#JanuAIRWAY Day 31 (the last day!) – Difficult Airway Conditions. There are loads – what follows isn’t a definitive list – but it’s pretty long all the same! Let’s dive in…
#DifficultAirway #FOAMed
#JanuAIRWAY 1/7 ImageImageImageImage
Unfortunately this #OnePager has to occupy this tweet by itself #FOAMed
#JanuAIRWAY 3/7 Image
Here are some papers / links on some lesser known eponymous syndromes that you might find interesting:
🔗jaccr.com/anesthetic-man…
🔗ncbi.nlm.nih.gov/pmc/articles/P…
🔗e-yujm.org/journal/view.p…
#FOAMed
#JanuAIRWAY 4/7
And that’s it - that completes #JanuAIRWAY for 2022! Thanks for joining us - we hope you've enjoyed it! And also to all our expert contributors @dr_imranahmad @noolslucas @gasgal13 @Admckdoc @SOBAuk Alistair Baxter, @ENT_UK’s Sadie Khwaia and Adam Donne.
#JanuAIRWAY 5/7
Note: Watch this space for details on the compilation, other tweetorials and other of upcoming #DASeducation events. But in the meantime why not join us for all the latest DAS updates
👉das.uk.com/membership_det…
#JanuAIRWAY 6/7
*Disclaimer: Inclusion of content (equipment, techniques and scoring systems etc.) in #JanuAIRWAY does not constitute DAS endorsement 7/7

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More from @dastrainees

Jan 27
#JanuAIRWAY Day 27 – The Neurosurgical Airway (thanks to @gasgal13 for her expert contribution to today’s content!). Head Vs Spine. Elective Vs Emergency. So many points of interest for airway managers. Here's a pair of #OnePagers to kick off!
#JanuAIRWAY 1/5 ImageImage
Key principles:
- Prevent rises in ICP
- Avoid hypoxia & low BP
- Minimise C-spine movement where indicated
- Be aware of positioning
- Beware of potential difficult airway in neurosurgical pathology
- Beware of post-op issues e.g. haematoma post-ACDF
#JanuAIRWAY 2/5
We can, in general, divide acute / emergency patients into 2 groups:
1) Cooperative – awake techniques may be the best option in anticipated difficulty
2) Uncooperative – asleep laryngoscopy or asleep FOI (consider LMA conduit)
#FOAMed #JanuAIRWAY 3/5
Read 5 tweets
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
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
Read 6 tweets
Jan 25
#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
Read 5 tweets
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
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
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

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