Application of Ultrasound in Airway Management

Hi everyone, I hope your week is going well. I have recently played with ultrasound more often at work and grow fond of it. The topic on airway is one of my favorites since we have to deal with this everyday. In addition, we had a lost airway case. This made me think what we…

What Does the Airway Assessment Really Tell You?

Every time you see a patient in preop, you do your routine airway assessments to predict whether patient has an easy or difficult airway. Have you ever asked yourself  what the assessments really tell you and why some patients would have difficult airways based on your Mallampati score, neck circumference mouth opening or the protruding teeth? It…

Tips with Glidescope

Some of the students asked me the tips with the glidescope for the anterior airway when I was in clinical the other day. I remember I had struggled with the glidescope for the anterior airway when I first started using it. I had to do some research online to figure out how to get the…

Cricoid Pressure – Friend or Foe?

This is another dogma I feel overdue for discussion. This is one practice that was instilled in our training when we were students: trauma/NPO non-compliant would get RSI with CP.    Cricoid pressure was originally described by Sellick with the patient in a head down, tilted to the left position back in 1960’s. It was claimed that…

Ditch the Needle, Teach the Knife Part II

Dr. Larson, a well-known anesthesiologist at Stanford once stated that an emergency cricothyrotomy is much quicker, easier, safer and more effective than any needle-based technique. I can state with confidence that there is no place in emergency airway management for needle-based attempts to establish ventilation. As you all can tell, I love airway topics as…

Should We Mask Ventilate Before Giving Muscle Relaxant?

Have you ever wondered whether we should mask ventilate before giving muscle relaxant? I know we were taught that we should attempt to mask ventilate first. But is this evidence based?  The answer is that this practice is really not evidence-based. There is a growing body of evidence suggesting that the NBD should be given…