Does Ramped Position Impact Intubation Success?

Does Ramped Position Impact Intubation Success?

There was no difference in first pass success with a non-supine (ramped) vs supine intubating position in this retrospective study, and composite adverse events were more common when ramped.  But patients most likely to be ramped were also obese or had predicted difficult airway.

Advanced Airway for Pediatric Cardiac Arrest - Should We Just Bag?

Advanced Airway for Pediatric Cardiac Arrest - Should We Just Bag?

There may be a slight advantage for pediatric cardiac arrest patients in survival with good neurological outcome by using simple bag-valve mask ventilation over advanced airway management.

Advanced Airway For Non-Shockable OHCA?

Advanced Airway For Non-Shockable OHCA?

Advanced airway management (AAM) was associated with increased overall survival in out-of-hospital cardiac arrest (OHCA) (though not survival with favorable neurological outcome) in patients with non-shockable initial rhythm. There was no difference in survival with use of AAM in patients with initial shockable rhythm.

Succinylcholine or Rocuronium - Which Is Better?

Succinylcholine or Rocuronium - Which Is Better?

A large observational series with over 4,000 intubations compared succinylcholine vs. rocuronium in rapid sequence intubation and found no association between these two paralytics and first-pass intubation success or peri-intubation adverse effects.

PROTRACH - HFNC for Preoxygenation in the ICU

PROTRACH - HFNC for Preoxygenation in the ICU

High-flow nasal cannula (HFNC) compared to bag-valve mask (BVM) ventilation for preoxygenation of critically ill patients did not improve lowest SpO2 but significantly reduced severe complications (SpO2 < 80%, severe hypotension, and cardiac arrest); 6% HFNC vs. 16% BVM, NNT = 10.

ETT vs. SGA for OHCA - Metaanalysis Includes AIRWAYS-2 and PART

ETT vs. SGA for OHCA - Metaanalysis Includes AIRWAYS-2 and PART

There was no difference in an endotracheal tube vs supraglottic airway for patients with out-of-hospital cardiac arrest in the outcomes of return of spontaneous circulation, survival to admission, survival to discharge, or survival with good neurological outcome in studies with low risk of bias in this large metaanalysis.

Prehospital Airway Management

Prehospital Airway Management

In light of the important prehospital airway management articles that came out this week, I thought it might be helpful to go into more depth on the topic of prehospital airway management.

How Many Intubations Does It Take For Proficiency?

How Many Intubations Does It Take For Proficiency?

It is estimated that to place an endotracheal tube (ETT) successfully in 30-60 seconds, using direct laryngoscopy, would take 3-5 years of experience and 137-243 endotracheal intubations (ETI). Increased experience did not reduce the time chest compressions were paused. The key take home is that ETI during CPR is really hard. Be prepared.

EMS ETT or LT for OHCA? Answers in PART

EMS ETT or LT for OHCA? Answers in PART

For adults with out-of-hospital cardiac arrest, initial laryngeal tube insertion by emergency medical service providers was associated with improved 72-hour survival, return of spontaneous circulation, hospital survival, favorable neurologic outcome, and airway success compared to initial endotracheal tube insertion.

Where Will You Cut the Neck? POCUS Makes Perfect

Where Will You Cut the Neck? POCUS Makes Perfect

Practicing to find the midpoint of the cricothyroid membrane with ultrasound is a much better way to learn than by using only external landmarks and no ultrasound.

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