King Tube vs IGEL for Airway ManagementIn this episode of Wilderness Medicine Updates, Dr. Patrick Fink addresses a listener's question on whether to use a King Tube or an IGEL as an out-of-hospital airway adjunct. The episode begins with an overview of airway management techniques from mouth-to-mouth resuscitation to supraglottic airway devices. Dr. Fink explains the benefits and drawbacks of various airway adjuncts, including oral and nasal pharyngeal airways. The discussion then shifts to a detailed comparative analysis of King Tubes and IGELs based on retrospective and prospective studies. Dr. Fink evaluates the evidence indicating that IGEL may be more effective and easier to use than King Tubes, particularly in pre-hospital cardiac arrest situations. The episode concludes with recommendations for pre-hospital providers and an encouragement for listeners to share their questions and feedback.Links:iGel LMAKing TubeSmida T, Menegazzi J, Scheidler J, et al. A retrospective comparison of the King Laryngeal Tube and iGel supraglottic airway devices: A study for the CARES surveillance group. Resuscitation. 2023;188:109812. doi:10.1016/j.resuscitation.2023.109812Smida, Tanner & Menegazzi, James & Crowe, Remle & Scheidler, James & Salcido, David & Bardes, James. (2023). A Retrospective Nationwide Comparison of the iGel and King Laryngeal Tube Supraglottic Airways for Out-of-Hospital Cardiac Arrest Resuscitation. Prehospital emergency care. 28. 1-13. 10.1080/10903127.2023.2169422. Lønvik, M.P., Elden, O.E., Lunde, M.J. et al. A prospective observational study comparing two supraglottic airway devices in out-of-hospital cardiac arrest. BMC Emerg Med 21, 51 (2021). https://doi.org/10.1186/s12873-021-00444-0Chapters00:00 Introduction and Listener Question00:55 Understanding Airway Adjuncts02:12 Basic Airway Management Techniques06:34 Advanced Airway Devices: King Tube and LMA11:35 Comparative Studies on Airway Devices17:35 Prospective Data and Final Thoughts25:24 Conclusion and Listener EngagementAs always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD FAWM. Connect with us by email at wildernessmedicineupdates@gmail.com.You can pay us a compliment and share the show with a new listener on any popular platform here.

In this discussion, Dr. Ross Hofmeyr, an anesthesiologist and wilderness medicine expert from South Africa, sheds light on methoxyflurane, a game-changer for pain management in remote settings. He shares the history and practical applications of this anesthetic gas, which boasts efficacy and ease of use, particularly as a 'green whistle' device. Dr. Hofmeyr emphasizes its importance in acute traumatic pain scenarios and discusses the challenges of using it in extreme conditions, making a compelling case for its role in wilderness medicine.

Dr. Christopher Van Tilburg, an expert in emergency and wilderness medicine, discusses the innovative use of ketamine for pain management in challenging outdoor settings. He shares insights on administering ketamine during mountain rescues, comparing it to traditional medications like fentanyl. The conversation dives into dosing strategies, environmental considerations, and the importance of patient monitoring. Dr. Van Tilburg also teases his upcoming book, 'Crisis on Mount Hood,' celebrating a century of mountain rescue stories.

Dive into the life-saving techniques behind the ICAR resuscitation algorithm for avalanche victims. Discover the critical factors that determine survival, from burial duration to airway management. Detailed explanations of Basic and Advanced Life Support algorithms make complex protocols accessible. Real-life case studies illustrate practical rescue scenarios, emphasizing the urgency of quick action and the impact of hypothermia. Essential listening for anyone involved in avalanche emergencies!

Dive into a thrilling tale of survival during a backcountry hut trip in Colorado where a surprise medical crisis unfolds. Discover the harrowing diagnosis of high-altitude pulmonary edema and the emergency response that follows. The discussion highlights essential medications and tools required for remote expeditions. Learn about the crucial lessons on preparedness and how to navigate medical emergencies in the wild. This is a must-listen for anyone venturing into the great outdoors!

Explore how airway patency heavily influences survival rates for avalanche victims. The discussion delves into a meta-analysis revealing that many victims manage to keep their airways clear, despite being buried. Current safety technologies receive scrutiny for their effectiveness, highlighting the need for advancements. The importance of better incident reporting and ongoing research is emphasized, shedding light on critical factors that could enhance rescue efforts and survival outcomes.

Explore groundbreaking updates on spinal injury management in wilderness settings. The discussion emphasizes a goal-oriented approach for protecting spinal cords while maintaining neutral alignment. Discover the innovative lift and slide technique and learn about the vacuum mattress—an effective alternative to traditional backboards. Plus, dive into the open-access Wilderness Medical Society guidelines that are revolutionizing how we think about spinal immobilization!

In this discussion, Jason Albert, editor of The-High-Route.com and former Wild Snow editor, dives deep into the importance of avalanche airbags for backcountry enthusiasts. He argues that these backpacks should be standard gear, exploring their effectiveness in enhancing safety. The conversation also touches on the evolution of these safety devices, their impact on skiers' decision-making, and how advancements have made them more accessible. Listeners will gain insights into wilderness preparedness, the essentials of emergency kits, and the blend of adventure and safety in the backcountry.

Dive into the chilling physiology behind resuscitating avalanche victims. Understand how burial time and core temperature impact survival chances. Explore the stark realities of cardiac arrest from trauma versus hypoxia. Discover why CPR training is essential for outdoor enthusiasts and the intricate challenges of reviving those trapped under snow. Learn about the importance of assessing a victim's condition and the surprising role of potassium in treating severe hypothermia. Get ready for a complex yet crucial discussion on wilderness medicine!

In this engaging discussion, Michael Buchanan, a flight paramedic and founder of Mountain Medical Academy, delves into the nuances of caring for avalanche victims. He sheds light on essential first aid techniques, like effective airway clearance and CPR protocols specific to avalanche situations. The conversation emphasizes the critical role of psychological care for rescuers and survivors alike. Buchanan also shares valuable tips on survival gear and the significance of mental resilience in backcountry emergencies, ensuring outdoor enthusiasts are well-prepared.