PHARM Podcast 40 – Airway stuff with Dr Neill and Dr DuCanto
Dr Andy Neill Dr James DuCanto
Hi there folks!
Remember a few months ago there was that French paper on carotid blood flow interruption with LMA and Supraglottic cuffed airways in a pig model of cardiac arrest?
Scott Weingart recorded a podcast about it and got the lead author to make comments on this blog post
Are EXTRAGLOTTIC AIRWAY DEVICES HARMFUL IN CARDIAC ARREST?
Dr Andy Neill of the awesome EmergencyMedicineIreland blog site and Dr James DuCanto, the PHARM resident airway expert, got together to try to demonstrate that in a normal HUMAN patient, a cuffed LMA type extraglottic airway does not distort or obstruct carotid vessels appreciably.
They actually submitted a short paper for publication based on actual live MRI images of a patient with an AirQ device insitu.
Andy wrote a great article on his blog with the images as well as a draft of the original paper (Resuscitation journal published it as a much shortened letter to Editor). He also recorded some screencast video explaining the anatomy. Check it all out here!
WHY THE LMA IS PROBABLY SAFE IN CARDIAC ARREST!
We also discuss an airway topic that is current : Video laryngoscopy vs direct laryngoscopy!
Stay safe and enjoy the interview!
Minh
Now on to the Podcast
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Good combination of Aussie , Irish and an American . MR images from Andy’s blog are amazing. Just one question for Dr DuCanto , what patients group population did you study for MR images ? anesthetic patients ? or this study is just basically for research ? Well done guys ! . Much needed knowledge in airway world . Keep up your good jobs.
The patient was under General Anesthesia. It was an elective case, selected on the basis of my curiosity and my willingness to do something a little different, I.e. put a little Gadolineum into some saline and use it to inflate the cuff.
Thanks for your reply , Dr DuCanto .
Interesting talk gents, thank you. Jim, I hope you enjoyed your visit to my neck of the woods (Toronto). Minh, I look forward to your more comprehensive reply to Dr. Walls.
I am sitting on the fence right now whether VL should replace DL as the primary approach in the near future (at least for in hospital). I wonder if the answer is any different when considering a VL such as the McGrath Mac or the CMac. One could make the argument that with a Mac shaped VL the technique is similar enough to DL that a routine VL user could comfortably transition back to a standard mac laryngoscope in case of equipment issues.