Episode 123: Surgical Airway with Andrew Merelman

In this 123rd episode I welcome Andrew Merelman to the show. Andrew is a paramedic and medical student with an interest in emergent surgical airway management. We discuss the human factors involved in the procedure, when it is indicated, how to do it and how to practice.

References and Links:

Airway Ap information:


http://www.airwaycollaboration.org/

iOS – https://itunes.apple.com/ca/app/the-airway-app/id1112657910?mt=8

Android- https://play.google.com/store/apps/details?id=com.parse.airway&hl=en 

3D printed models – https://link.springer.com/article/10.1007%2Fs12630-017-0926-9 Videos:

https://vimeo.com/132394603

https://vimeo.com/132394747

https://emcrit.org/emcrit/real-surgical-airway/

https://www.airmedicaljournal.com/article/S1067-991X(09)00037-6/fulltext

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3727957/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5749220/

https://www.ncbi.nlm.nih.gov/pubmed/20491685

https://www.ncbi.nlm.nih.gov/pubmed/30173584
https://journals.lww.com/jtrauma/Citation/2012/09000/Is_bougie_aided_cricothyrotomy_really__extremely.42.aspx

https://www.researchgate.net/publication/253332531_Comparison_of_a_percutaneous_device_and_the_bougie-assisted_surgical_technique_for_emergency_cricothyrotomy_an_experimental_study_on_a_porcine_model_performed_by_air_ambulance_anaesthesiologists

https://www.ncbi.nlm.nih.gov/pubmed/30686312

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6078881/

Episode 121: Difficult Airway Response Team With Lynette Mark

In this 121st episode I welcome Dr. Lynette Mark to the show. Dr. Mark is the founder of our Difficulty Airway Response Team (DART) here at Hopkins and a founding director for the Society of Airway Management. We discuss the origins of the DART program and how to approach a difficult airway.

References:

https://www.criticalcare.theclinics.com/article/S0749-0704(17)30102-1/abstract

Difficult Airway Algorithm and Rescue Cricothyrotomy (DAARC): http://sgschallenge.com/2018daarc/

https://wamm2019.com World Airway Management Meeting, Amsterdam, Netherlands, November, 2019. Drs. Mark and Feinleib will be presenting about the DART program.

Dr. Cooper’s article on surgical airway: https://anesthesiology.pubs.asahq.org/article.aspx?articleid=2724164

Dr. Mark’s article from A&A and the accompanying editorial:

https://www.ncbi.nlm.nih.gov/pubmed/26086513

https://www.ncbi.nlm.nih.gov/pubmed/26086503

Episode 115: The Contaminated Airway with Steve Freiberg

In this 115th episode I welcome Dr. Steven Freiberg back to the show to discuss management of the contaminated airway.

References:

Han, S; Fisher, J. Airway Management During Persistent Flooding Of the Oropharyngeal Airway.  Anesthesiology News. 2016. March.

Joshi, R; Hypes, C; et al.  Difficult Airway Characteristics Associated with First-Attempt Failure at Intubation Using Video Laryngoscopy in the Intensive Care Unit.  Ann Am Thorac Soc. 2017 Mar;14(3):368-375

Stockton, E.; Lockey, D; et. al.  Contamination of the airway in pre-hospital trauma patients. European Journal of Anaesthesiology. 2008. May; 25:188

Uday, J; McCunn, M; et al. Management of the Traumatized Airway.  Anesthesiology. 2016, Vol.124, 199-206

Episode 111: Tracheostomies, Cricothyrotomies and ENT surgery with Dr. Zandy Hillel

In this 111th episode I welcome Dr. Zandy Hillel to the show. Dr. Hillel is an otolaryngologist here at Johns Hopkins and we discuss tracheostomies, Cricothyrotomies, laryngeal surgery and difficult airways.

References:

Crichothyrotomies:

https://www.ncbi.nlm.nih.gov/pubmed/30054081

https://www.ncbi.nlm.nih.gov/pubmed/30726035

Difficult Airway Response Teams:

https://www.ncbi.nlm.nih.gov/pubmed/26086513

Episode 96: Peds difficult airway with Nick Dalesio

In this episode, episode 96, I welcome Dr. Nick Dalesio to the show.  Dr. Dalesio is the director of the pediatric difficult airway program here at Johns Hopkins.  We discuss the pediatric difficult airway response team, consult service, and how to anticipate and manage difficult airways in kids, both anticipated and unanticipated.

Reference:

Planning Prevents Poor Performance: An Approach to Pediatric Airway Management

 

Episode 50: CSE vs Epidural Debate with Mike Hofkamp and Jacqueline Galvan

In this episode, episode 50, I welcome back Dr. Mike Hofkamp, and, for the first time, I welcome Dr. Jacqueline Galvan to the show.  Drs. Hofkamp and Galvan go head to head in a debate over which is a better, more evidence-based technique, the traditional epidural or the CSE (combined spinal epidural).

All of the articles that were referenced can be found here: References

Episode 47: Arterial Lines with Stephen Freiberg

In this episode, episode 47, I welcome back Dr. Stephen Freiberg, one of our chief residents, to discuss all you ever wanted to know about arterial lines.  We discuss the indications, contraindications, complications, placement technique, and how to interpret the waveform.

Slides with figures mentioned in the podcast can be found here: Arterial Line Podcast Images

If you are a regular listener to the show please consider becoming a patron at patreon.com/accrac to help support the costs of making the show.  Even just a dollar or two makes a big difference.  Thanks so much.

Episode 37: OR Crises

In this episode, episode 37, I go over crises that can happen in the OR, when to suspect them, and what to do about them.  I draw from two excellent sets of OR crisis checklists that are available for free.  The Stanford Anesthesia Cognitive Aid Group’s lists and the Ariadne Labs/Brigham/Harvard School of Public Health lists.

The Stanford checklists can be downloaded for free here: http://emergencymanual.stanford.edu

The Harvard checklists can be downloaded for free here: http://www.projectcheck.org/crisis-checklist-download.html

Episode 35: Pleural effusions with Dr. David Feller-Kopman

In this episode, number 35, I welcome Dr. David Feller-Kopman to the show.  Dr. Feller-Kopman is an associate professor of medicine and Otolaryngology and the director of Bronchoscopy and Interventional Pulmonology here at Johns Hopkins.  I interview him about pleural effusions including what they are, where they come from, how to categorize them, how to treat them and how to deal with them if they recur.

The NEJM article on the use of TPA and DNAse is here: http://www.nejm.org/doi/full/10.1056/NEJMoa1012740#t=abstract

Episode 29: PA catheters with Dr. Glenn Whitman

In this episode, episode 29, I welcome to the show Dr. Glenn Whitman.  Dr. Whitman is a cardiac surgeon and intensivist and runs the cardiac surgical ICU here at Johns Hopkins.  I interview Dr. Whitman about PA catheters.  We discuss when to place them, when not to place them, how to use them and when to take them out.