This is a recent study from the Danish Anaesthesia Register and they looked at predictors for difficulties with facemask ventilation.
Interestingly if their score is between 6–10 points these patients need special attention as it could turn out difficult mask ventilation compared to those with lower score. Higher the risks are obvious. A clear cut off value was not to establish and their proposed score needs prospective validation in clinical practice. All in all a new attempt to solve a nearly impossible task - predicting what happens in the future but still a needed task - pre-anaesthesia evaluation to focus attention to possible problems of the patients, the process or the anaesthesia personnel which includes all of us.
Have fun in reading the article
Lundstrøm LH, Rosenstock CV, Wetterslev J, Nørskov AK: The DIFFMASK score for predicting difficult facemask ventilation: a cohort study of 46,804 patients, Anaesthesia. 2019 May 20. doi: 10.1111/anae.14701. [Epub ahead of print]
Article of the Month | March 2019
Dear airway enthusiasts,
This month's article is from Arnd Timmermann. In this very large multicentre, prospective observational cohort study including almost 250000 patients from more than 200 hospitals from 28 European countries the authors could demonstrate that the use of neuromuscular blocking agents (NMBA) in general anaesthesia was associated with an increased risk of postoperative pulmonary complications. Interestingly, this was more evident in patients with ASA status I or II. Nor the use of qualitative or quantitative neuromuscular monitoring or the use of reversal agents could reduce the risk of postoperative pulmonary complications.
They concluded that Anaesthetists must balance the potential benefits of NMBA´s against the increased risk of postoperative pulmonary complications.
The reader must know that it is not clear if these increased pulmonary complication rate are due the use of NMBA´s or the use of the endotracheal tube, since the airway of the group who has received no NMBA were almost all managed by the use of supraglottic airway devices.
The article adds to the knowledge that the use of SGA in general anesthesia should be considered as the first line airway management strategy whenever feasible.
Kirmeier E, Eriksson LI, Lewald H, Jonsson Fagerlund M, Hoeft A, Hollmann M, Meistelman C, Hunter JM, Ulm K, Blobner M; POPULAR Contributors: Post-anaesthesia pulmonary complications after use of muscle relaxants (POPULAR): a multicentre, prospective observational study, Lancet Respir Med. 2019 Feb;7(2):129-140
First TAT course in Portugal in the beautiful city of Braga! Amazing team work was the key to turn this experience into a wonderful moment of one and a half days.
Thanks to everyone that made that possible, especial prof. Greif (Tino) and the magnificent group of 15 students that couldn't have been better chosen...
We think that EAMS has another team to go forward!
Sofia Torrinha, Portugal
In patients with pathology of the neck ultrasonography is highly accurate in localizing the cricothyroid membrane and is comparable to CT-scan as the accepted standard. And in this population the cricothyroid membrane was only identified successfully in 8% of the patients whereas ultrasonography resulted in 81% success. These are the findings of our colleagues Siddiqui, You-Ten and co-workers from Toronto who authored the first of the two EAMS-articles-of-the –Month for May 2019. It thus seems beneficial to identify the cricothyroid membrane before initiating airway management in this notoriously difficult group of patients, and we should consider to use bedside-ultrasound for this purpose.
This leads to the second of the articles where we look at the useful information for managing the airway of the difficult patients that we gain from identifying both the cricothyroid membrane and other important structures of the front-of-the-neck.
Enjoy your reading!
And remember that it is possible to comment on all articles-of-the-month via our EAMS-webpage.
Best from Copenhagen!
Michael Seltz Kristensen
Siddiqui N, Yu E, Boulis S, You-Ten KE: Ultrasound Is Superior to Palpation in Identifying the Cricothyroid Membrane in Subjects with Poorly Defined Neck Landmarks: A Randomized Clinical Trial, Anesthesiology. 2018 Dec;129(6):1132-1139
Welcome letter from the new President, Michael Seltz Kristensen
Dear EAMS member! Dear co-airway-afficionado!
It is an honour to take over this position as President of EAMS!
The “European” in “European Airway Management Society” is not meant geographically!
It is meant to describe a European approach based on multiple inputs, discussion and best evidence, accepting different needs and resources, and based on human diversity.
Therefore, we are a true GLOBAL society, with members, You!, from all parts of the world.
Dear EAMS members
We invite you to take the European Airway Management Society Survey about Videolaryngoscopes.
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