What size tube would you use for CICO?

Join us today at 1200 BST to discuss emergency cricothyroidotomy with @NicholasChrimes @dasairway @dr_imranahmad @rosshofmeyr @ketaminh! pic.twitter.com/HzCVmUuHWP

— Anaesthesia (@Anaes_Journal) May 2, 2017

Here is a link to the study #FOAMed that we will be discussing – please join in! #sizematters https://t.co/d8F9V4epRI https://t.co/Lutkta1FbL

— Anaesthesia (@Anaes_Journal) May 2, 2017

@elboghdadly @rosshofmeyr @ketaminh @dasairway The paper does acknowledge this, but I wouldn't change my airway trolley content o the basis of this paper

— Imran Ahmad (@dr_imranahmad) May 2, 2017

@elboghdadly @rosshofmeyr @ketaminh @dasairway Let me explain why..all scalpel crics are done with the next fully extended..so the measurements in the neutral position are not relevant

— Imran Ahmad (@dr_imranahmad) May 2, 2017

@dr_imranahmad @elboghdadly @rosshofmeyr @ketaminh @dasairway That is WRONG technique. Neutral puts the membrane in lax position. Do not extend the neck!

— Dr Tim Hardcastle (@vemadoc) May 2, 2017

This is new data #sizematters – does it need validating in any way or is this enough to change guidelines? https://t.co/d8F9V4epRI https://t.co/GpTwt7szDD

— Anaesthesia (@Anaes_Journal) May 2, 2017

Is there enough data here or does it need repeating with other methods/positions etc? #sizematters https://t.co/d8F9V4epRI https://t.co/Skyy1HmOrt

— Anaesthesia (@Anaes_Journal) May 2, 2017

@Wilkinsonjonny @Anaes_Journal Agree this the issue. Many elective PERCS & PERC assisted by ENT for difficult access wld suggest leeway for 6-7 is real.

— Ian McPhee (@iGas2) May 2, 2017

on size fits all? But should it be a smaller size??? #sizemattershttps://t.co/d8F9V4epRI https://t.co/yGJmEQ8ENV

— Anaesthesia (@Anaes_Journal) May 2, 2017

@Anaes_Journal @NicholasChrimes @ketaminh @Wilkinsonjonny Nice cric review by ENT:Fagan's FOAM textbook https://t.co/ctnsn1ZxYl #sizematters

— Ross Hofmeyr (@rosshofmeyr) May 2, 2017

@rosshofmeyr @Wilkinsonjonny @ketaminh @elboghdadly @dasairway @Anaes_Journal @airwaycam @AirwayApp We don't..but that's partly my point, we can't change practice solely on this paper in my opinion

— Imran Ahmad (@dr_imranahmad) May 2, 2017

@Chronotrope @rosshofmeyr @ketaminh @dr_imranahmad @elboghdadly @dasairway @Anaes_Journal Can achieve all your goals and still use a smaller ETT. I am still to be convinced that a bigger ETT is better #sizematters

— Journal Club (@STHJournalClub) May 2, 2017

@ketaminh @elboghdadly @rosshofmeyr @dasairway @Anaes_Journal Nothing wrong with a smaller tube, but in that situation at that time we shouldn't be deciding on tube size..and that's my fear..

— Imran Ahmad (@dr_imranahmad) May 2, 2017

@ketaminh @Wilkinsonjonny @elboghdadly @rosshofmeyr @dasairway @Anaes_Journal @airwaycam Consistency and standardisation is the key to this procedure..let's stick to one technique, one tube size and standard kit

— Imran Ahmad (@dr_imranahmad) May 2, 2017

@ketaminh @dr_imranahmad @elboghdadly @dasairway @Anaes_Journal I routinely ventilate adult ENT patients through 4.0 or 5.0 MLTs without much difficulty, so I'm not against the idea for CICO

— Ross Hofmeyr (@rosshofmeyr) May 2, 2017

@dr_imranahmad @ketaminh @Wilkinsonjonny @elboghdadly @dasairway @Anaes_Journal @airwaycam Indeed…but we should be thoughtful in deciding what the standard should be. This study makes me reconsider whether it should be 5 or 6 mm

— Ross Hofmeyr (@rosshofmeyr) May 2, 2017

SO – are you going to change then? #sizematters https://t.co/d8F9V3WOt8 https://t.co/N6pmM9ep2J

— Anaesthesia (@Anaes_Journal) May 2, 2017