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You are here: Home / EMCrit-RACC / The HOP Mnemonic and AirwayWorld.com Next Week

The HOP Mnemonic and AirwayWorld.com Next Week

June 21, 2012 by Scott Weingart 12 Comments

On June 28th at 5pm EST, I will be appearing on AirwayWorld.com for a lecture on DSI and NIV preox. It is free to register, so come check it out.

The folks that run the site are from the Emergency Airway Course. They like difficult airway assessment acronyms, such as:

Difficult to Bag (BONES)

  • Beard
  • Obesity
  • No Teeth
  • Elderly (>55)
  • Snores

Difficult to Intubate   (LEMON)

  • Look at head and neck
  • Evaluate 3-3-2
  • Mallampati (Using Samsoon and Young mod, which added class IV, 1987)
  • Obstruction=hot potato voice, can’t handle secretions, and Stridor (if audible=90% obstruction)
  • Neck Mobility

Difficult Extraglottic Device (RODS)

  • Restricted Mouth Opening
  • Obstruction: at or below the level of the larynx
  • Disrupted or distorted airway. If the seat or seal of the device is disrupted
  • Stiff lungs or cervical spine. Poor lung compliance or inability to extend neck may hamper seal

 

Difficult Cricothyrotomy (SHORT)

  • Surgery/Disrupted Airway
  • Hematoma
  • Obese/Access Problems (Can’t get to neck)
  • Radiation
  • Tumor

Well during next week's lecture, I will suggest one more to be added to the list:

Difficult Physiology (HOp)

The Physiologically Difficult Airway, aka you will box your pt during the intubation if you don't take steps to prevent it: the HOp Killers

Here are the parts of the HOp mnemonic:

  • Hypotension – either preintubation or the potential for intubation to cause it
  • Oxygenation – either already satting poorly or the patient has minimal reserve
  • pH -Ventilatory kills. Either the patient has a severe metabolic acidosis, or they are a brain injury patient with potential ICP issues.
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Scott Weingart

An ED Intensivist from NY.

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Filed Under: EMCrit-RACC Tagged With: blogpost, featured

Cite this post as:

Scott Weingart. The HOP Mnemonic and AirwayWorld.com Next Week. EMCrit Blog. Published on June 21, 2012. Accessed on April 19th 2018. Available at [https://emcrit.org/racc/hop-mnemonic/ ].

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Unless otherwise noted at the top of the post, the speaker(s) and related parties have no relevant financial disclosures.

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12 Comments on "The HOP Mnemonic and AirwayWorld.com Next Week"

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Mike Sherriff
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Mike Sherriff
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“Make sure your patient isn’t HOPping before you intubate.”

So when I read your tweet, I though HOP? What could that stand for?
Hypoglycemic? Opiate overdosed? Post-ictal? Yeah that must be it. It’s poor form to intubate your patient, only to find out they are hypoglycemic, opiate overdosed or post-ictal.

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5 years ago
Scottweingartwannabe
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I will now be HOPping and HOPing before prior to all me tubes. Thanks.
Matt

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5 years ago
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The difficult airway – a new perspective | foam-europe.org
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[…] In a recent paper in the Western Journal of Emergency Medicine, Mosier et. al. talk about the “physiologically difficult airway” – a very good and nicely written perspective on airway management in the critical patient (full paper available for free here). It expands on topics already mentioned by (who else?) Scott Weingard a few years back. […]

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2 years ago
Justin Riedel Paramedic
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Justin Riedel Paramedic
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My god the “SHORT” reference with the “Full Metal Alchemist” is fantastic. I wonder how many people actually got that reference…

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1 year ago
Scott Weingart
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Scott Weingart
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tee hee

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1 year ago
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Critical Care Updates: Resuscitation Sequence Intubation - Hypotension Kills (Part 1 of 3) - R.E.B.E.L. EM - Emergency Medicine Blog
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[…] was mostly derived from a podcast by Scott Weingart (Twitter: @EMCrit) where he talked about the physiologic killers during preintubation and perintubation. In this podcast, Scott mentions the HOp killers: Hypotension, Hypoxemia, and Metabolic Acidosis […]

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1 year ago
trackback
Critical Care Updates: Resuscitation Sequence Intubation – Hypotension Kills (Part 1 of 3) by R.E.B.E.L. EM - HEMS Critical Care
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[…] was mostly derived from a podcast by Scott Weingart (Twitter: @EMCrit) where he talked about the physiologic killers during preintubation and perintubation. In this podcast, Scott mentions the HOp killers: Hypotension, Hypoxemia, and Metabolic Acidosis […]

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1 year ago
trackback
Critical Care Updates: Resuscitation Sequence Intubation - Hypoxemia Kills (Part 2 of 3) - R.E.B.E.L. EM - Emergency Medicine Blog
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[…] was mostly derived from a podcast by Scott Weingart (Twitter: @EMCrit) where he talked about the physiologic killers during preintubation and perintubation. In this podcast, Scott mentions the HOp killers: Hypotension, Hypoxemia, and Metabolic Acidosis […]

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1 year ago
trackback
Critical Care Updates: Resuscitation Sequence Intubation – Hypoxemia Kills (Part 2 of 3) - HEMS Critical Care
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[…] was mostly derived from a podcast by Scott Weingart (Twitter: @EMCrit) where he talked about the physiologic killers during preintubation and perintubation. In this podcast, Scott mentions the HOp killers: Hypotension, Hypoxemia, and Metabolic Acidosis […]

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1 year ago
trackback
Critical Care Updates: Resuscitation Sequence Intubation - pH Kills (Part 3 of 3) - R.E.B.E.L. EM - Emergency Medicine Blog
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[…] was mostly derived from a podcast by Scott Weingart (Twitter: @EMCrit) where he talked about the physiologic killers during preintubation and perintubation. In this podcast, Scott mentions the HOp killers: Hypotension, Hypoxemia, and Metabolic Acidosis […]

Vote Up0Vote Down  Reply
1 year ago
trackback
Critical Care Updates: Resuscitation Sequence Intubation – pH Kills (Part 3 of 3) by R.E.B.E.L. EM - HEMS Critical Care
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[…] was mostly derived from a podcast by Scott Weingart (Twitter: @EMCrit) where he talked about the physiologic killers during preintubation and perintubation. In this podcast, Scott mentions the HOp killers: Hypotension, Hypoxemia, and Metabolic Acidosis […]

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1 year ago
trackback
emDOCs.net – Emergency Medicine EducationR.E.B.E.L. EM - Critical Care Updates: Resuscitation Sequence Intubation – Hypotension Kills (Part 1 of 3) - emDOCs.net - Emergency Medicine Education
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[…] was mostly derived from a podcast by Scott Weingart (Twitter: @EMCrit) where he talked about the physiologic killers during preintubation and perintubation. In this podcast, Scott mentions the HOp killers: Hypotension, Hypoxemia, and Metabolic Acidosis […]

Vote Up0Vote Down  Reply
5 days ago

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