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Jan 25 • 5 tweets • 7 min read
#JanuAIRWAY Day 25 – Obstetric Airways (thanks to @noolslucas for her expert contribution to todays content!). Let’s dive in…Here's a #OnePager and decision tools from a great review article
🔗doi.org/10.1111/anae.1…
#JanuAIRWAY 1/5
Failed intubation requires a different approach in Obs. The 2015 @dasairway /@OAAinfo guidelines are really helpful for this! Covering safe Obs GA, failed intubation and GA.
#JanuAIRWAY 2/5
The DAS/OAA guidelines also cover decision making – when to bail out / when to proceed and aftercare – which mustn’t be overlooked!
#JanuAIRWAY 3/5
Here are some papers / links that you might find:
🔗das.uk.com/guidelines/obs…
🔗…-publications.onlinelibrary.wiley.com/doi/full/10.11…
🔗bjanaesthesia.org/article/S0007-…
🔗link.springer.com/article/10.100…
🔗…-publications.onlinelibrary.wiley.com/doi/full/10.11…
🔗…-publications.onlinelibrary.wiley.com/doi/full/10.11…
🔗…-publications.onlinelibrary.wiley.com/doi/10.1111/an…
#JanuAIRWAY 4/5
Hope that helps. Tomorrow we’ll look at the traumatic airway. See you then! #JanuAIRWAY 5/5

*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 Profile picture
Jan 26
#JanuAIRWAY Day 26 – The Traumatic Airway. Particularly stressful airways to manage = one part of a wider critically ill patient. Let’s kick off with a #OnePager
#FOAMed #JanuAIRWAY 1/5 Image
The principles of Rx are:
-Beware the isolated environment
-Plan for uncooperative patient
-Prevent aspiration
-Protect C-spine
-Plan for difficult airway
#FOAMed #JanuAIRWAY 2/5
Define type of trauma early – blunt vs penetrating (neck divided into 3 zones), and assess for:
-Distorted anatomy
-Bleeding
-Subcut. Emphysema – injury to gas containing structure
-Other traumatic injury – e.g. head, thorax, abdomen, etc
#FOAMed #JanuAIRWAY 3/5 Image
Read 5 tweets
Difficult Airway Society (DAS) Trainees Profile picture
Jan 24
#JanuAIRWAY Day 24 -Paediatric Airways. (ft. expert contributions from Alistair Baxter and @ENT_UK’s Adam Donne). Let’s dive in … Here's some #OnePagers covering anatomy, induction, airway manoeuvres and basic airway equipment.
#JanuAIRWAY 1/10
Top tip from Alistair Baxter: Remember that a Macintosh blade is a hyperangulated blade in an infant and requires an intubation stylet shaped to match the curve of the blade
#JanuAIRWAY 2/10
The difficult paediatric airway = #SCARY. Upper airway obstruction in children – broad range of presentations, three important diagnoses; Croup, Epiglottitis and Inhaled Foreign Body. Here’s some #OnePagers.
#JanuAIRWAY 3/10
Read 10 tweets
Difficult Airway Society (DAS) Trainees Profile picture
Jan 23
#JanuAIRWAY Day 23 (the final stretch!). Malacias and SVC Obstruction. Here's a pair of #OnePagers to get started..
#JanuAIRWAY 1/10
What are malacias? = rare dynamic airway obstruction - (congenital / acquired) due to loss of cartilaginous support
Decreased intratracheal pressure + increased intrathoracic pressure lead to airway compression
Severity is proportional to expiratory force
#JanuAIRWAY 2/10
Issues
Obstruction can occur even if aymptomatic
Maintain spont. Vent. if poss
Emergency management =+ve pressure (splint airways open) or bypass obstruction
Surgery depends on location / extent
Extubate deep (avoid coughing) or directly to CPAP
#JanuAIRWAY 3/10
Read 10 tweets
Difficult Airway Society (DAS) Trainees Profile picture
Jan 22
#JanuAIRWAY Day 22. Airway Obstruction – Infraglottic (intrathoracic). Again, presents its own set of challenges. Let’s dive in … Here's a #OnePager (Ft. expert contribution Sadie Khwaja @ENT_UK )
#JanuAIRWAY 1/7
Issues:
- Upper/Mid lesions usually low risk – ETT may pass beyond
- Low tracheal/Bronchial lesions = high risk, best managed in specialist centres
- CT scan = essential
- Sudden obstruction can occur at ANY time
- Potential compression of heart/vessels
#JanuAIRWAY 2/7
Severe Obstruction:
- Check position patient breaths best in
- Spont vent may help, IPPV may cause airway collapse
- Opinion re: IV vs inhalational = mixed
- Ketamine ?preserves chest wall tone
- Need back up plan
- Consider Heliox/bypass/ECMO before starting
#JanuAIRWAY 3/7
Read 7 tweets
Difficult Airway Society (DAS) Trainees Profile picture
Jan 21
And just like that we’re 3 weeks into #JanuAIRWAY. Here’s your week 3 round up!

Day 15 – Tracheostomies

Day 16 – CICO Needle Techniques

Day 17 – CICO Scalpel Techniques


#JanuAIRWAY 1/4
Day 18 – CICO Extra Equipment


Day 19 – The Obstructed Airway: Supraglottic

Day 20 – The Obstructed Airway: Periglottic

#JanuAIRWAY 2/4
Day 21 – The Obstructed Airway: Infraglottic Extrathoracic

Week 4 starts tomorrow continuing the theme of obstructed airways with Infraglottic Intrathoracic Obstruction. See you then!

#JanuAIRWAY 3/4
Read 4 tweets
Difficult Airway Society (DAS) Trainees Profile picture
Jan 21
#JanuAIRWAY Day 21. Airway Obstruction – Infraglottic (extrathoracic). Presents a unique set of challenges. Let’s dive in … Here's a #OnePager
#JanuAIRWAY 1/6
Physiology
- Theory=fixed lesion unaffected by respiratory cycle / anaesthesia induction (most have dynamic element)
- Extrathoracic lesions usually better in expiration +ve pressure splints airway open
- Lets’ revisit flow-volume loops as they can be helpful
#JanuAIRWAY 2/6
Issues:
- Laryngoscopy likely to be uneffected. However, major concern = inability to pass ETT atraumatically beyond the level of obstruction
- Nasendoscopy can be useful to view lesion
- AFOI/FOI may cause ‘cork in bottle’ effect depending on lesion size/location
#JanuAIRWAY 3/6
Read 6 tweets

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