This is the second episode of the three part series of the podcast dedicated to technical and communications aspects of managing the airways of COVID patients. In this episode we are breaking down the case of a particular difficult airway case published online by Chris Hicks earlier, and discovering that the approach is not all that different to the guiding principles, communications and checklists we would have used in the non-COVID related intubations.
What seems to trip us up is the process, precautions and PPE. Sticking to general principles and processes is the rule here but we have to be careful in how we’re communicating, and the specific terminology we’re using.
Bottom line, COVID or no COVID, best way to manage a difficult intubation is via the tried and tested emergency resuscitation procedures that have proven to be safe, effective, simple and familiar.
Do you agree? Comment below to join in on the conversation.
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Roger Harris is a senior staff specialist in the intensive care unit at the Royal North Shore hospital and the Sydney Adventist hospital (SAN). He is dual qualified in Emergency Medicine and Intensive Care. Roger is one of the co-founders of SMACC and Coda. He is passionate about education, his five children and especially his beautiful wife Georgie.
Jon is a Sydney-based Intensive Care Specialist with special interests and qualifications in medical education, simulation and debriefing. He likes to take simulation out of the Sim centre, running inter-professional scenarios in-situ in the Royal North Shore ICU. Jon is an organ donation specialist and lead trainer for the Organ and Tissue Authority Family Donation Conversation workshop. He has extensive experience with simulation training for difficult conversations. Jon is also an airway fanatic. He is the incoming President of the Safe Airway Society of Australia and New Zealand and runs the Critical Care Airway Management Course. He is also interested in patient safety and quality, and is a member of the Best Practice Working Group at Intensive Care NSW: part of the Agency for Clinical Innovation. He loves spending time with his family: Caroline, Thomas and Holly.
Christopher Hicks is an emergency physician and trauma team leader at St. Michael’s Hospital in Toronto, and Assistant Professor and Clinician-Educator in the Department of Medicine at the University of Toronto. He is an education research scientist at the Li Ka Shing Knowledge institute, and appointee to the International Centre for Surgical Safety, with a program of research that focuses on simulation-based psychological skills training, human factors and clinical logistics. He has innovated in several areas of resuscitation and psychological skills, including mental practice, stress inoculation training and the trauma black box program. In 2018, Chris co-created and chaired resusTO, an inter-professional simulation-based resuscitation conference in Toronto with international acclaim. In 2020, he co-founded Advanced Performance Healthcare Design, consulting with hospitals and industry using simulation to inform the design of systems, spaces and teams. Chris is an avid speaker and lecturer, staunch #FOAMed supporter, occasional runner and cyclist, fledgling boxer, semi-retired pianist, and proud father of three lunatic boys.
Adam Rehak is a consultant anaesthetist at Royal North Shore Hospital and the coordinator of anaesthesia and airway training at the Sydney Clinical Skills and Simulation Centre (SCSSC). Creator of the ATTAAC airway management course, instructor on the CCAM course, and executive member of the ANZCA Airway Management Special Interest Group, Adam has been heavily involved in multidisciplinary airway management teaching for more than 10 years.