NEJM recently published an interesting review article on upper airway obstruction. This podcast was spurred by a rantorial on twitter by Farkas regarding the article:

this fresh review article in NEJM on acute upper airway obstruction is the most horrifically wrong & dangerous piece of literature I've encountered in a while 😳 (#rantorial 1/6)https://t.co/sDCY53cWkn pic.twitter.com/2FdCly2b0C

— 𝙟𝙤𝙨𝙝 𝙛𝙖𝙧𝙠𝙖𝙨 💊 (@PulmCrit) November 14, 2019

I took a look–and it was indeed bad…

Here is the Article:

Eskander et al. Acute Upper Airway Obstruction

Some Additional References

Here is the review article on which some of the flawed messages of the NEJM piece are based:

• Cricothyrotomy versus Trachetomy: An Otolaryngologist's Perspective. Laryngoscope. 1988 Feb;98(2):131-5.

These two pieces from the ENT and OMFS literature correct these errors:

• Cricothyrotomy: When, Why and Why Not: Am J Otolaryng 2000;21(3):195
• Elective Surgical Cricothyroidotomy in Oral and Maxillofacial Surgery Br J Oral Max Surg 2013;51:779

Updates:

Best Practices for Emerg Surg Airway (Laryng Invest Otolaryng 2019;4:602)

Now on to the Podcast…

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Scott Weingart

Editor-in-Chief, EMCrit.org at EDECMO LLC

An ED Intensivist from NY. No conflicts of interest (coi).

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