Tasty Morsels of EM 011

5 Jul

I keep a little, ever-expanding note on my phone where I jot down little morsels of goodness that I pick up while listening to or reading one of the many excellent sites/podcasts in the useful resource section.

I’ll try and transfer them here for your enlightenment.

From issue #3 of Emergency Physicians International. If you haven’t seen this yet then sign up and see it. There’s some great stuff there.

There’s an article from the High King and Emperor of airway management (did i get the title right?) – Rich Levitan.

Know your dominant eye

  • when looking down the laryngoscope blade you don’t want to be squinting to work out which eye is the best to look with
  • to work this out – hold larygoscope as normal with an object in line with the tip. Close an eye, if the object in view is in the same position then the open eye is the dominant one
Or if you prefer video here’s a guide. NB the comparison between archery and intubation should not be stretched too far.

[youtube http://www.youtube.com/watch?v=sncwpYapswk?rel=0&w=560&h=349]

  • ear to sternal notch is the best postion (as opposed to the classic sniffing the morning air). This often requires a pillow, something compulsory in the OT but seems to go out the window when someone is being intubated in the ED
  • raise the head of bed to help positioning. This can be reverse trendelenburg for immobilised trauma pts. This was something we did in the ICU in NZ all the time, partly for comfort for both us and patient but also with a hope to reduce reflux and aspiration

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