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- Oct 3, 2003
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I have an Airway rotation comming up. We stress Fiberoptic use but do you guys have any rec's on other techniques which I should become familiar with?
Things which I will do:
Oral Fiberoptic awake and asleep
Fast-trach LMA
Light Wand
That shikani optical stylette gizmo
Things I wanna do:
Intubate through a standard LMA with small tube or with a bougie.
Blind nasal's
Nasal FOI's (risk of epistaxis will limit any/all elective nasal intubations I assume)
Retrograde (muhahaha)
Jet ventilate (maybe if I snag a cadaver...)
Off the above subject, a question for you all:
For the "awake fiberoptic," the point is its more difficult to cause serious harm to an awake spontaneously ventilating than an asleep patient (even one who is spontanously ventilating). Well, if we do the standard series of airway blocks: glossopharyngeal, recurrent laryngeal, and superior laryngeal, along with oral topicalization, and we keep the guy awake and he vomits what did we really do for him? How did all that prep work help?
Now the guy is going to aspirate all that stuff through his "reflex-less" airway and it is now going to be an emergency intubation.
When chosing fiberoptic how do YOU choose between awake n' numbed up, vs asleep n' paralyzed, vs taking a look while asleep and still ventilating, etc?
Things which I will do:
Oral Fiberoptic awake and asleep
Fast-trach LMA
Light Wand
That shikani optical stylette gizmo
Things I wanna do:
Intubate through a standard LMA with small tube or with a bougie.
Blind nasal's
Nasal FOI's (risk of epistaxis will limit any/all elective nasal intubations I assume)
Retrograde (muhahaha)
Jet ventilate (maybe if I snag a cadaver...)
Off the above subject, a question for you all:
For the "awake fiberoptic," the point is its more difficult to cause serious harm to an awake spontaneously ventilating than an asleep patient (even one who is spontanously ventilating). Well, if we do the standard series of airway blocks: glossopharyngeal, recurrent laryngeal, and superior laryngeal, along with oral topicalization, and we keep the guy awake and he vomits what did we really do for him? How did all that prep work help?
Now the guy is going to aspirate all that stuff through his "reflex-less" airway and it is now going to be an emergency intubation.
When chosing fiberoptic how do YOU choose between awake n' numbed up, vs asleep n' paralyzed, vs taking a look while asleep and still ventilating, etc?