Intubation

Intubation is a key part of advanced airway management.

Although some of you out there may not intubate, we’ll be covering aspects where the identification of the need for intubation and how contributing as a team to the process can make a real difference to patient outcomes.

Intubation is subject of a considerable amount of evidence and debate. Increasing use of supraglottic airways both in theatre and in cardiac arrest creates a situation in which there are limited opportunities to train and learn the skill. This brings into question who should these limited opportunities to train go to, what defines competence, which patients now would benefit from intubation.

In this episode we’re going to cover these topics and more, including talking through how to fine your intubation technique as much as possible. We’re coming at this episode with our collective neonatal, ED and PHEM practice which all involve advanced airway management and it’s fair to say that we’re all passionate about delivering intubation and advanced airway management to the highest level possible. 

We hope this episode gives a further opportunity to consider the topic in great depth and reflect upon how we can all contribute to improving practice.

Once again we’d love to hear any thoughts or feedback either on the website or via twitter @TheResusRoom.

Enjoy!

Simon, Rob & James

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References

Effect of a Strategy of a Supraglottic Airway Device vs Tracheal Intubation During Out-of-Hospital Cardiac Arrest on Functional Outcome. The AIRWAYS-2 Randomized Clinical Trial. Benger J. JAMA. 2018

Effect of a Strategy of Initial Laryngeal Tube Insertion vs Endotracheal Intubation on 72-Hour Survival in Adults With Out-of-Hospital Cardiac ArrestA Randomized Clinical Trial. Henry E. Wang, MD. 2018

Effect of Bag-Mask Ventilation vs Endotracheal Intubation During CardiopulmonaryResuscitation on Neurological Outcome AfterOut-of-Hospital Cardiorespiratory Arrest: A Randomized Clinical Trial. Jabre P. JAMA. 2018 

Association of Anaesthetists; Safer Prehospital Emergency Anaesthesia 2017

The Importance of First Pass Success When Performing Orotracheal Intubation in the Emergency Department. John C. Sakles. Acad Emerg Med. 2013

The First Shot Is Often The Best Shot: First Pass Intubation Success in Emergency Airway Management. Bernhard. International Anaesthesia Research Society. 2015

Complications increase with greater than one endotracheal intubation attempt: experience in a Canadian adult tertiary-care teaching center. Duggan LV. J Clin Anesth 2014

Association of Anaesthetists; Safer pre-hospital anaesthesia 2017

Effectiveness of Apneic Oxygenation During Intubation: A Systematic Review and Meta-Analysis. Lucas Oliveira J E Silva. Ann Emerg Med. 2017

Apnoeic oxygenation during intubation in the intensive care unit: A systematic review and meta-analysis. Matthew J Binks. Heart Lung. 2017

Apnoeic oxygenation during intubation: a systematic review and meta-analysis. L D White. Anaesth Intensive Care. 2017

Significant Delay in the Detection of Desaturation between Finger Transmittance and Earlobe Reflectance Oximetry Probes during Fiberoptic Bronchoscopy: Analysis of 104 Cases. Barak Pertzov. Lung. 2019

Guidelines for the management of tracheal intubation in critically ill adults. A Higgs. Br J Anaesth. 2017

Advancing emergency airway management by reducing intubation time at a high-volume academic emergency department. Bharath Gopinath. BMJ Open Qual. 2021

The Resus Room; AIRWAYS-2

The Bottom Line; AIRWAYS-2

ERC 2021 guidelines

Course Content

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