Critical Care Scenarios Episode 70: Airway evaluation for non-anesthesiologists, with Jed Wolpaw
Jan 31, 2024
In this fascinating discussion, Dr. Jed Wolpaw, an anesthesiologist and intensivist from Johns Hopkins, dives into the critical aspects of airway management for non-anesthesiologists. He talks about evaluating patients before intubation, highlighting tools like the Malampati scoring system and the importance of medical history. The conversation covers tailored intubation techniques, the role of video laryngoscopy, and the complexities of managing critically ill patients. Preparation and understanding patient backgrounds are key to ensuring successful airway management.
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Assess Mask and Intubation Difficulty
- Always assess both mask ventilation and intubation difficulty separately before airway management.
- Prepare backup tools like oral airways, nasal trumpets, and LMAs especially if mask ventilation seems difficult.
Check Prior Intubation Records
- Always review a patient's prior intubation history and who performed it to anticipate challenges.
- Document intubation details carefully to guide future airway management and planning.
Bougie Use Isn't Always Best
- Routine use of a bougie as first attempt in intubation is not universally beneficial.
- Experts use bougies as adjuncts, not defaults, to reduce potential complications and improve success.