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Airways, like Martinis, are Best "Dry"
IC Cordes, Procedural Education Steven Carleton, MD PhD IC Cordes, Procedural Education Steven Carleton, MD PhD

Airways, like Martinis, are Best "Dry"

Have you ever looked down the blade of a laryngoscope and said to yourself, “Damn!  This airway is just too dry!”  I thought not.  Rather, we often look down the blade into a mucky swamp of secretions that drip from the pharyngeal walls like drool from a big, sloppy dog, and often obscure familiar landmarks and goop-up our optical and video adjuncts.  Is there no solution?  There is!  Let us review an illustrative case...

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Oxygen is Good, Methods for Delivery Often are Not
IC Cordes, Procedural Education Steven Carleton, MD PhD IC Cordes, Procedural Education Steven Carleton, MD PhD

Oxygen is Good, Methods for Delivery Often are Not

An elderly patient with steroid and oxygen dependent COPD, and NYHA Class IV CHF, presents with dyspnea.  The patient is alert but looks somewhat desperate, confused, and exhausted.  Exam reveals accessory muscle use, grunting expirations, poor air movement, and cool clammy skin.  The patient speaks in two-word phrases.  Attempts to improve the situation are made with Lasix, nebulizers, and non-invasive ventilatory support.  The patient cannot tolerate BiPAP due to anxiety.

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