Cite this post as:
Scott Weingart, MD FCCM. Airway Miscellany and Such (Sux?). EMCrit Blog. Published on May 21, 2012. Accessed on May 21st 2022. Available at [https://emcrit.org/emcrit/airway-miscellany/ ].
Financial Disclosures:
Dr. Scott Weingart, Course Director, reports no relevant financial relationships with ineligible companies.
This episode’s speaker(s), (listed above), report no relevant financial relationships with ineligible companies.
CME Review
Original Release: May 21, 2012
Date of Most Recent Review: Jan 1, 2022
Termination Date: Jan 1, 2025
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Whoo Hoo, Dr Hinckley! I used to work with him and the amazing team in the ER in Cincinnati (2004-2007) prior to joining the AF. Way to represent UC, Dr Hinckley!! I miss you guys a TON!
PS: love the mention of Freakonomics!
Can’t believe it’s been five years, Shelley. Time flies. Great to hear from you.
Excellent Dr. Hinkely. I’m encouraged by the ” No Desat” emphasis that prevails throughout these pod casts.
Thanks, guys! Speaking of NO DESAT, I can’t believe I forgot to mention nasal apneic oxygenation as one of the keys to DASH-1A success. I’m a big proponent. One other thing I need to clarify: when I mentioned 83% as the success rate reported by NEAR, that was first attempt success (DA-1A), with or without hypoxia, not overall success as I made it sound in the video.
Bill, I think Ron Walls will forgive you
Don, Bill, nasal oxygenation as part of your DASH1A concept is a brilliant addition and needs to be specifically planned for because it is so new to current practice of Emergency intubation/airway management. I mean its not even mentioned in Ron Walls bible yet! Prob in the next edition, right, Bill? My point is that when I have introduced it into my own practice in the last 9 months, it takes some explanation and planning to your aircrew or retrieval team about what the heck you are doing and why you want to take an extra portable oxygen cylinder with… Read more »
Dr. Hinckely…the very thing I sat down and discussed with my airmedical crew this afternoon as a training topic. Just no one has officially tried it here in a RSI setting as of yet. When we do I’ll post something back as how it went. But it’s my feeling that with Dr’s Levitan, Weingart and now yourself bringing this to the fore front that we will reap the benefits of your lengthy good experiences.
Don, I’ll look forward to hearing about how it goes for you and your team. Thanks!
A bit behind on my podcasts! Thanks for the erudite dissection of a relatively controversial issue. I agree that first pass success is not a measure that is particularly important. In our HEMS program, our goals generally are: 1. Oxygenation, 2. Ventilation, 3. Airway protection. The particular device and method to achieve these goals is not of great concern (a la Darren Braude). We must not give short shrift to ventilation however. Hypercapnea is likely as bad as hypoxia. In addition, we need to heed Dr. Dan Davis and Steve Aguilar with respect to our measure of hypoxia. The assumption… Read more »
Mike, I thought exactly the same thing. I think the measure should be nadir saturation during the peri-intubation. If they are 66% 2 min after the tube is in, that is the sat that should be counted.
Totally agree, gentlemen. That’s exactly how I measure it. Sorry that I didn’t clarify that.