I hope you manage to stay well and healthy and are still able to get to some reading done in this crazy year. Flexible endoscopic intubation has been praised as the standard technique for expected difficult intubations by numerous international guidelines. Current literature suggests that this is an easy technique with a high success rate and low complication rate. However, having taught flexible endoscopic intubations at workshop skill stations throughout the world, I found that anesthesiologists' skills in this technique are often inadequate. There seems a significant disconnect between published literature and clinical reality.
In this month's manuscript, Dr. Grange et al. examined the experience with flexible intubation in the UK. They show what others already knew: one of the critical skills in anesthesiology is not as frequently used as it should be, the complication rate does not seem to match the published data.
Enjoy the read in the EAMS journal TACC!
Documents and Links
Consensus guidelines for managing the airway in patients with COVID-19
OUTBREAK OF A NEW CORONAVIRUS. WHAT ANAESTHETISTS SHOULD KNOW BJA 2020
THE ITALIAN CORONAVIRUS DISEASE 2019. OUTBREAK ANAESTHESIA 2020
March moth’s articles comes as a pair: Two 2020-papers (epub ahead of print 2019) that have to be read in conjunction: Ahmad and co-workers review on multiple aspects and practical guidance for AWAKE INTUBATION – The cornerstone technique in managing the predicted difficult airway, plus our accompanying editorial that reminds us that if an awake intubation is indicated then we shouldn’t abandon it easily – but remember that a spontaneous-ventilating intubation may be a close second best.
Ahmad I, El-Boghdadly K, Bhagrath R, et al. Difficult Airway Society guidelines for awake tracheal intubation (ATI) in adults [published online ahead of print, 2019.
Aziz MF, Kristensen MS. From variance to guidance for awake tracheal intubation [published online ahead of print, 2019.
The most stressful situation for an anaesthesiologist may be a No intubate/No oxigenate (NINO) patient. A recent study (NAP 4) says that in spite of the fact that all algorithms have a strategy for this situation- in all of them cricotirotomy is the final solution-, the resolution is not good in most of them. Why is this? How could we correct the mistakes that arise?. Simulation has proven to be an effective tool to improve how crisis resources are managed, such as NINO patient and CPR. It allows mistakes to be analyzed and solutions found, thus improving our performance. But, what if we have a NINO patient on whom we are performing cardiopulmonary resuscitation? This study by Ott et al (BMJ 2019) tries to address this question by establishing a possible airway management situation that, however infrequent, must not be forgotten. We hope you enjoy reading it.
Ott T, Stracke J, Sellin S, et al. Impact of cardiopulmonary resuscitation on a cannot intubate, cannot oxygenate condition: a randomised crossover simulation research study of the interaction between two algorithms. BMJ Open 2019;9:e030430. doi:10.1136/bmjopen-2019-030430
Open acces link (january 23th, 2020): https://bmjopen.bmj.com/content/9/11/e030430.info
Dear airway enthusiasts,
This month’s article is a from Fiadjoe et al. about pediatric normal and difficult airway management. If you are curious about the following questions you have to read the full text:
- • What are cognitive biases observed in pediatric difficult airway management?
- • What are the strengths and weaknesses of videolaryngoscopes and flexible bronchoscopes for tracheal intubation?
- • What is the current evidence for spontaneous versus controlled ventilation techniques when managing the anticipated difficult airway?
- • What is the role of passive oxygenation in difficult airway management in the OR and pediatric ICU?
- • What is the current evidence regarding the use of neuromuscular blockade in neonatal tracheal intubation and difficult airway in children?
Have fun at http://eamshq.net
Kemal Tolga Saracoglu
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.
Please click on the banner below.