FiremanMike
Just a dude
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Just curious what it's like in other parts of the country/world. When I speak of primary and secondary airway methods, I'm referring to what tools you grab first and then where do you go if your first method fails?
For me, my primary as of last year has been an intubrite MAC 3 with a bougie. I used to grab the MAC 4 first, but I've found that most airways can be visualized at least partially with a mac 3, and this allows me to choke up and hook my pinky around the jaw (of course pediatric patients would get smaller blades..). I've also made an effort to elevate the cot 30 degrees if possible before intubating, I find using gravity to help is wondrous. Some of you might wonder why I grab the bougie right away, and my answer is "why not". The bougie is about $6 more expensive than the stylet, but offers much more flexibility when encountering poor airway visibility.
My secondary airway method would be the king vision with a channeled blade (we also carry the unchannelled blade as an option, but it would be my third choice with no other mitigating factors). We were fortunate to purchase the king airway and an endless supply of blades and it really does do a supurb job, especially on obese patients. It is, of course, not an "end all, be all", and sometimes patient anatomy simply doesn't work right with the king/channeled, but it is definitely a great tool to have.
So, what says the masses?
**ETA - I use the bougie as a stylet, holding the tube back about 10" from the tip and pinching the bougie through the tube for manipulation.
For me, my primary as of last year has been an intubrite MAC 3 with a bougie. I used to grab the MAC 4 first, but I've found that most airways can be visualized at least partially with a mac 3, and this allows me to choke up and hook my pinky around the jaw (of course pediatric patients would get smaller blades..). I've also made an effort to elevate the cot 30 degrees if possible before intubating, I find using gravity to help is wondrous. Some of you might wonder why I grab the bougie right away, and my answer is "why not". The bougie is about $6 more expensive than the stylet, but offers much more flexibility when encountering poor airway visibility.
My secondary airway method would be the king vision with a channeled blade (we also carry the unchannelled blade as an option, but it would be my third choice with no other mitigating factors). We were fortunate to purchase the king airway and an endless supply of blades and it really does do a supurb job, especially on obese patients. It is, of course, not an "end all, be all", and sometimes patient anatomy simply doesn't work right with the king/channeled, but it is definitely a great tool to have.
So, what says the masses?
**ETA - I use the bougie as a stylet, holding the tube back about 10" from the tip and pinching the bougie through the tube for manipulation.
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