The Difficult Airway with Colin McCloskey
The Difficult Airway with Colin McCloskey
Jan. 1, 2022
It's the EM resident's responsibility to learn and perfect the basics of the airway - including those difficult cases. On this episode of EMRA*Cast, host Matt Dillon, MD, shares insight and 4 key lessons from Colin McCloskey, MD, board-certified in both anesthesiology critical care medicine and emergency medicine.
Host
Matt Dillon, MD
ChristianaCare EM/IM, PGY-4
Twitter: @mdmd_8889
EMRA*Cast Episodes
Guest
Colin McCloskey, MD
Emergency Medicine and Anesthesiology Critical Care Medicine, University Hospitals Cleveland
Assistant Professor, Anesthesia and Perioperative Medicine, CWRU School of Medicine
@CgMack31
It's the EM resident's responsibility to learn and perfect the basics of the airway - including those difficult cases. On this episode of EMRA*Cast, host Matt Dillon, MD, shares insight and 4 key lessons from Colin McCloskey, MD, board-certified in both anesthesiology critical care medicine and emergency medicine.
OVERVIEW
On this episode of EMRA*Cast, host Matt Dillon, MD, picks up tips from Colin McCloskey, MD, about managing the difficult airway. Dr. McCloskey is board-certified in both anesthesiology critical care medicine and emergency medicine and splits his time 50/50 between the two departments.
It's the resident's responsibility to learn the basics of the airway, which includes equipment, medications, and indications. But what's the next step? How can you be best prepared for the unexpected? We cover 4 key lessons in this episode that you can implement on your very next shift. We’re also going to walk you through a few cases to help solidify these lessons. Enjoy!
TAKE-HOME POINTS
Lesson 1: Resuscitate before you intubate.
You often have more time than you think before you truly need to secure a definitive airway. Avoid that peri-intubation arrest by starting the appropriate combination of crystalloid, blood, and pressors.
Lesson 2: Prepare your kit.
There's nothing worse than needing a piece of equipment, only to realize you don't have it on hand. Try to keep your airway equipment stocked in a regimented fashion
Lesson 3: Verbalize your plan.
Whatever airway algorithm you subscribe to, say it out loud! Don’t be afraid to say the "cric" word. Make sure the whole team is on the same page about what is going to happen when stuff hits the proverbial fan.
Lesson 4: Anticipate the post-intubation problems.
This includes vent settings, sedation, and analgesia. These things are often forgotten in the celebration of securing an airway, but they are just as important!
References
- Nickson C. Difficult Airway Algorithms. Life in the Fast Lane. Published Nov. 3, 2020.
- Wang HE, Schmicker RH, Daya MR, et al. Effect of a Strategy of Initial Laryngeal Tube Insertion vs Endotracheal Intubation on 72-Hour Survival in Adults With Out-of-Hospital Cardiac Arrest: A Randomized Clinical Trial. JAMA. 2018;320(8):769-778.
