James DuCanto just emailed me with a guide to intubating through LMAs. My first question, of course, is can I share it with the listeners, so…
Here is the guide
Scott Weingart
An ED Intensivist from NY.
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Jimmy D owns the airway, not me!
Thanks for posting it!
This guide is almost 7 years old, by the way.
I use this technique with both recognized difficult airways and unrecognized difficult airways. In recognized difficult airways, I will often place the Air-Q under moderate to deep sedation, ventilate the patient, squirt topical lidocaine through the mask to topicalize the airway and then intubate through the Air-Q with this technique. Refer to Mihn’s photos for a more “modern” shape that is suitable for this procedure–the shape shown in this guide corresponds to information I garnered 7 years ago during my initial discovery of this procedure. The stylet I use looks just like Mihn’s. I use the Air-Vu Plus. I do have a Levitan bent in this configuration, but I keep it as an emergency (just in case) stylet in a bag I keep in my vehicle.
To date, I have intubated more than 500 patients using this technique, and have used it to rescue colleagues of mine on almost 10 occasions.
Folks, send me your airway, sedation and anaesthesia questions For Jim to answer when I interview him in an upcomng episode!