I'm prepping an airway talk for my EM interns, focus on RSI/laryngoscopy
Any thoughts/suggestions?
leave them here: http://t.co/0Y5VoRtfeg
— Seth Trueger (@MDaware) July 8, 2014
Thanks to everyone who responded!- @MDaware be ready to do a tracheostomy on yourself
- @drlfarrell I'm an emergency physician — I do crics, not trachs.
- @MDaware @drlfarrell preparation wards off the evil airways. and vice versa.
- @choo_ek @drlfarrell agree w the sentiment. my version: the more I prepare, the luckier I get
- FTFY: @rfdsdoc: @MDaware @choo_ek @drlfarrell exactly. You need airway checklist ! You need group preparation :-)
- @rfdsdoc @MDaware @drlfarrell Assume Seth will be teaching them the Airway Hail Mary and the ritual airway dance.
- @rfdsdoc @MDaware @drlfarrell It's not really an airway course unless you've learned to secure one with a ballpoint pen and a straw.
- @drlfarrell @rfdsdoc @MDaware I feel like we're being really helpful. Are you ready for your talk now?
- @MDaware Drugs and dosages. I'm a little tough, but I tell the interns they get one free pass if they don't know them and why they're used.
- @MDaware If they don't know after that, they don't intubate. (I know, I sound mean, I'm really not). They never disappoint though
- @MDaware Also, recommend teaching them to set everything up themselves in case resp. isn't there. And always have backup--bougie, glidescope
- @MDaware Sorry I don't have any of those accounts to leave a message on your blog where are you working now?
- @MDaware 6P's of Preparation: Proper Preparation Prevents Piss Poor Performance. Preoxygenation is key
- @MDaware -good laryngoscopy is good epiglottoscopy - which drugs do you use in special populations? - when to pull out/ a 'code' for help
- @MDaware if lost, pull back. Then you'll be unlost (probably). I think I may have recalled that mid intubation from you.
- @RobJBryant13 *preox plus positioning!
- @MDaware remember when all else fails, have a blade handy and don't be afraid to use it!
- @MDaware I like emphasizing BVM, if BVM not good on crashing pt, will be doing DL on dead person
- @MDaware for DL, every micro step in prep, positioning, and technique done well increases chance of success. Neglect no detail
- @MDaware always have back up plan and rescue plan
- @MDaware agree w use of great videos from @airwaycam
Lots of Airway Cam videos- I did a recent airway talk where I used several of them (available on LITFL Own the airway series) and got several comments that the videos "made everything make sense"
ReplyDeleteI also had them do prep work ahead of time- my own airway podcast (had to do it), Levitan on emcrit, and Reuben strayer's 2 person BVM video.
Hope that helps- good luck
Steve
It's not all about laryngoscopy
ReplyDeleteEmphasis airway assessmet, optimisation, maintenance (preox, BMV, LMA)
If going to perform laryngoscopy, learn from experts first - read airwaycam book, watch the various FOAmed resources
Know your drugs
Know your airway drills for difficulty
USE A FREAKIN' CHECKLIST FOR ALL ROUTINE RSI
And remamber fellas - airways ARE like willies - the more you fiddle, the harder they get
First pass, NODESAT. Everytime.