Comment:
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