Airway

Pre-AeRATE RCT – HFNC 60L vs NC 15L for Apneic Oxygenation

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There was no benefit to using high-flow nasal cannula at 60L/min vs regular NC at 15L/min for pre- and apneic oxygenation during emergency department intubations.

Source
Pre- and apnoeic high-flow oxygenation for rapid sequence intubation in the emergency department (the Pre-AeRATE trial): A multicentre randomised controlled trial. Ann Acad Med Singap. 2022 Mar;51(3):149-160. doi: 10.47102/annals-acadmedsg.2021407.

Does Video Laryngoscope Shape Affect Ramped Intubation Success?

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There was no significant difference in first-attempt success rate for ramped and upright position intubations in the Emergency Department when comparing hyperangulated and standard geometry video laryngoscopes.

Source
Impact of video laryngoscope shape on first-attempt success during non-supine emergency department intubations. Am J Emerg Med. 2022 Apr 27;57:47-53. doi: 10.1016/j.ajem.2022.04.024. Online ahead of print.

How Often Does EMS Perform Pediatric Airway Management?

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One in 180 out-of-hospital pediatric encounters require bag-mask ventilation (BMV) or advanced airway management (AAM). Of these, 49% involve tracheal intubation (TI) despite a lack of evidence showing superiority to BMV.

Source
Epidemiology of out-of-hospital pediatric airway management in the 2019 national emergency medical services information system data set. Resuscitation. 2022 Apr;173:124-133. doi: 10.1016/j.resuscitation.2022.01.008. Epub 2022 Jan 19.

Does Ramped Position Increase First-Pass Success During Intubation?

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This systematic review and meta-analysis does not show any statistical difference in first-pass success rate or adverse intubation-related events between patients intubated in a inclined versus supine position.

Source
Effect of inclined positioning on first-pass success during endotracheal intubation: a systematic review and meta-analysis. Emerg Med J. 2022;0:1-7. Doi:10.1136/emermed-2021-212968

Can’t Intubate, Can’t Oxygenate | Teaching Invasive Airway With Impalpable Neck Anatomy

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Scalpel-finger-cannula was faster and had higher first-attempt success rate than scalpel-finger-bougie for front-of-neck access in simulated obese, bleeding manikin models.

Source
Success and Time to Oxygen Delivery for Scalpel-Finger-Cannula and Scalpel-Finger-Bougie Front-of-Neck Access: A Randomized Crossover Study With a Simulated “Can’t Intubate, Can’t Oxygenate” Scenario in a Manikin Model With Impalpable Neck Anatomy. Anesth Analg. 2022 Mar 3. doi: 10.1213/ANE.0000000000005969. Online ahead of print.

How to Teach Invasive Airway Access So It Sticks

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A high-fidelity simulation training program was very effective in teaching anesthesiologists to place invasive subglottic airways; skill retention was outstanding as well.

Source
Emergency Subglottic Airway Training and Assessment of Skills Retention of Attending Anesthesiologists With Simulation Mastery-Based Learning. Anesth Analg. 2022 Feb 10. doi: 10.1213/ANE.0000000000005928. Online ahead of print.

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