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, MD FCCM

Editor-in-Chief, at EMCrit.org

An ED Intensivist from NY.
Professor
Chief, Division of Emergency Critical Care
Director, Resuscitation and Acute Critical Care Unit
Stony Brook Medicine
Stony Brook, NY, USA
No conflicts of interest (coi).

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