Discover and read the best of Twitter Threads about #Intubation

Most recents (5)

(1/7)
#Intubation #DifficultAirway
ich bin seit langem mal wieder im OP und freue mich, dass eine meiner lieblings-assistentinnen im nachbarsaal narkose macht. wir verstehen uns sehr gut und unternehmen auch ab und an privat etwas zusammen. wir stehen also kurz vor 7:30 uhr am PC
(2/7)
am stützpunkt des OP und warten gemeinsam, dass unsere patient:innen von den stationen gebracht werden. ihr erster patient habe laut prämedikationsprotokoll einen „schwierigen atemweg“. wir geben einer #OhGottPJ und einem NFS-azubi bescheid und gehen gemeinsam nochmal
(3/7)
unseren standard für solche situationen durch. wir vereinbaren, dass sie mich informiert, wenn sie die narkose einleitet, damit ich dazukommen kann. wir nutzen das setting, um für alle teaching zu betreiben. der patient wurde in verbesserter jackson-position gelagert ✔️ Verbesserte Jackson-Position zur Erleichterung der Intubatio
Read 7 tweets
PSA: You *CANNOT* use a "bougie" or Eschmann Intubating Stylet to do an endotracheal tube exchange. I have seen this mistake twice in the past 6 months. You will lose the airway. A simple look at the length of the bougie and an #ETT will make this clear.
The length of an adult ETT is about 32 cm and the length of the #eschmannstylete is 70 cm. This leaves no room in the center for you to grab it. When you retract the #ETT to the end of the stylet, its distal tip is still in the patient's mouth & entire stylet is covered
To do a tube exchange, you need 2x the length of the ETT and then some additional length to work with, else you risk retracting the exchange device too far and losing the airway. This is why they make an "airway exchange catheter" and its length is 83cm: cookmedical.com/products/cc_ca…
Read 15 tweets
The Video Classification of Intubation (VCI) score: a new description tool for tracheal #intubation using #videolaryngoscopy. A Tweetorial on #VCI 1/15 @R_S_Chaggar @LondonSneh Michael Berry Rajan Saini @sanooj_soni @oldandbaffled @EJA_Journal journals.lww.com/ejanaesthesiol…
Tracheal intubation using VL is prevalent, yet a classification & documentation tool has not been widely adopted into clinical practice. We have developed the #VCI score & assessed its validity & reproducibility in manikins & patients. 2/15 Image
We investigated whether 2 anaesthetists could generate congruent #VCI scores for a given patient. The VCI scores recorded by each anaesthetist were identical in 34/35 (97.1%) patients. 3/15
Read 15 tweets
#CCCF2020 Brian Kavanaugh Controversies - #COVID19: #ARDS or not? What we really addressed - not so much "is it ARDS?" but rather, "does it matter?" So happy to have been a part of this, but man, I still have so much to say! My take on the ? – yes, it matters - to an extent 🧵 1/ Image
Pre-intubation management: YES, but not because it substantially changes methods of support, or the criteria used for #intubation. It matters because categorizing patients as having #ARDS has value. 2/
If we use the Berlin definition, patients on Venturi masks or arguably #HFNC don’t actually meet criteria for #ARDS because they’re not on PEEP >/= 5. The natural history of ARDS though almost certainly begins prior to the use of mechanical ventilation (invasive or not). 3/
Read 13 tweets
Starting a series on clinical Pearls I am gathering in #COVID19 patients based on experiences of many experts

Will add as we go along

Feel free to add your own observations/experiences

#covidclinicalpearls /1
Anosmia is likely the most specific #COVID19 related symptom
30% of patients have anosmia as their 1st symptom
#covidclinicalpearls /2
Around 90% of patients have fever.
50% maybe afebrile at the time of presentation
Fever tends to be very resistant to routine measures in hospitalized patients
There is no consensus that NSAIDs are to be avoided in #COVID2019 patients

#covidclinicalpearls /3
Read 66 tweets

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