☑️HALLOWEEN 2022 @AirwayMxAcademy and @dasairway airway nightmare case🎃You are a critical care doc and decorating your ultimate Halloween party👻underwater cave with a healthy friend. The room is now flooding with water and your friend falls down on the rocks…oops😳1/13 #meded 
2/13 “Are you okay?”Yes but I have difficulty breathing and it hurts. There is 1 scuba🤿unit, and you see a HFNO device & oxygen cylinder. You know that underwater breathing is possible with HFNO. How much flow is needed to swim 0,5 m below surface & b able 2breath underwater?
3/13 First you check the oxygen tubing which is long enough, than you check the class E oxygen cylinder: 1000 PSI. Save PSI 200. How much time/oxygen do you have at 40 l/min to swim underwater? #halloweenairway #foamed #foamcc #airway
4/13 You swim 🏊♀️ with your friend out of the underwater cave and arrive at a remote🏝️beach. Before you can ask for help a 🐝 flies into your friends mouth and he is stung (he is allergic to bees😳) This requires immediate action. You have epinephrine, 💉 how much do you give?
5/13 After 3 minutes all seems fine, your friend has a red face, swollen tongue but breathing is unobstructed. You remember his difficulty with breathing and his ribs hurt and see an ultrasound machine in the sand of the beach. If you try to diagnose a #pneumothorax 🫁you expect:
6/13 There are signs of pneumothorax, but you do not have a thorax-drain🤔You need to transfer your friend to the other side of the island to a junglehospital but in the middle is a 5500 mtr high mountain🏔️There is a 🚁Do you ask pilot to fly over summit (fastest way) or around?
7/13 After 30 min flight time you arrive at the jungle 🌴 hospital 🏥 Your friend is really sick now, RR 90/60, HR 142, SpO2 87% and hypothermic. And you see a swollen tongue with airway obstruction…#eFONA @EM_RESUS @cliffreid
8/13 At the hospital they just implemented @AirwayTriageApp 📱 and the @dasairway guidelines. First they do an airway triage. What is the classification of this airway?
9/13 How many complexity factors can you find for this case? Please specify.
10/13 There is a need for a surgical airway, the swelling of the tongue is impressive. What do you need to ask for at the hospital?
11/13 Ready set go, you declare eFONA and give ketamine, use lidocaine for local analgesia, you do an emergency surgical airway 🔪 What is best method to know your tube is in the right place?
12/13 You just saved your friends life 👏 You now wake up in your bed 🛌 from this nightmare airway dream and go to work 😷 Please tweet us your answers. Poll answers tomorrow after 24 hrs. Happy 🎃 Halloween and thanks for interaction 👻 🧙. Please retweet.
13/13 Ping @NaveenEipe @NightShiftMD @dastrainees @dr_imranahmad @jducanto @rosshofmeyr @LeifRognas @ketaminh @airwayGladiator @fibroanestesia @navarroguillej @UrtubiaRicardo @oldandbaffled @GongGasGirl @bobfunn @lowebrad @NicholasChrimes @JohnCSakles @SheilaMyatra @SAMHQglobal
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