The Jaw Thrust Finds a Purpose During Flexible Fiberoptic Intubation

Calvin A. Brown, III, MD, FAAEM   During oral flexible fiberoptic intubation, the jaw-thrust maneuver was more effective when patients were in a semi-erect position than a supine position.   An unobstructed path through the airway makes fiberoptic intubation easier to perform. Patient positioning, airway adjuncts, and jaw or tongue manipulation have all been... Read more..

Time to Adopt High-Flow Oxygen Delivery Systems for Emergency Airway Procedures

Calvin A. Brown, III, MD   High-flow oxygen delivery via nasal cannula improved oxygen saturations and prevented desaturation in patients with difficult airways undergoing flexible bronchoscopic intubation.   Flexible bronchoscopic intubation, although not a common procedure in the emergency department, is usually performed in the setting of an airway difficulty. Maintaining adequate oxygenation during... Read more..

Be Ready to Extend the Incision Beyond Landmarks When Performing a Crich!

Ali S. Raja, MD, MBA, MPH, FACEP   Compared with ultrasound, three classic landmark techniques were inaccurate for identification of the cricothyroid membrane.   Cricothyrotomy is a rare procedure, and it is becoming more so given the increasing adoption of video laryngoscopy. However, it remains an essential skill, not only as a rescue procedure... Read more..

“Protective” Ventilation During Surgery Lowers Risk for Postoperative Complications

Patricia Kritek, MD   Ventilation in the operating room probably should resemble ventilation in the intensive care unit.   Low tidal volume ventilation (6 mL/kg predicted body weight; plateau pressure, <30 cm H2O) has become the standard of care for patients with acute respiratory distress syndrome (ARDS). Because of concern about ventilator-induced lung injury,... Read more..

Physician-Led Prehospital Airway Management in Trauma

R. Eleanor Anderson, MD; Ron M. Walls, MD, FRCPC, FAAEM   Intubation was successful in 99% of patients, and all surgical airways were successful in this large retrospective series.   To assess airway management of trauma patients in a physician-led prehospital system in England, researchers conducted a retrospective database review of 7256 prehospital trauma... Read more..