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Difficult Airway Society (DAS) Trainees

1 Jan, 7 tweets, 5 min read

Happy New Year Everyone. Welcome to #JanuAirway. Let’s start with the basics – Oxygen. Meaningful delivery of adequate oxygen is the fundamental aim of airway management. Think A.B.O. – Always, Be, Oxygenating. Here’s a #OnePager covering the basics of oxygen physiology 1/7

Knowledge of the three basic equations for oxygen physiology is essential: -

Arterial Oxygen Content

Oxygen Delivery

Oxygen Consumption

They can steer us towards various physiological parameters that we can manipulate to treat hypoxia / hypoxaemia. 2/7

#JanuAIRWAY

Oxygen cascade shows levels and processes involved and differentials for hypoxia/hypoxaemia: -

Oxygenation (e.g. low O2)
Diffusion (e.g. pulm fib)
Ventilation (bullae)
Perfusion (low cardiac output)
Oxygen carriage (anaemia)
Oxygen demand / use (sepsis) 3/7
#JanuAIRWAY

Oxy-Hb curve shows why the focus in desaturation must be getting oxygen in, when SpO2 starts to fall, it’s slow to start then precipitous. The benefit is, often a little oxygen going back in, in general means a rapid rise back to safety. 4/7

#JanuAIRWAY

@airwaycam

Pre/apnoeic oxygenation must be done well. Patience, VC breaths +/- high flow nasal oxygen are key. We’ll cover Optiflow & jet ventilation later this month, here are #OnePagers covering NO-DESAT by @airwaycam & THRIVE by Anil Patel and @larynxUK. 5/7 #FOAMed #JanuAIRWAY 5/7

Here are some articles that might be of interest: -

pubmed.ncbi.nlm.nih.gov/25388828/

pubmed.ncbi.nlm.nih.gov/16029221/

epmonthly.com/article/no-des…

If you have any others of interest, tweet them to us for inclusion next time! 6/7

That wraps up day 1. Tomorrow we’ll look at the bedside tests for airway assessment. #JanuAIRWAY 7/7

*Disclaimer: Inclusion of content (equipment, techniques and scoring systems etc.) in #JanuAIRWAY does not constitute DAS endorsement

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More from @dastrainees

Difficult Airway Society (DAS) Trainees

@dastrainees

2 Jan

@doctimcook

#JanuAIRWAY Day 2. Bedside Airway Assessment. NAP4 @doctimcook showed poor airway assessment contributes to poor outcomes. Thorough assessment = essential. Here’s a #OnePager on bedside tests to help assess for potential difficult airway management. #FOAMed #JanuAIRWAY 1/8

Airway Assessment should be holistic & comprised of three basic parts: -
1) History - including review of previous management (if possible),
2) Examination - visual examination and bedside tests &
3) Investigations (we'll look at these more later this month).
#JanuAIRWAY 2/8

NAP4 gives us a structure to focus our examination on anatomical/procedural difficulty: -
1) Difficult bag mask vent.
2) Difficult SAD insertion
3) Difficult laryngoscopy
4) Difficult intubation
5) Difficult Front of Neck Airway (FONA)
6) Difficult extubation
#JanuAIRWAY 3/8

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