Thursday, April 8, 2010

Amazing video: Awake endotracheal intubation

Videos are priceless when trying to teach procedures. This amazing teaching video by Dr. Michael Bailin at Mass General demonstrates a novel way of anesthetizing the airway during an awake intubation.
  1. Inject 3 cc of lidocaine using a small butterfly needle through the cricothyroid membrane. This causes coughing, which spreads the lidocaine throughout the upper airway.
  2. Inject 5 cc of atomized lidocaine through the fiberoptic scope port to anesthetize the posterior oropharynx and vocal cords.
  3. Slide the endotracheal tube over the fiberoptic scope.
Seeing is believing.
Great video.




(The video really gets started around the 1:17 mark.)

Thanks to Dr. Demain Szyld (Simulation Education Fellow at Brigham and Women's Hospital) for letting me know about this crazy/amazing teaching video.
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2 comments:

  1. You think that's crazy, then check out:
    http://blog.emcrit.org/misc/awake-intub-video/

    scott
    emcrit blog & podcast

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  2. Hi Scott: Wow, that is indeed crazy! I thought our students practicing ABGs and phlebotomy on each other was extreme, but you are on a whole different league of your own. I like the use of glycopyrrolate to dry the mucosa. We don't have an atomizer unfortunately, but the rest of your numbing process would be great an adjunct to our Glidescope inspection for fishbone FBs in the lower posterior oropharynx. Thanks!

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