#JanuAIRWAY Day 9. High Flow Nasal Oxygen (HFNO). This has been a game-changer in recent years. Thank you A.Patel and S Nouraei for their amazing landmark paper on THRIVE! 🔗pubmed.ncbi.nlm.nih.gov/25388828/
Let’s dive in…
#JanuAIRWAY 1/6 Image
Oxygen consumption continues during apnoea, gradual loss of alveolar volume/reduction in pressure. If upper airway remains patent, gas can be drawn into lower airways and oxygenation can continue and delay desaturation.
#JanuAIRWAY 2/6 ImageImage
HFNO:
1. Reduces heat and moisture loss from the airway
2. Decreases anatomical deadspace
3. Provides PEEP
4. Improves Oxygenation

See this @BJAJournals article which summarises the physiological basis and clinical contraindications👇
🔗academic.oup.com/bjaed/article/…
#JanuAIRWAY 3/6
HFNO Limitations:
1) Airway must be patent
2) Secretions can accumulate
3) Obesity – shorter duration of oxygenation, more rapid desaturation.
4) CO2 accumulation (apnoeic patients) – without hypoxia / raised ICP, unlikely to be problem
#JanuAIRWAY 4/6
Here are some papers / links you might find interesting:
🔗academic.oup.com/bjaed/article/…
🔗pubmed.ncbi.nlm.nih.gov/25388828/
🔗bjanaesthesia.org/article/S0007-…
🔗…-publications.onlinelibrary.wiley.com/doi/full/10.11…
🔗epmonthly.com/article/no-des…
If you have any others, tweet them to us for inclusion next time!
#JanuAIRWAY 5/6
Hope that helps. Tomorrow we'll look at the Cook Airway Exchange Catheter. See you then!
#JanuAIRWAY 6/6

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

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More from @dastrainees

12 Jan
#JanuAIRWAY Day 12. Awake Techniques (ft. expert contributions from @dr_imranahmad). This is a key skill for an airway manager. Here’s a #OnePager covering the basics of Awake Tracheal Intubation (ATI) and nasendoscopy. Let’s dive in…
#JanuAIRWAY 1/11 Image
Key = topicalization (if right, may not need sedation). Top tips:
- Know nerve supply CN V, IX & X.
- Block Ant.ethmoidal AND Sphenopalatine ganglion supply to the nasal septum
#JanuAIRWAY 2/11 ImageImage
Often you don’t need high dose LA if in right spot – this video is @Vapourologist after only gargling instilagel.
#JanuAIRWAY 3/11
Read 11 tweets
11 Jan
#JanuAIRWAY Day 11. The Aintree Intubation Catheter – an amazingly useful piece of equipment – every airway practitioner should be familiar with. Here’s a #OnePager. Let’s dive in…
#JanuAIRWAY 1/5 Image
Main function is as a stop-gap to maintain tracheal access & facilitate tracheal intubation through a supraglottic airway device (SAD) using a fibreoptic scope. They are Long, hollow, semi-rigid, powder blue, polyurethane catheters
#JanuAIRWAY 2/5 ImageImage
To highlight: NEVER insert beyond 26cm. NEVER insufflate with an oxygen flow >2l/min … or just NEVER use for insufflation!
#JanuAIRWAY 3/5
Read 5 tweets
10 Jan
#JanuAIRWAY Day 10. The Cook Airway Exchange Catheter – it’s a useful piece of equipment, but one not everyone will be familiar with. Here’s a #OnePager. Let’s dive in…
#JanuAIRWAY 1/6 Image
Main function is as a stop-gap to maintain tracheal access & facilitate ETT exchange. They are long, hollow, radiopaque, soft-tipped tubes – types for use with single / double lumen tubes.
#JanuAIRWAY 2/6 Image
All users MUST be trained & knowledgeable of how to use such devices together with their limitations and dangers. The Gordon Ewing case makes for tragic reading – but highlights this point. Essential reading for airway practitioners.
🔗scotcourts.gov.uk/search-judgmen…
#JanuAIRWAY 3/6
Read 6 tweets
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
This thread by @doctimcook is fantastic and we recommend everyone read it! #NoTraceWrongPlace
🔗
#JanuAIRWAY 3/10
Read 10 tweets
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
Read 6 tweets
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
Read 4 tweets

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