow nasal cannula at 20 – 30 LPM
  2. Next consider using IM Epinephrine 0.3 – 0.5mg of 1:1000. Severe asthmatics will have a hard time getting inhaled beta agonists into the small airways, but parenteral epinephrine will get into the circulation and get to where it needs to provide support.
  3. Non-Invasive Positive Pressure Ventilation (NIPPV)
  4. Corticosteroids
  5. 2g IV Magnesium and repeat it up to 2 more times over an hour
  6. Give IVF at a dose of 30cc/kg because patients with acute asthma exacerbations because patients will have insensible losses.

…and many more including intubating and ventilating the Crashing Asthmatic Patient…great read.

 

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How to choose the right blade to intubate a child

The distance from the upper incisor teeth to the angle of the jaw seems to be an excellent clinical landmark for laryngoscope blade length selection for pediatric intubations. When the blade (excluding the handle insertion block) is placed at the upper midline incisor teeth and the tip is located within 1 cm proximal or distal to the angle of the mandible, oral tracheal intubations are more consistently accomplished on the first attempt. READ MORE
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4 more big airways pearls from the Crash Airway Course…

Positioning

  • Ear to Sternal Notch
  • Ramped up positioning
  • External Laryngeal Manipulation
  • Head Lift

Make some space for yourself

  • insert the laryngoscope like we insert the OPA
  • ask your assistant to pull the cheek on one side while
    you are inserting the laryngoscope inside the oral cavity.

The ET Tube – A major pitfall while inserting the tube is, when we try and go straight into the mouth after visualising the cords. This blocks our own view of the cords and can lead to misplacement of the tube. This can be fixed by entering the mouth from the right side.

 Bougie is your best friend! Bougie must be available for every airway. Keep it in your airway kit – right next to you before taking the first attempt rather than asking for it after you have failed.