Clinical Pearls for Airway Management of Morbidly Obese Patients

Joseph Esherick, M.D., FAAFP, FHM
More Articles – advanced airway, Airway management, awake intubation, cricothyroidotomy, difficult airway, difficult airway management, Difficult Intubation, Difficult LMA, direct laryngoscopy, emergent intubation, Endotracheal Intubation, Featured, GlideScope, Glidescope Intubation, HPC Updates, intermediate airways, Intubation, Ketofol, Laryngeal Mask Airway, laryngoscopy, LMA, Mechanical Ventilation, Propofol, supraglottic airway, Vascular access, Ventilation, video laryngoscopy, Videolaryngoscopy
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Morbidly obese patients can pose numerous challenges when it comes to airway management. Morbid obesity can make vascular access more difficult and you need good vascular access prior to any attempts at safe airway management. In addition, morbid obesity can…
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The Jury is Still Out on Whether Awake Prone Positioning in Non-intubated Patients with COVID-19 Pneumonia Decreases Mortality or Endotracheal Intubation

https://hospitalprocedures.org/endotracheal-intubation-course/
Joseph Esherick, M.D., FAAFP, FHM
More Articles – Acute respiratory distress syndrome, Airway management, Anti-coagulant, ARDS, Bilevel noninvasive positive pressure ventilation, BiPAP, corticosteroids, COVID, CPAP, Endotracheal Intubation, Featured, HPC Updates, Mechanical Ventilation, noninvasive positive pressure ventilation, noninvasive ventilation, NPPV, respiratory failure
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COVID-19 pneumonia can be a frustrating infection to treat because we have limited medications that have proven benefit in moderate-severe infections. Patients with COVID-19 pneumonia who require up to 2L/min supplemental oxygen have at least moderate infection. Patients with severe…
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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 Procedure, HPC update, HPC Updates
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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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Airway Management Pearls to Optimize Your Chances of Securing an Airway

https://hospitalprocedures.org/endotracheal-intubation-course/
Joseph Esherick, M.D., FAAFP, FHM
More Articles – advanced airway, Airway management, difficult airway, difficult airway management, Difficult Intubation, direct laryngoscopy, emergency procedures, emergency procedures course, emergent intubation, Endotracheal Intubation, Featured, Glidescope Intubation, hospital procedures, hospital procedures course, HPC Updates, Hypoxia, Intubation, King Tube, Laryngeal Mask Airway, LMA, Mechanical Ventilation, medical procedures, medical procedures course, preoxygenation, rapid sequence intubation, respiratory failure, supraglottic airway, supraglottic airways, surgical airway, video laryngoscopy, Videolaryngoscopy
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TOP TEN AIRWAY MANAGEMENT PEARLS TO OPTIMIZE YOUR CHANCES OF SECURING AN AIRWAY Develop a difficult airway management plan Huddle with your nurse and respiratory therapist in advance to alert everybody what plan A/B/C/D are for the patient If plan…
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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 Procedure, 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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Procedural Competency in Academic Emergency Medicine Attending Physicians

Joseph Esherick, M.D., FAAFP, FHM
More Articles – ACLS, advanced airway, Airway management, Central line insertion, central line placement, central lines, chest tube placement, cricothyroidotomy, difficult airway, difficult airway management, Endotracheal Intubation, Featured, HPC Updates, Intubation, Lumbar Puncture, paracentesis, Paracentesis, Procedural Sedation, Simulation Based Training, Simulation-based procedural training, Thoracentesis, Tube Thoracostomy
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A recent article summarizes a cross-sectional survey aimed at determining the processes in place to assess the procedural competency of academic emergency medicine attendings.[i] The survey was sent to the 39 ACGME-accredited Emergency Medicine programs in the U.S. and had…
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Simulation Based Training Improves Airway Management Skills

https://hospitalprocedures.org/endotracheal-intubation-course/
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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Tips for Management and Bedside Procedures in Critically Ill Patients with COVID Pneumonia

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Acute respiratory distress syndrome, advanced airway, Airway management, ARDS, Arterial Line, Arterial line insertion, Arterial line placement, Arterial Lines, asystole, Cardiac Arrest, cardiac arrest survival, Central Line, Central line insertion, central line placement, central lines, Central Venous Catheter, central venous catheters, COVID, CPR, difficult airway, difficult airway management, Difficult Intubation, emergent intubation, Endotracheal Intubation, Featured, Glidescope Intubation, hospital procedures, hospital procedures course, HPC Conference, HPC Updates, ICU, Intubation, Mechanical Ventilation, PEA, preoxygenation, prone positioning, pulseless electrical activity, Radial Artery Catheterization, respiratory failure, Simulation Based Training, Simulation-based procedural training, ultrasound-guided arterial lines, Ultrasound-Guided Central Line Insertion, video laryngoscopy, Videolaryngoscopy
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The SARS-COV-2 pandemic started in January 2020 and has decimated the majority of U.S. hospitals for the past 18 months. The impact of COVID-19 has not only affected available hospital beds, but has limited the ability of hospitals to perform…
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Airway Management in COVID-positive Patients

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Airway management, COVID, Featured Procedure, 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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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, HPC Updates, 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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Troubleshooting Difficult Intubations

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Airway management, Endotracheal Intubation, Featured Procedure, HPC Updates, 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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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, HPC Updates, 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, HPC Updates, 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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