#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
Hope that helps. Tomorrow we’ll look at the Neurosurgical airway (ft. expert contributions from @gasgal13). See you then! #JanuAIRWAY 5/5

*Disclaimer: Inclusion of content (equipment, techniques and scoring systems etc.) in #JanuAIRWAY does not constitute DAS endorsement
Note: a revision to this one pager based on feedback and suggestions can be found together with others at this thread

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More from @dastrainees

May 13
Next up - Dr Craig Lyons, editor at @Anaes_Reports
@Anaes_Reports Challenges HFNO research: choosing an outcome of value is tricky (may not be patient centred), research unblinded, and research world is different (closed mouth, no talking, proper 3 minutes). to how we practise in the real world! Airway providers are different & so are patients
@Anaes_Reports We can't necessarily amalgamate info from many different categories of patients from lots of different contexts in meta-analyses
Read 12 tweets
Jan 2
#JanuAirway Day 2. Yesterday highlighted the need for strategy, so let’s talk Airway Planning. Decision making = the true art of airway management! NAP4 @doctimcook showed that poor judgement is implicated in many airway complications. This #OnePager covers the major themes. 1/9 Image
#JanuAirway What's the issue? We encounter difficult airways relatively infrequently, & complications are rare. Low exposure leads to high anxiety. Add in multiple options @huitink & Bouwman suggest >1mill combinations of options to oxygenate. More options = more anxiety 2/9 Image
Cognitive load can lead to decision fatigue & increasing bias & poorer decisions. Metacognition can help debias. Chew et al’s () came up with the TWED checklist which can help: -
3/9 ncbi.nlm.nih.gov/pmc/articles/P…
Image
Read 9 tweets
Jan 1
Welcome to #JanuAIRWAY2024. Every weekday we'll be bringing you Airway #FOAMed. Starting off with management of transgender airway -here's a #OnePager. It's a huge topic going beyond just the airway. Thanks to Drs @LukeFlower1 @drkamillak & Alice Humphreys for all their help! 1/7 Image
The facts are that there's a huge knowledge gap when it comes to healthcare providers and gender diverse patients. Let's start with terminology, the gender continuum and principles of gender-affirming care - here's a #OnePager covering just that! 2/7 Image
When it comes to peri-operative care, there are a number of effects that hormone therapy can have that depend on the type of transition. Additionally biochemical values also need to be interpreted with care. Check out this #OnePager 3/7 Image
Read 7 tweets
Oct 6, 2022
The law and airway management, looking at what we do through a different lens now with Maryanne Balkin. The tort of negligence has 4 elements:
1. duty of care
2. breach of standard of care
3. causation
4. injury or harm

#DAS2022
Expert witnesses are paramount in establishing the standards of care in cases where there is an issue with diagnosis or treatment #DAS2022
Recent medicolegal claim data from the NHS in England - …-publications.onlinelibrary.wiley.com/doi/abs/10.111…
Read 5 tweets
Oct 6, 2022
Peri-extubation complications - where are we? @MatteoParotto #DAS2022
For every study on extubation there are almost 10 on intubation, we don't appear to pay as much attention for extubation....#DAS2022
NAP 4 showed that extubation is where a significant amount of airway complications occur #DAS2022
Read 7 tweets
Oct 6, 2022
Why do we used cuffed tracheal tubes in children? Starting the international session this afternoon, the links @dasairway has with other airway societies is wonderful
The subglottic area is the narrowest part in children, the resistance whilst advancing the ETT is due to stenosis in the subglottic region #DAS2022
Microcuff paediatric ETT have really changed practice, moving from uncuffed tubes to cuffed tubes in paediatric patients #DAS2022
Read 5 tweets

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