Summary of Difficult Airway Management in COVID-19 Patients

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Airway management, COVID, difficult airway, difficult airway management, Difficult Intubation, Difficult LMA, direct laryngoscopy, emergent intubation, Endotracheal Intubation, Featured, Intubation, noninvasive ventilation, NPPV, supraglottic airway, supraglottic airways, video laryngoscopy, Videolaryngoscopy
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The Society of Airway Management recently issued guidelines for Difficult Airway Management in COVID-19 patients.  The SARS CoV-2 (COVID-19) virus is extremely contagious via respiratory droplets and therefore extra precautions are needed for airway management in severe COVID-19 infection.  Airway…
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Video laryngoscopy has a superior first pass success rate compared with direct laryngoscopy in the ICU

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Airway management, direct laryngoscopy, emergency procedures, Endotracheal Intubation, Featured Procedure, Glidescope Intubation, HPC Updates, Intubation, Procedure Blog of the Week, video laryngoscopy
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Video laryngoscopy is superior to direct laryngoscopy for emergency intubations in the ICU. A recent meta-analysis based on nine trials evaluated 2,133 ICU patients and concluded that video laryngoscopy (VL) has a higher first pass success rate compared to direct…
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Airway Management in COVID-positive Patients

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Airway management, COVID, Featured, HPC Updates, Intubation
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A number of additional factors must be considered with airway management in COVID-positive patients. Hospital Procedures Consultants (HPC) can provide simulation-based training to prepare providers for airway management in COVID-positive patients. The first essential consideration is to place the patient into a…
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The Likelihood of a Difficult Intubation

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Airway management, difficult airway, Endotracheal Intubation, Featured, HPC Updates
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A recent article in JAMA reviewed 62 high-quality articles to determine the clinical factors that can help to predict the patient with a difficult airway.  Airway management experts have devised different scoring systems and exam findings that can predict the…
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Simulation Based Training Improves Airway Management Skills

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Airway management, Endotracheal Intubation, Featured Procedure, Glidescope Intubation, HPC Updates, Intubation, King Tube, Laryngeal Mask Airway, Procedure Blog of the Week
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Simulation-based procedural training has been shown to improve procedural competence, safety, operator confidence and most importantly patient safety for every bedside procedure studied.  Now, a new systematic review and meta-analysis confirms that simulation-based training in airway management improves procedural competence…
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Troubleshooting Difficult Intubations

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Airway management, Endotracheal Intubation, Featured Procedure, Procedure Blog of the Week
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Have you ever been able to see the vocal cords during direct laryngoscopy but you weren’t able to pass the endotracheal tube cuff beyond the cords?  This occurs not too infrequently during endotracheal intubation and I am going to share…
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Tricks of the Trade for Stylet-guided Endotracheal Intubations

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Airway management, Endotracheal Intubation, Featured
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Eschmann stylets, or Bougies, can assist the clinician with endotracheal intubation in difficult airway scenarios.  The stylet when properly placed can act to guide the endotracheal tube (ETT) into the trachea.  However, there are different troubleshooting techniques that once must…
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Predictors of failed intubations using video laryngoscopy such as failed Glidescope intubations

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Airway management, direct laryngoscopy, Endotracheal Intubation, Glidescope Intubation, Intubation, shockable vs. nonshockable rhythms, video laryngoscopy
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In a study conducted at two academic medical centers, records showed that of 71,570 intubations 2,004 used Glidescope for airway management. Success rates and complications were documented in these Glidescope intubations. The overall success rate for Glidescope intubations was 97%.…
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Pre-hospital cardiac arrest patients do best with supraglottic airway or BVM ventilation

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Airway management, Cardiac Arrest, HPC Updates, Intubation, King Tube, supraglottic airways
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Cardiac arrest patients who were intubated had similar outcomes to those who had a supraglottic airway device (e.g., King tube) inserted in the pre-hospital setting. A literature review of 5 studies and over 300,000 patients with pre-hospital cardiac arrest demonstrated…
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Does Cricoid Pressure Prevent Aspiration During Endotracheal Intubation?

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Airway management, Endotracheal Intubation, Glidescope Intubation, intermediate airways, King Tube, Laryngeal Mask Airway, Procedure Blog of the Week
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There has always been some controversy about the utility of applying cricoid pressure (aka Sellick Maneuver) during rapid sequence intubation for the purpose of preventing aspiration.  Theoretically, applying pressure on the cricoid cartilage posteriorly should occlude the esophagus against the…
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