Thread by @dastrainees

#JanuAIRWAY Day 16 (we’re over ½ way!) Cannot Intubate Cannot Oxygenate (CICO) Scenario - Needle Techniques. Potentially controversial (DAS primarily advocates scalpel techniques), but worth knowing about - particularly for paeds! Here’s some #OnePagers to start..
#JanuAIRWAY 1/7

CICO Key = decide on your plan before you're in the situation. @dasairway promotes scalpel techniques (final common pathway of CICO) MUST be taught. For more on the Needle technique check of Dr Andy Heard’s work at the Perth ‘wet’ lab. 🔗bjanaesthesia.org.uk/article/S0007-…
#JanuAIRWAY 2/7

Integrating the needle technique into CICO algorithms could look something like this #OnePager. There are 2 scenarios for each technique (needle & scalpel):
-palpable and
-impalpable anatomy
another reason to decide early –> lower cognitive load. #FOAMed
#JanuAIRWAY 3/7

All techniques require a degree of muscle memory for each step, and knowledge of potential pitfalls / ancillary equipment. Here’s some #OnePagers on needle approaches for palpable and impalpable anatomy. We’ll cover extra equipment on Tuesday! #FOAMed
#JanuAIRWAY 4/7

You’re not alone in having airway skills – remember your surgical colleagues & involve them early. BUT remember not all surgeons are equal (same as anaesthetists!) – having subspecialty interests a rhinologist might not be comfortable doing FONA either!
#JanuAIRWAY 5/7

Here are some papers / links that you might find interesting:
🔗pubmed.ncbi.nlm.nih.gov/20645953/
🔗pubmed.ncbi.nlm.nih.gov/21423020/
🔗youtube.com/user/DrAMBHear…
🔗link.springer.com/article/10.100…
If you have any others of interest, tweet them to us for inclusion next time!
#JanuAIRWAY 6/7

Hope that helps. Tomorrow we'll take a look at Scalpel Techniques for CICO Scenario. See you then! #JanuAIRWAY 7/7

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