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)
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Editor-in-Chief, at EMCrit.org
An ED Intensivist from NY.
Professor
Nassau University Medical Center
No conflicts of interest (coi).
Professor
Nassau University Medical Center
No conflicts of interest (coi).
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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.