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#FOAMEd Online Airway training Program – more Anatomy, blade technique and topicalisation by Dr Seth Trueger

Hi folks! This episode we cover:

  1. Laryngeal anatomy in detail
  2. laryngoscope blade technique and importance of tip positioning
  3. Real time effects of neck positioning on laryngeal view
  4. real time effects of laryngeal manipulation on view
  5. Airway topicalisation

DISCLAIMER AGAIN : This video and laryngoscopy is for educational purposes alone and any medical examination procedure of this invasive nature should only be performed by trained professionals. THis was performed in my own time at my house using privately purchased materials with no financial sponsorship from anyone. I had formally fasted for the examination and used local anaesthetic as described in the recording. Show note references :

  1. Airway Cam – Dr Levitan’s awesome website
  2. EMUPDATES – Dr Strayer’s awesome website

CHALLENGE LEARNING ACTIVITY : As part of the online airway training program, we present learning challenges to highlight or reinforce specific aspects of the episode topic. In this teaching session recording, Seth and I deliberately omitted an important aspect of airway topicalisation during our conversation.

  1. CAN YOU IDENTIFY THE OMISSION AND DESCRIBE HOW IT SHOULD BE DONE?
  2. FOR THE ADVANCED LEARNER, HOW WAS I ABLE TO PERFORM THE PROCEDURE AND ACHIEVE ADEQUATE IMAGING WITHOUT IT?
8 Comments Post a comment
  1. Thanks for the awesome post! Re: the omission – do you need to dry the mucous membranes of the airway first, to make the lignocaine more effective? Can be done using IV glycopyrolate? 2. – maybe you premedicated with some oral anticholinergic and dried with guaze swabs?

    October 28, 2012
    • Well done
      Got the first part right
      But not the second part !
      It’s all got to do with airway basics

      October 28, 2012
  2. Reblogged this on MEDEST.

    October 29, 2012
  3. Sean Marshall #

    My guess for the second part of your learning activity:
    I see a fair bit of saliva present in the camera view so I’m guessing you used healthy doses of lidocaine and swished,gargled and sprayed till you were well frozen without using a drying agent. As for visualization, you were careful not to let the lens of your video laryngoscope touch any secretions so the view stayed clear.

    November 2, 2012
    • hi Sean. thankyou for comment. Correct I did not use any drying agent which should be part of standard topicalisation plan. But I used very little lidocaine, 3 mls 1%. This demonstrates that the VL allows a gentler and less stimulating laryngoscopy for ME anyway. as for secretions, its a very basic airway rule applied here. its got nothing to do with the way I used the VL. its evident in the video.
      have a closer look and let me know if you figure it out. Historically, look at the images and photos of how the great pioneers of laryngoscopy did their examinations.

      AND LET ME REITERATE HERE. I DO NOT RECOMMEND ANYONE COPY WHAT I DID.

      November 2, 2012
      • Sean Marshall #

        Are you getting at the fact that you’re sitting upright, and that gravity in this position would keep secretions from pooling in the pharynx

        November 10, 2012
      • Yes! that is my experience

        November 10, 2012

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