A NEXTGEN LEARNING SPACE DESIGNED TO ELEVATE YOUR AIRWAY PRACTICE
START HERE 👆
Easter egg; bagpipes? Find out why here 🥚
what you’ll find here
- The most important laryngoscopy concept to improve FPS
- Learn the incremental approach of progressive laryngoscopy
- Set of laryngoscopy microskills
- Self-practice & guided audio tools
- Integrated hands on training ✋
rapid review to Dive Deep 🤿
This space is organized to bring you the most rapid and essential knowledge first. After that, go ahead and customize your learning by exploring what’s important to you in the content below. Look for the ✋emoji for learning that has an associated hands on component for in person learners.
Don’t make this mistake
Don’t plunge and pray or overshoot your anatomic landmarks in a search for the cords as demonstrated in this video by AOD. (another great FOAMed resource to help you build your learning network).
Instead learn progressive laryngoscopy
The most important first step in mastering laryngoscopy is to have the right approach. If you do this instead of the typical “plunge & pray technique in a desperate search for the cords you will immediately increase your first pass success rate.
why are we teaching this approach?
In this foundational learning space we want to give you an all purpose skillset. We chose VL with a hyperangulated blade. We know some may disagree with us (and that’s okay) but we think if you’re going to learn one approach to laryngoscopy in the age of VL you should master this one first. It has universal applicability, especially for beginners and infrequent intubators, and is excellent as a go to foundation that you can expand on. (We have no conflict of interest or financial connection with the makers of Glidescope)
Here is a great thread about this choice. @JohnCSakles is another great airway educator to add to your learning network.
Rapid review of HAvl with glidescope
Just need a quick refresher? Here it is in less than 60 seconds. Then head to the deep dive below. ✋
full procedure video
The full video of the steps of progressive laryngoscopy using a video laryngoscope with a hyperangulated blade ✋
Microskills – from opening the mouth to tube delivery
There are three steps of laryngoscopy
Within each of these are a set of microskills or “gestures” that require mastery. The collection below highlights many of those important gestures so that you can practice them in our hands on stations.
Key Gestures 🤙
Hold it! Hold it right…
Holding the laryngoscope lightly at the base of handle will allow you to place the blade in the mouth without overriding the important anatomic landmarks. ✋
A great explanation by @Aimeairway
Key Gestures 🤙
The most important gesture in laryngeal exposure is seating the blade in the vallecula and engaging the hyo-epiglottic ligament. ✋
A real life example of what usually occurs when you perform this maneuver. On a mannequin it’s not as dramatic, but you should still practice it at one of our hands on training labs in this space. .
After valleculosopy, External Laryngeal Manipulation (ELM) is the second of the critical skills for laryngeal exposure that you should have in your toolkit. Simply place your free hand on the larynx and apply gentle downward pressure. Move left or right until you get your best view. ✋
Key Gestures 🤙
Your ability to deliver the tube depends a great deal on how you shape that stylet. ✋
thumbs up – Tube Delivery
The glidescope has a hyper-angulated blade which gives you better views but requires the use of a rigid stylet for delivery. In order to safely pass the tube you need to withdraw the stylet. Best done by using the thumb. ✋
Use care when removing a rigid stylet from your tube. Lock your tube to the laryngoscope handle with your thumb, reverse your grip and pull it out like a scimitar from its sheath. ✋
A review of three important microskills in your toolbox for tube delivery by @Aimeairway Dr Kovacs – another great airway FOAMed resource to add to your network
Great Moments in PAC history
thumbs up – Tube Delivery
One our favorite moments from PAC20. Tube delivery, Hawaiian Style 🏄♂️🌈 🤙 with Jim DuCanto MD @jducanto
Don’t lose that tube!!!
After tube delivery you need to safely remove the stylet without bringing the tube with it! Here is a great tip by Jose Torres MD Another great FOAMEducator. ✋
How helpful are these difficult airway predictor mnemonics?
Can you predict a difficult airway?
the bottom line
- Don’t plunge & pray!
- Use a methodical and progressive laryngoscopy technique
- Find your landmarks (epiglottoscopy)
- Expose the larynx (valleculoscopy)
- Deliver the tube
- Learn the optimization techniques within each of these space to improve your intubation success
Training labs, coaching, simulations!!
For in person events look for the✋emoji next to content in this space, and seek out all the training labs, expert coaching, and simulation challenges to help you master essential concepts and skills.
No one is better at teaching this progressive laryngoscopy technique than @TBayEDguy Yen Chow. Build your learning network and follow him on Twitter for regular hits of great airway learning.
One of the great FOAMED talks on the progressive laryngoscopy apprroach by @AIMEairway
For in person learners, locate any of the posters below within the installation to continue your training. Then snap the QR codes embedded within them to access the learning space. Look for the ✋emoji for integrated hands on training opportunities.
when you can’t be with us – Online learning
When you can’t be with us in person, you can still access all the same content on this topic. Simply click on the masterclass link below to take you to the online masterclass learning space.