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Difficult Airway Society (DAS) Trainees

@dastrainees

8 Jan

#JanuAIRWAY Day 8. Capnography. This is one of essential pieces of monitoring equipment needed during airway management. But its presence isn’t enough, correct interpretation is vital. Let’s start with a #OnePager looking at the different waveforms.
#JanuAIRWAY 1/10

Oesophageal intubation still occurs & EtCO2 = key tool to help prevent avoidable deaths such as Glenda Logsdail’s. Key message = flat or no trace indicates oesophageal intubation until proven otherwise #NoTraceWrongPlace
#JanuAIRWAY 2/10

@doctimcook

This thread by @doctimcook is fantastic and we recommend everyone read it! #NoTraceWrongPlace
🔗

https://twitter.com/doctimcook/status/1455871411730452483?s=20

#JanuAIRWAY 3/10

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Difficult Airway Society (DAS) Trainees

@dastrainees

7 Jan

#JanuAIRWAY Day 7. Equipment. Laryngoscopy is an essential skill for airway managers. Let’s start with #OnePagers looking at a classification of the different types of laryngoscopes
1/6

A fundamental understanding of ‘position’ theory can help e.g. the two-curve theory for videolaryngoscopy. Primary Curve either needs to be flattened or ‘looked around’. Here’s some #OnePagers
#JanuAIRWAY 2/6

2 basic techniques direct (DL) & video (VL), but different scopes require specific techniques. We may even combine multiple scopes (there’s no universally agreed term for this, here we’ve called it Flexi-Assisted Laryngoscopy (FL) Here’s some #OnePagers
#JanuAIRWAY 3/6

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Difficult Airway Society (DAS) Trainees

@dastrainees

6 Jan

#JanuAIRWAY Day 6. Equipment. Good workers know their tools – knowing our equipment is essential! Here’s some #OnePagers - the fundamentals of masks, NP/OPs, SADs, and ETTs.

#JanuAIRWAY 1/4

We’ll cover specific airway devices such as Cook airway exchange catheters, Aintree Intubation Catheters, Staged Extubation Kits, OLV equipment, Tracheostomies, etc later in the month. But in the meantime here's a #OnePager on Frova intubating introducers

#JanuAIRWAY 2/4

Here are some papers / links that you might find interesting:
a.anaesthesiajournal.co.uk/article/S1472-…
b.ncbi.nlm.nih.gov/pmc/articles/P…
c.das.uk.com/content/diffic…
d.ncbi.nlm.nih.gov/pmc/articles/P…
If you have any others of interest, tweet them to us for inclusion next time!

#JanuAIRWAY 3/4

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Difficult Airway Society (DAS) Trainees

@dastrainees

5 Jan

@doctortimcook

#JanuAirway Day 5. Airway Planning. Decision making is the true art of airway management, and something that we don’t really get taught! NAP4 @doctortimcook showed that poor judgement was implicated in many airway complications. Here’s a #OnePager covering the major themes. 1/16

@AirwayMxAcademy

#JanuAirway Why is this an issue? Difficult airways = relatively rare & complications = rarer still. Low exposure --> high anxiety. Add in multiple options @AirwayMxAcademy & Bouwman suggest >1,000,000 combinations of options to oxygenate. More options = more anxiety 2/16

#JanuAirway
Cognitive load can lead to decision fatigue/increased bias/poor choices. Chew et al’s ncbi.nlm.nih.gov/pmc/articles/P… TWED metacognition checklist may help: -
Threat– define problem
Wrong- What if I’m wrong?
Evidence
Dispositional factors – environment/hunger/fatigue 3/16

Read 16 tweets

Difficult Airway Society (DAS) Trainees

@dastrainees

4 Jan

#JanuAIRWAY Day 4. Airway Investigations. 2 broad categories we can use to round out our airway assessment; flow/volume-based lung function tests & imaging techniques. They vary in their usage and usefulness. Here's some #OnePagers #FOAMed on Spirometry and Flow-volume loops 1/17

Spirometry (literally ‘measuring breath’) and flow-volume loops give us information on the mechanics of ventilation. They can be helpful in a more global assessment of respiratory function, but are less helpful in acute airway management.

#JanuAIRWAY #FOAMed 2/17

Diffusing Capacity / Transfer factor can augment lung function tests and give us info about alveolar diffusion and alveolar thickness. Again, helpful in global assessment, but less helpful acutely. Here’s another #OnePager covering the theory and the practice

#JanuAIRWAY 3/17

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Difficult Airway Society (DAS) Trainees

@dastrainees

3 Jan

#JanuAIRWAY Day 3. The Difficult Airway. Many definitions. NAP4 has a procedural framework. Useful but not the whole picture. @HansHuitnik and Bouwan’s seminal pubmed.ncbi.nlm.nih.gov/25511477/ introduces ‘complexity factors 1/7

@Huitink

Complexity factors make easy things difficult e.g. operator experience, location, time pressure. Must be considered. @Huitink also suggest ditching the term ‘difficult’ in favour of ‘basic & advanced’ Here’s a #OnePager covering the basics
#JanuAIRWAY #FOAMed 2/7

Our airway assessment aims to determine difficulty of management. We want to use our holistic assessment (Hx, Ex and Ix) answer several questions.

Here’s a #OnePager outlining some of the key information we need

#FOAMed #JanuAIRWAY 3/7

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Difficult Airway Society (DAS) Trainees

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Difficult Airway Society (DAS) Trainees

Difficult Airway Society (DAS) Trainees

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