Airway Week 5: Dr. Haney Mallemat

This week’s video analysis is with epic guest commentator Dr. Haney Mallemat (@criticalcarenow), while at Castlefest/Resusfest 2017, a critical care and ultrasound conference held in Lexington, Ky.   In part one of two, we discuss a difficult code intubation and a burned airway, both perilous in their own way.  Check out Dr. Mallemat’s take on these challenges.

 

Pearls from this week’s difficult airways:

  1. Chest compressions should be the priority during cardiopulmonary resuscitation; alternatives to intubation can successfully ventilate and oxygenate without prolonging time off the chest.
  2. Have help when keeping track of time during an arrest- your attempt at intubation may be depriving your patient of compressions or adequate respiratory support.
  3. A bougie can help to secure a bouncing, coding airway.
  4. Burned airways can get edematous quickly and are prone to worsen with multiple attempts, have your bougie, smaller tube and scalpel bedside.
  5. Prep your room.  Have everyone on the same page before shit hits the fan with a difficult airway.

 

References:

read_icon_512Video laryngoscopy vs. direct laryngoscopy: Which should be chosen for endotracheal intubation during cardiopulmonary resuscitation? A prospective randomized controlled study with experienced intubators. JW Kim, S Park. Resuscitation 2016. 105: 196-202.

read_icon_512Association between tracheal intubation during adult in-hospital cardiac arrest and survival. Anderson et al. JAMA. 317: 494-506.

Read my review of this article here.