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.
CME: https://earnc.me/kFl0sc
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://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
Excellent topic.
Suggested reading : Hirshberg & Mattox, Top knife the art and craft of trauma surgery. ISBN-13: 978-1903378229 .
Generally an interesting read (and I think it is useful when you are in anesthesia as well) but what I personally took out of this book is the “don’t flail” idea.
It describes a surgeon repeating essentially the same move with more vigour to get hemostasis and failing/flailing.
Hence the don’t flail.
If something doesn’t work (reasonably excecuted) the first time there is little reason it should work the 2nd (less so the 3rd -15th) time. So you should proceed to the next step early and without delay.
Especially when going to surgical airway it is essential to get there early.
But I found it applies equally well to more general practice, say hemodynamic instability.