28 Tips Later
Inspired by an awesome zombie flick.
1. ETCO2 for Tube Confirmation
2. Blow to Know
3. The Metronome
4. ETCO2 for CPR Quality
5. ETCO2 for Futility
6. IO is in, Central Lines are out in CPR
7. You CAN shock while compressing
8. ETCO2 for ROSC Detection
9. How to place the recalcitrant probe
10. Suction-as-you-go ETT
11. Multi-person Suction
12. Mark the Cric Site
Cuts down on time and psychological barriers
13. Use an Industrial Sharpie for Body Marks
14. Have an Airway Algorithm
I like this one from Shock Trauma.
15. Have the items for it at the Bedside
16. A-line set-up in real time
See the full video here.
17. CPAP for Preoxygenation
- Cressey DM, Berthoud, MC, Reilly, CS. Effectiveness of continuous positive airway pressure to enhance pre-oxygenation in morbidly obese women. Anaesthesia. 2001;56: 680-684.
- Delay JM, Sebbane, M, Jung, B, et al. The effectiveness of noninvasive positive pressure ventilation to enhance preoxygenation in morbidly obese patients: a randomized controlled study. Anesth Analg. 2008;107: 1707-1713.
- Futier E, Constantin, JM, Pelosi, P, et al. Noninvasive Ventilation and Alveolar Recruitment Maneuver Improve Respiratory Function during and after Intubation of Morbidly Obese Patients: A Randomized Controlled Study. Anesthesiology. 2011;114: 1354-1363.
- Gander S, Frascarolo, P, Suter, M, et al. Positive end-expiratory pressure during induction of general anesthesia increases duration of nonhypoxic apnea in morbidly obese patients. Anesth Analg. 2005;100: 580-584.
- Herriger A, Frascarolo, P, Spahn, DR, et al. The effect of positive airway pressure during pre-oxygenation and induction of anaesthesia upon duration of non-hypoxic apnoea. Anaesthesia. 2004;59: 243-247.
- Antonelli M, Conti, G, Rocco, M, et al. Noninvasive positive-pressure ventilation vs. conventional oxygen supplementation in hypoxemic patients undergoing diagnostic bronchoscopy. Chest. 2002;121: 1149-1154.
18. PEEP valve for easy CPAP
You can see my JEM article now and hopefully the annals article will be available soon.
19. A1 Sedation
Dr. Breen wrote performed an excellent study on analgesia first sedation.
20. Chest CTs are rarely needed
21. Chest Tube Kink Test
Adame created this excellent test for kinking.
22. Chest tube location just doesn’t matter
So long as it is intrapleural of course. Bunch of studies:
- Emerg Med J 2010;27(10):792 AJR 1994;163:1339-1342
- Emerg Med J 2008;25(8):523-5.
- Clin Imaging 2005;29(6):401-5.
- Resuscitation 2007;72(2):226-33
23. Make your own ETCO2 sedation NC
Tutorial is here on the ehced site.
24. Avoid Bad Trips with Ketamine
I love that these folks actually studied this.
Here is Reuben Strayer's Article on Ketamine use in Adults for procedural sedation.
25. Awake Cricothyrotomy
Here is one case report of the technique.
There is also evidence for “Urgent Awake Tracheotomy for Impending Airway Obstruction“.
26. Bougie-Aided Cricothyrotomy
Darren Braude is the man!
27. Cric Trainer
Idea is from an anesthesia article. See the full video.
28. If you like my Lectures, you will love my podcasts. Check them out here: emcrit.org.