Jim trains firefighter paramedics in airway management using Oxylator and McGrath video laryngoscope
Hi folks, this video from Jim DuCanto is a good demonstration of teaching airway skills to novices using two novel devices. The use of the Oxylator encourages and promotes excellent two handed mask application and jaw thrust. The audible clicking of the Oxylator when there is airway obstruction is an ideal guide to novices as to when their technique is suboptimal. The McGrath video laryngoscope is used to allow teaching of direct laryngoscopy as well as indirect intubation technique. Nice
Apologies as the audio quality is not good but the video footage is excellent and shows the techniques well.
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9 thoughts on “Oxylator and McGrath Video intubation in firefighter training”
Wonderful training! I only wish our program had this level of support when we were learning airway management.
Very impressed with the Oxylator after these last few videos.
Brilliant, nice demonstration of stable vital signs while performing direct and video laryngoscopy as well. I would love to hear more about the device and how practical it can be. What do you think about using the black mask holder in the emergency department?
Jim & Minh, Loved the oxylator during my trial of the device. I have ventilators at every bedside in my EDICU, so I don\’t need it. If I was not in this scenario, I would buy my own oxylator.
One concern, the oxylator during CPR will only put breaths in during the up-phase of the compression. This is the exact opposite of when we would want a breath giving to allow heart filling.
thanks Scott for comments
This small pig study, cited in the show notes for the Oxylator supercharge your oxygenation podcast, seems to indicate the opposite of your concerns. Better coronary perfusion and peak aortic systolic pressure and God Forbid, even better carotid artery flow, compared with manual ventilation.
Sorry here is the study link
Click to access the-abstract-ccs-2008.pdf
if you delve in to how they set the oxylator in that study, they are essentially using the oxylator as an apenic oxygenation device. A pop-off setting of 12 cm H20 is giving a negligible amount of non-deadspace tidal volume. I have consistently thought that the ultimate cpr oxygenation would be high flow cpap with an ITD and probably a NC. This is a similar concept but very different than trying to actually deliver true breaths with the oxylator. Jim, which way are you actually using the device during cpr.
actually belay part of that comment, they had it set to 12 mm Hg which is ~16 cm H20. So the question then is how much ventilation is actually going in in the brief period between compressions.
good point Scott. Looking at that pig study..oh pigs again! despite recorded ventilation rates of 90-100/min with the Oxylator, because of the fixed flow of 30L/min, there was better measured ETCO2 and reasonable PaO2 compared with manual ventilation at 6-8/min but with flow of >100L/min.
Scott, the Oxylator they used had a minimum pressure release setting of 20 cm H2O (the EMX model or the FR-300 model)–the Oxylator with the 15 cm H2O pressure release (the HD model) had not come out when they did that study. The Oxylator is being used in Automatic mode during this study, and I have used it in 2 cases of cardiac arrest myself—no interrruption of chest compressions at all, continuous ventilation. Dr. Dorian found results similar to the ITD with the Oxylator in his research with the two devices–he has yet to publish these results, thought.
In the two cardiac arrest cases in which I was involved using the Oxylator, one experienced ROSC, the other did not. The ROSC was detected on capnography before it was detected clinically on ECG or by checking pulse. This is because manual chest compressions disrupt the ECG signal, of course. I carry the EMMA capnometer, especially to assist in cardiac resuscitation–it fits right on the tracheal tube/SGA/facemask. http://www.phasein.se/products/emma-capnometer/
Yes, I did video those arrests–I can share them offline to show you how it all came together. I am considering publishing these two cases as a report, but am too busy right now.