BVM or ETT in Arrest – New RCT
Bag mask ventilation and endotracheal intubation were equal for airway management in patients with cardiac arrest in terms of good neurological outcome at 28-days.
People Are Not Using EtCO2 for ETT Confirmation?
This study showed 7% of doctors intubating children were not using any form of EtCO2 detection to confirm placement: waveform capnography or colorimetric. This is appalling. The point of the article was to encourage use of capnography, but a more important message is you must use some form of EtCO2 detection.
C-MAC + Bonfils Scope for Extremely Difficult Airways
The combination of videolaryngoscopy (VL) and Bonfils rigid intubation endoscope (BIE) was an excellent way to safely intubate patients with extremely difficult airways.
Paradigm Shift – Cuffed ETT for Children
Cuffed endotracheal tubes (ETT) had better ventilation characteristics and fewer complications during routine surgery than uncuffed.
A Skeptical Look at a VL vs. DL Meta-analysis
This meta-analysis of direct vs video laryngoscopy showed no improvement in first-pass success with VL over DL, but it excluded patients at risk for a difficult airway. So view this with a healthy skepticism.
Don’t BURP the Baby?
External laryngeal manipulation (ELM) was associated with reduced first-pass success in critically ill children requiring emergent intubation. But it could have simply been a marker of a more difficult airway, not the cause.
Failure on Peds First-Pass ETT and Risk of Arrest
In pediatric patients with respiratory distress, failure of intubation on the first attempt was associated with increased risk of arrest.
Big Person? Big Dose of Succinylcholine
Not surprisingly, heavier patients had lower first-pass endotracheal tube success. They also had succinylcholine under-dosed more often. Give yourself the best chance for success and optimize muscle relaxation in obese patients.
No Teeth? No Problem. Use a Smaller Blade
When intubating edentulous patients, using a smaller Macintosh curved blade (Mac 3 for men and Mac 2 for women) led to an improved glottic view.
Capnography Flatline Beats Gestalt for Paralysis in RSI
Using loss of wave capnography rather than gestalt assessment of relaxation after paralytic administration for RSI in the ED led to shorter time to intubation and increased first-pass success.