Airway Management · Cervical Spine Injury · Traumatic Brain Injury

A Few Handy Resources on Airway Management

Patients with head- and neck injuries can have challenging airways. We often use videolaryngoscopes or flexible fibrescopes (single use scope) when performing intubation in such patients. Our colleagues in Copenhagen have put together a useful website with videos and other learning resources on that subject. They also arrange an annual  two-day airway course with a very extensive workshop. Read more… Continue reading A Few Handy Resources on Airway Management

Airway Management · Neurocritical Care · Neurotrauma · Traumatic Brain Injury

More Brain Impact Apnoea

Brain impact apnoea causes secondary brain injury.  The duration of the apnoea reflects the energy in the injury. We often see these patients in our trauma center as they come intubated. CT-scan can reveal structural brain damage or bleeding. In some pastients the CT-scan is “normal”. However, the brain may have suffered hypoxic injuries undetectable with… Continue reading More Brain Impact Apnoea

Airway Management · TBI General · Traumatic Brain Injury · Ventilation and Oxygenation

SJTREM: Physician Staffed EMS Associated With Improved Outcomes From TBI

In a recent article in the Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine by Pakkanen et al, retrospective data from a Finnish prehospital service is presented. They looked at prehospital management of severe TBI (severe head injury with GCS 8 or lower) over a 6-year period, including some 458 patients for analysis. They found a… Continue reading SJTREM: Physician Staffed EMS Associated With Improved Outcomes From TBI

Airway Management · Systemic Effects of CNS Pathology · TBI General · Ventilation and Oxygenation

Brain Impact Apnea

Immediate apnea after acute head trauma is a concept that has received renewed focus lately. BIA/IBA (Brain Impact Apnea or as some call it, Impact Brain Apnea) was described in animal models as far back as 1874 by Koch and Filehne (1). A number of subsequent studies (2-5) have established a clear link between severity of impact and duration of… Continue reading Brain Impact Apnea

Airway Management · Podcasts

Awake Intubation Lecture from SMACC

“Dry them out”; use glycopyrrolate (no central effects). How to use local anesthetics and more… emcrit.org  Listen to the podcast here. EMcrit recommend: Airway Regional Anesthesia for Awake Fiberoptic Intubation, Simmons et al, Regional Anesthesia and Pain Medicine 2002. Read the review article here. Fibreoptic vs videolaryngoscopic (C-MAC(®) D-BLADE) nasal awake intubation under local anesthesia. Kramer et al. Anaesthesia. 2015… Continue reading Awake Intubation Lecture from SMACC

Airway Management · Anaesthetic Agents · TBI General

Roc or Sux in RSI of TBI Patients?

Retrospective cohort study by Patanwala and colleagues including 233 head injured patients that required RSI with either rocuronium or suxamethonium. The results reveal that sux was associated with increased mortality in the most severely injured subset, compared with roc. In patients with less severe injury there was no significant difference between the two NMBs. Interesting… Continue reading Roc or Sux in RSI of TBI Patients?