Nicholas Chrimes In my head it’s a can’t intubate CAN ventilate treatment. Although the only time I used it I had a can ventilate to a degree, to a can just about ventilate full stop. Not a pleasant 7min

Al May Precisely. And if the ‘can ventilate’ situation has only been achieved through use of NMBA, sugammadex might precipitate a ‘can’t ventilate, can’t intubate’ situation.

Hans Huitink Nose Coloured Glasses - Stavros Prineas How would you know return to spontaneous ventilation has occurred while the patient has an intubating dose of roc on board?

Nicholas Chrimes Hans Huitink I think Hans is suggesting that SGX would reverse the intubating dose of roc and permit the possibility (at least) of the return of spontaneous breathing. But granted yes you might still have an obstructed airway to deal with.

Nicholas Chrimes Hans Huitink Nose Coloured Glasses - Stavros Prineas Tim Cook Nilesh Vasan After some thought here is the way out of this conundrum . ➡️Sugammadex is useful for reversing rocuroniun in a patient that can be ventilated but can’t be intubated , so the intention is to wake the patient up and consider a planned intubation .

Selvan Ramsamy Nicholas Chrimes Hans Huitink Tim Cook Nilesh Vasan You may be right; this looks like a granularity problem Airway scenarios vary widely in complexity and evolution SGX may be a bad idea some times/a good idea in others There may be features experts invoke to distinguish btw the two; it would seem garrulous to be absolute about it

Selvan Ramsamy Nicholas Chrimes Hans Huitink Nose Coloured Glasses - Stavros Prineas Tim Cook Nilesh Vasan After some thought I have decided not to jump into the ring of this bullfight.

I don’t know. but I am having fun imagining Nicholas Chrimes and Hans Huitink doing this together…

Nicholas Chrimes Nose Coloured Glasses - Stavros Prineas Hans Huitink Unfortunately, patients don’t always abide by the playbook & human factors are human factors, so it’s not that simple when humans are involved It’s easy in the cold light of day to simplify complications of airway management, one of the most stressful scenarios in medicine

bob funnekotter Nicholas Chrimes Hans Huitink Someone snapped a photo of us working through a difficult airway using this same professional hug technique.

Nicholas Chrimes Nose Coloured Glasses - Stavros Prineas Hans Huitink I would suggest you are unconsciously extremely competent, if that is your reductive viewpoint. Bravo. But don’t denigrate our profession because of it. (And pride comes before a fall esp in medicine )

#FOAMed airway management videos, interviews, webinars, lessons and innovations. #airwaymanagement Airway Management Academy Multimedia Library 🎥 vimeopro.com/airwaymanageme…

Hans Huitink Nino Chillemi Resus Pieces Yes , this it . You have just given us the answer to your first question on this thread .

Fearne Hill Nose Coloured Glasses - Stavros Prineas Hans Huitink I'm consciously extremely competent. I'm not suggesting we're not highly technically skilled. I'm saying that the appropriate decision making in an airway emergency is well defined. Most avoidable airway disasters arise from not adhering to these basic principles.

Dr Huw Nose Coloured Glasses - Stavros Prineas Hans Huitink Human factors are part of what prevent us adhering to the playbook but you'll be hard pushed to find an avoidable airway emergency where following the guidelines wouldn't have been the right thing to do. Airway crises are very sterotypical. It's the same issues over & over.

Hans Huitink Fearne Hill Nose Coloured Glasses - Stavros Prineas I'm not being drawn into this "what is an expert? nonsense. I'm just clarifying that in saying that the principles of airway management are straightforward, I'm not denying that airway operators are highly skilled.

Hans Huitink Fearne Hill Nose Coloured Glasses - Stavros Prineas However, if perceived expertise is used to justify not abiding by well established principles of airway management, that's dangerous. It's how 16 attempts at intubation occur and tubes get left in the oesophagus despite inadequate CO2 - "bc my expertise tells me I know better!"

Dr Huw Nicholas Chrimes Nose Coloured Glasses - Stavros Prineas Hans Huitink A strange take on things, Nick. If I was ever in any form of emergency, the very first person I would want to arrive both to resuscitate and keep me safe would be an anaesthetist.

Jay Dr Huw Nose Coloured Glasses - Stavros Prineas Hans Huitink Not sure what you think I've said that contradicts this. What I wouldn't want is someone who considers themselves so expert that the core principles of care don't apply to them. There's no room for this 'airway management is an art form' nonsense.

Nicholas Chrimes Jay Dr Huw Hans Huitink I agree with the 2nd statement; the 3rd statement doesn't follow from it and IMHO represents an immature/incomplete world view consistent with Nick's previous stated positions on this matter in a strangely persistent Dunning Kruger way. Open your mind Nick. Back to my tax return