Dr Dave Forster: A tough airway made easy
Welcome back! Apologies for being away for a few weeks. You may know that a large part of the FOAM community was attacked, hacked and disabled by malignant robots last month.
Thanks to Dr Mike Cadogan and his band of merry men we are now back online along with other awesome sites that fell victim to this pillaging ( KIDocs, St Emlyns, The RAGE podcast, etc).
In case you missed the podcast was still alive during the carnage over at the LITFL bunker… and I managed to record a little chat with my local hero and fellow Broome Doc – Dave Forster.
Dave is a man of many talents, he is a gadget guy = remote controlled airplanes etc. He is therefore a master of the Atari and fiberoptic bronchoscope! And many don’t know this – but if you download the free “Introduction to Bedside Ultrasound” textbook and check out the SUSSIT chapter – his is the really, really hairy chest used for still images. (And yes, he does routinely wear a Bon Jovi T-shirt to work… overdressed for Broome some might say 😉
What a man: sono-model and master of the airways. You can even follow him on Twitter after a few years of arm twisting he is on there @DavidFo00088350
In this podcast he outlines his approach to a really tough, “back to the wall” case where an airway needed to be placed in a really difficult scenario.
Sure there are some great technical pearls in here, but for me it is all about the team and how a confident, communicative leader can turn a shit storm into a sleigh ride.
Have a listen HERE. Then spend a moment thanking Mike Cadogan and his team for all this stuff that you, our fantastic audience, get for free. Without folk like Mike we would not have FOAM… and the Medical world would be a bigger, emptier and less safe place.
Casey
Superb case, chaps, with a fantastic outcome.
I’m not familiar with the early details of the case, but, in retrospect, do we think the CT scan on a patient with an obstructing airway was a worthwhile risk? Was there any scan result which could have made a significant difference to the management?
Lovely. They say that using adrenaline in your LA to pre-anaesthetise the marked-up neck gives a pretty clean field, and to use lots (expecting a pretty long incision). Not that I have done it – just what they say.
Sounds like the stuff of GP anaesthetic legend… An intensivist I have worked with sage advice with anticipated difficult airways was that “you don’t burn any bridges” with AFOI, meaning you can opt to back out, and reconsider your plan and options. Also there is a great AFOI app through ITunes (authored by members of the ANZCA airway SIG) which is a great overview and quick guide.
Thanks David
Yes I have that app from Pierre & mates
Will add a link to that for reference
Casey