4/Point being made : MAC VL gives you superior laryngeal views than DL and superior training can get the ETT into the trachea without an introducer / Stylet.

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Ellen O’Sullivan teases the content of the upcoming PUMA Extubation guidelines being launched at the Airway SIG Meeting 27th Aug. Followed by launch of the Foundation guideline at #SAS2026 on Aug 28th. Both in Noosa, QLD, Aust anzca.edu.au/events-and-cour… sas-sas2026-annual-meeting.e…

The old ( C&L Grade 1-4) works just fine . VL will not change the grading but does improve the accuracy of the grading because of the better laryngeal view .

Sciatic nerve blockade in the supine position is highly effective for trauma patients and others unable to tolerate leg repositioning. This video reviews lateral and anteromedial approaches to expand your regional anesthesia toolbox 💉🛠️ youtu.be/3pKka0aQKKo?si=T53h…

✔️If a tracheal tube is accidentally placed in the oesophagus, a capnogram is the gold standard to detect this and prevent hypoxia. ⛔️ The big universal 🌎 problem: on most medical monitors the ventilator pressure curves can look very similar to capnogram curves!! (See images 1 and 2) ⚠️This is a call to action for all capnograph device companies in the world to set shaded capnograph curve as default (Image 3). Open curves look like other measurements. People have died because of this (Image 4) Currently, on most monitors the default cannot be changed manually. We need a universal shaded curve for capnography to increase patient safety. If you care about patient safety: please #retweet and #share. @doctimcook @NaveenEipe @dasairway @wei_huafeng @cliffreid @altgm @ProfEllenO @SheilaMyatra @jducanto @NicholasChrimes @NightShiftMD @ProtectedAirway @EM_RESUS @emcrit @maffygirl @AnRocad @DaveOlvera1 @Philips @Masimo @Verathon @HamiltonMedical @storz_karl @MassGenBrigham @Siemens @Sony @Olympus_Corp @fisherpaykelAU @RUHAnaesthesia @oldandbaffled @PentaxMedical @SafeAirway @SaferSurgery @psmn999 #shadedcapnocurve #anaesthesia #patientsafety #criticalcare #ambulance

Wow! I am not sure I agree with the paranormal comparison here in this opinion piece by some very respected authors. As we are learning, there is some nuance to performing this block correctly, and it still fulfils many criteria that make it a plan A block. Interesting 🤔

Wordle 1,773 6/6* Almost lost my streak on hard mode ⬜⬜🟨🟨⬜ 🟩🟨⬜⬜⬜ 🟩⬜🟨⬜⬜ 🟩⬜🟨⬜🟩 🟩⬜🟩🟩🟩 🟩🟩🟩🟩🟩

If can be intubated using VL, it is not a can’t intubate scenario.

It's not really a myth else there wouldn't be an industry centered around bougies, stylets and introducers that get round the corner.

Yes but what do we then do for airway management….? We know the incidence of a non-empty stomach in all elective patients is around 5-6% (much higher in some series) But the incidence of aspiration is around 1 in 10,000 That’s 600-fold lower If we start doing RSIs or even intubating all these patients then there is a significant risk we’ll cause more harm. So I think identifying who has a full stomach is the easy bit. Working out who is actually at high risk or deciding what to do about it is the complex one! @kariem

Why no? For all the reasons I’ve reasons I’ve explained, imo,

Older surgical patients are at risk because of age-related physiologic decline and comorbidities. In a new article, Zhou et al. analyze the effectiveness of a widely used monitoring device in improving outcomes. Read the article: ow.ly/MsSn50Y5642

My comments regarding the new DAS2025 guidelines for management of the unanticipated difficult tracheal intubation. 📖 kwnsfk27.r.eu-west-1.awstrac… @BJAJournals @NicholasChrimes @NaveenEipe @dasairway @navarroguillej @dr_imranahmad @maffygirl @DaveOlvera1 @PedsAnesNet @NightShiftMD

No NTWP is….. Retired Defunct Gone Exited Done with Deleted Absent Obsolete …..It is no more. (Please read the editorial if that’s not clear)

Let me ask a question and offer some observations….. When we wrote NAP6 the evidence base for treating anaphylaxis to roc (or indeed to any drug) was pretty poor. See rcoa.ac.uk/sites/default/fil… Has that changed? The first drug to give in anaphylaxis is adrenaline (or you could use epinephrine if you’re in the USA😊😊) The other interesting and relevant finding was that anaesthetists over-estimate the proportion of cases of anaphylaxis by NMBs by about 40%. Ie that they identify NMB as the culprit 40% more often than it is found to be the culprit on testing (chlorhexidine is one culprit easily forgotten) Anaesthetists also over diagnose anaphylaxis as a cause of severe hypotension/ventilation difficulty…classically in cases of oesophageal intubation) #NAP7 See rcoa.ac.uk/sites/default/fil…

You cannot FMV during laryngoscopy attempts; so FMV in plan A refers to between laryngoscopy attempts

Medicolegal issues with AI: If you include AI in your care of the patient, then you are obliged to let them know when seeking consent. This includes if their data goes to a third party for data processing.

I guess the trouble with a definition like that is that it it’s entirely open to interpretation So let’s break it down…. Is 95% most of the glottis? YES Is 80% most of the glottis? YES Is 63% most of the glottis? YES etc etc until Is 50% most….NO! So we end up having to agree anything >50% = most of the glotts That’s the logical definition, and what they’ve written If asked ‘what % defines most of? I doubt you’ll get agreement on 95%, 80%, 63% etc So I think technically it has to fall at 50% However the kicker is that when C&L describe grade 2 they start with talk of the posterior larynx. Grade 1 vs 2 has to have a cut off….one side grade 1 vs other side grade 2 Logically and technically this has to be 50% (unless the logic is that everything from 100% to at 10% is grade 1 with grade 2 only kicking in at POGO 20%….. which makes no sense because 20% most certainly isn’t most) Even I don’t say that The only attentive is POGO say 808 to 20% is a C&L wilderness, an ungraded no man’s land! So logically and technically >50% grade 1 <50% grade 2 @VirtueOfNothing

No See my other tweets… At the moment I think your proposal seems to be Grade 1 = all re cords Grade 2 = none of the cords That leaves an ungraded vacuum in the middle…… And C&L grade is always the BEST view you can get so whether you’re moving the head or applying pressure is not relevant

Nope