Great explanation, of course if you suspect a potential difficult airway I rather secure it before surgery, even more if the conditions of the table are going to make even a normal airway difficult to secure.
Indeed. The video here aims at raising awareness, that the lack of attention to positioning for airway management on the shoulder table can lead to difficult ventilation and/or intubation even in patients with otherwise, uncomplicated airway. The video also demonstrate a quick, practical way of improving airway management. Of course, the same applies to all surgeries, etc - but shoulder table is notorious for this. Thank you for watching and your comment.
Just looking at the pts, you can realize that you have to modified the pots position if you want to have a safe intubation. Experience, great humility and attention. The surgeon MUST wait until the Anaesthesist has determined that it can proceed
Glad to see that except for the FI block, this is the exact SAB technique that I have used for years, and that I teach residents. I have found that typically propofol in slightly higher dose is all that is needed for positioning. Every patient gets 5L mask oxygen prior to and during the SAB. Our surgeons rarely take less than 20 minutes to get the patient positioned on the fracture table, prepped and draped. This is also the same basic technique I use for total hip replacement. It is good to have this in one's arsenal as it can be adapted for emergency C-section (except for the need to use an introducer and a pencil point needle, and a higher dose of isobaric bupivacaine).)
That would be a difficult intubation even with a video laryngoscope, in my opinion. Still gotta be able to get the video laryngoscope in the right position and have enough room to maneuver it
Yes, a number of times. I have witnessed even hypothermia occur, and/or mechanical ventilation had to be prolonged to protect the airway due to the excess (cold) fluid used during arthroscopic surgery. Thank you for watching.
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I see that the rush to start the surgery, even before finishing the anesthesia, is a universal problem
Anesthesia is a dangerous job, but gorgeous and exciting. But not everyone con do it
@@massimorunza4001 I agree!
This is what learning from the master really means.
Thanks for the lesson!! That helps me alot to figure out the ideal position, which make me always fail
Video laryngoscope should be standard of care these days. Also, intubation on a stretcher might be easier than dealing with a shoulder table.
I think that, in this case, the use of a video laryngoscope should be considered
Great explanation, of course if you suspect a potential difficult airway I rather secure it before surgery, even more if the conditions of the table are going to make even a normal airway difficult to secure.
Indeed. The video here aims at raising awareness, that the lack of attention to positioning for airway management on the shoulder table can lead to difficult ventilation and/or intubation even in patients with otherwise, uncomplicated airway. The video also demonstrate a quick, practical way of improving airway management. Of course, the same applies to all surgeries, etc - but shoulder table is notorious for this. Thank you for watching and your comment.
Very informative and well demonstrated...
Just looking at the pts, you can realize that you have to modified the pots position if you want to have a safe intubation.
Experience, great humility and attention. The surgeon MUST wait until the Anaesthesist has determined that it can proceed
Glad to see that except for the FI block, this is the exact SAB technique that I have used for years, and that I teach residents. I have found that typically propofol in slightly higher dose is all that is needed for positioning. Every patient gets 5L mask oxygen prior to and during the SAB. Our surgeons rarely take less than 20 minutes to get the patient positioned on the fracture table, prepped and draped. This is also the same basic technique I use for total hip replacement. It is good to have this in one's arsenal as it can be adapted for emergency C-section (except for the need to use an introducer and a pencil point needle, and a higher dose of isobaric bupivacaine).)
Excellent
Does this apply even for video laryungoscopy too?
Optimal positioning for intubation = optimal positioning, regardless of the equipment used to ventilate or intubate.
That would be a difficult intubation even with a video laryngoscope, in my opinion. Still gotta be able to get the video laryngoscope in the right position and have enough room to maneuver it
Ultimate explanation
What is your take on fluid extravasation. Have you ever seen that the airway is threaten by the fluid.
Thank you very much in anvance!
Yes, a number of times. I have witnessed even hypothermia occur, and/or mechanical ventilation had to be prolonged to protect the airway due to the excess (cold) fluid used during arthroscopic surgery. Thank you for watching.
Thanks for your help
You’re welcome! More videos coming soon!
Excellent and very useful!
Thank you.
Very good explanation and informative 👍👍
Glad you liked it
Thanks for the helpful advice.
Glad it was helpful!
Shall we intubate on trolley then shift to the shoulder table?
Magnifica idea!
Thanks
Welcome
*Laughs in my UK Anaesthetic room*, *Sips tea*
Tq
Welcome!
👍👍
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A 30 Sec concept …talks 5 min….very typical of western world ppl