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EMCrit 260 – Thoughts on the NEJM Acute Upper Airway Obstruction Review

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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:

https://twitter.com/PulmCrit/status/1195103809745440768?s=20

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)

Additional New Information

 

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Scott Weingart, MD FCCM
Latest posts by Scott Weingart, MD FCCM (see all)

Cite this post as:

Scott Weingart, MD FCCM. EMCrit 260 – Thoughts on the NEJM Acute Upper Airway Obstruction Review. EMCrit Blog. Published on November 30, 2019. Accessed on December 11th 2024. Available at [https://emcrit.org/emcrit/upper-airway-obstruction/ ].

Financial Disclosures:

The course director, Dr. Scott D. Weingart MD FCCM, reports no relevant financial relationships with ineligible companies. This episode’s speaker(s) report no relevant financial relationships with ineligible companies unless listed above.

CME Review

Original Release: November 30, 2019
Date of Most Recent Review: Jul 1, 2024
Termination Date: Jul 1, 2027

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Jordan Schooler, MD, PhD
Jordan Schooler, MD, PhD
5 years ago

I’m glad to see others had the same reaction I did. The myth of needing to urgently convert crics to trachs seems impossible to slay, among others.

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