ETM Podcast Episode 13 – Scott Weingart & Andrew Perry – Approach to the surgical airway – Part 2

The last episode of the ETM Podcast (available here) with Bruce Paix generated a lot of comments on the blog and activity on Twitter.  Scott Weingart (from EMCrit) very politely asked for some air-time to make a few additional comments on the topic of surgical airways and we were more than happy to oblige.  Andrew managed to get Scott on the line for what I’m sure you’ll agree is a great addition to, or extension of the podcast with Bruce in which he and Andrew discuss the novice vs expert approach to this procedure with some great pearls on mindset and training, the rationale for his approach to cricothyroidotomy (which differs from Bruce’s), the utility of the bougie and a bunch of other practical tips.  Scott also tells us how he would approach a surgical airway in a paediatric patient.

These two episodes combined are an outstanding  #FOAMed resource and are perhaps one of the most comprehensive overviews of the hands-on, practical approach to emergency surgical airways available anywhere.

It’s also timely as since the last episode was posted, ANZCA has clarified their position in response to the Royal College of Anaesthetists UK statement on the subject of CICO and surgical airways, which you can read here.

Huge thanks again to Bruce Paix for his interview, huge thanks to Scott Weingart and of course thanks to Andrew Perry for recording these two excellent episodes.

 

 

 

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3 Comments on “ETM Podcast Episode 13 – Scott Weingart & Andrew Perry – Approach to the surgical airway – Part 2”

  1. Minh lecong

    Thanks Scott and Andrew!

    Great analogy about dogfighting

    The differences in opinion about one or two incisions , bougie vs not seem minor points

    When two experienced practitioners disagree on same point it usually means both are right

    Bruce argues for simplicity in gear and technique based on prehospital experience

    I tend to favour that view of the world

    But both argue for use of finger in the technique which helps avoid this happening

    http://casereports.bmj.com/content/2016/bcr-2016-214898.full

    The paediatric issue is still vaguely defined and perhaps it’s better to hear from a paediatric neck expert

  2. Andrew Perry

    Thanks for the feedback Minh. I think your assessment of the two experts’ view is spot on – in medicine there are often many ways to skin a cat (although one of Scott’s main points is that he believes critical high-stress and stakes procedures should be standardised in a manner that addresses all situations).

    I loved the case report you shared – very much a salutary lesson on ensuring you are in the right space!

    And finally I agree that the paediatric surgical airway issue is still ill-defined and I am trying to find a paediatric ENT surgeon and anaesthetist to give me their thoughts via a podcast!

  3. Domagoj Damjanovic

    Andy, Bruce, Scott, Minh, thanks to all of you for this great discussion. It very much fits into my own preparation for our department’s annual airway workshop, with special focus on peds airways this year. I am very curious about the conclusions to be drawn by then. If I do find something useful (esp an ENT surgeon’s views), I will try to capture it. Any specific questions? I ve got one for you: What do think about the role in airway ultrasound?

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