I keep trying to remember (but paranoid I might forget) to talk directly to patient (same as when they might be awake), when they present with what seems to be GCS 3 especially when I am stressed/distracted by them being critically ill or injured

Airway teaching stuff

Universal VL

attribution https://t.co/aAA9C1TJk6 image BT363K

Lighten up Vader! Keep your laryngoscope hold fingertip light, low with inward elbow https://t.co/j4oKkmx5SR

cervical spine precautions in airway management https://t.co/SMToZ2do2R

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Too much force locks tissue in place and does not allow sweeping and clearing for view or tube delivery space. Force applied in the wrong direction and spot will not improve things no matter how much strength is used and only serves to traumatize airway and panic operator.

Less force and strength is required so the intubator's hand does not fatigue. Also only moving a few pounds of tongue and soft tissue. Light exploratory force allows one to find sweet spot, see how tissue responds. Is a technique of millimeters and degrees of gentle exploration.

Start with light fingertip laryngoscopy, holding VL or DL SG or HA blade with a choked up grip and just deploy whatever blade length is needed. More precision to blade tip movement with your fingertips holding base of blade versus being high up on handle.

@TBayEDguy @dasairway Occasional intubators also sadly intubate the oesophagus too often - I recently reviewed a paper describing occasional intubators in a high resource setting, with a >10% oesophageal intubation rate (many unrecognised).

@TBayEDguy @dasairway I’ll gently push back VL is an intrinsically better technique It improves laryngeal view, first pass success, reduces failure, force, trauma and complications (26,000 patients in Cochrane r/v with another 20,000 waiting to be added) In Prekker’s DEVICE study this nice

@TBayEDguy @dasairway Anaesthetise Paralyse Put the head and neck in the sniffing position (flextension) Get a good view (middle of the middle) Slide a suitably small tube (6.0-6.5 mm ID for adults) along the blade into the trachea And along the trachea (which is correctly aligned by flextension)

Difficult Face Mask Ventilation! An excellent presentation by Dr Solomon White (WSOA) @WAMM2025 #WAMM2025 #DAS #DASRegistry

Kevin Fong as always, delivered a wonderful talk on AI. It always fascinates me the huge carbon footprint of a medium we just think comes out of our computers. Complex systems require people focussed solutions. #WAMM2025

@Admckdoc discussing the airway management in patients living with obesity: best practice recommendations from the Society for Obesity and Bariatric Anaesthesia https://t.co/KVbSAV6M0a #WAMM2025

7 key recommendations from SOBA - detailed airway Mx - preO2 in ramped, >30 degrees head up position (pref in theatre) - consider HFNO - Intubation in theatre on table - VL 1st line - prior to extubation, preoxygenation & adequate reversal of NMB - suitable equipment #WAMM2025

Some pearls of wisdom in the world of obstetric and airway anaesthesia from @noolslucas #WAMM2025

A great day yesterday at #WAMM2025 so much to learn. Dr Behringer on aspiration and GLP1 agonists. They aren’t going away.