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More than You Ever Wanted to Know About Extra Glottic Devices
Our good friend Jim DuCanto visited us earlier this year. We spent several days sharing knowledge and perspectives.
Part of our time together was spent recording this podcast. It has been simmering and is finally available for listening. Within, we briefly go through the history of the extra-glottic device (EGD) in general, and then, we talk about the Laryngeal Mask Airway (LMA) and its “descendants” in great detail.
Jim really had a tremendous wealth of knowledge to share…
"Video Laryngoscopy" Needs to Die
Let the record show, this is not a debate for or against the use of video cameras on laryngoscopes. It’s not really a debate at all. It’s a plea. An honest plea…
The “DL vs. VL” debate has been had. It will continue to be had as our research evolves and our tools evolve (and we will participate). But, I beg of us as a community to pause and collectively consider a point of order: our discussion and debate, and worse our education of novice critical care providers, and even worse our research, is becoming marred by the fact that we aren’t all speaking the same language. We often throw around terms without RIGOROUS attention to detail.
Nobody Expects the Spanish Inquisition! (or, for that matter, the Cormak-Lehane Grade 4 Laryngoscopic View!)
A 68 year-old man presents by squad with shortness of breath. He is noted to have a nearly quiet chest with very poor air movement, to be using accessory respiratory muscles, and to be slightly lethargic. Quick perusal of old records discloses a history of severe COPD, steroid and O2 dependence, HTN and ulcer disease. The squad reports that his O2 sat was 86% at the scene, improving to 92% on a NRBM and two nebs.
His vitals are: p 138, r 22 and labored, bp 156/96, O2 sat 92% on a high-flow NRBM. His POC renal returns with a pCO2 of 88. His estimated weight is about 175 lbs.
A decision is made to intubate.