Mechanical CPR: Three CHEERS or a big thumbs down?

Originally posted on AmboFOAM:

There has been a fair bit about mechanical CPR devices floating around the FOAMasphere lately, so I thought I should probably do a post.

These devices are not exactly new (check out the Thumper, in use in Victoria in the 70s) However, there seems to be a surge in interest in these devices, and I must say there seems to me to have been a largely positive buzz about them in spite of the evidence for their effectiveness being somewhat lacking to say the least.

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Filed under: Uncategorized

Delayed Sequence Intubation: A Prospective Observational Study


Congratulations to Scott Weingart and co-authors for publishing an observational study on delayed sequence intubation!

This is truly a great example of innovation, introduced to world via FOAMEd/Social media networks, that has been formally studied and peer reviewed in a publication.

This is the highest quality FOAMEd, in my opinion. When content authors not only produce great FOAMEd, but also produce traditional peer reviewed material.

Kudos to Scott D. Weingart, MD, Seth Trueger, MD, Nelson Wong, MD, Joseph Scofi, MD, Neil Singh, MD, Soren S. Rudolph, MD

Here is the abstract ( ok its not true FOAMEd but hey everything in life isnt totally free!)

Delayed Sequence Intubation: A Prospective Observational Study

I expect to record a podcast with Scott and Seth on their paper!

Filed under: airway, Emergency anaesthesia, Emergency medicine and critical care, Online critical airway training Tagged: DSI, observational, study

Preferred position?

hey folks!

Doing my weekly reading and came across an interesting article on airway positioning.

here it is !

Age and Gender Are Important Considerations in Choosing the Sniffing Position for Laryngoscopic View

That then lead me to find this article..

Airway management and patient positioning : a clinical perspective


And finally like all things I compare for airway, I go back to a great teacher..

Ear to sternal notch positioning


Take home points :

  1. Sniffing position is 3 elements – lower neck flexion, upper neck extension & atlanto-occipital joint extension
  2. “”Win with the chin” is a more useful aide memoire to good sniffing position for airway management
  3. The Ramped position or Ear to Sternal notch is superior for obese patients
  4. a 7cm hard head rest is used in most airway studies to provide “sniffing position” conditions. Dont think a soft pillow is good enough!
  5. Young males <50yo are more likely to benefit from the “sniffing position” vs females or those >50yo who may benefit more from ear to sternal notch position
  6. Face plane parallel to ceiling or tilted with atlanto-occipital extension ( sniffing position) will be optimal depending on the patient anatomy/habitus. Maximal chin extension will afford greater mouth opening/jaw movement but may make laryngeal visualisation with DL more difficult.
  7. Position is everything

Filed under: airway, Emergency anaesthesia, FOAMEd, Online critical airway training Tagged: airway, positioning

PHARM PODCAST 106 : Prehospital airway


Image from Twitter. No financial disclosures

Image from Twitter. No financial disclosures

Hi Folks

On today’s show, I deliver Part one of a Two part podcast on Prehospital Airway.

Show note references:

  1. Courtesy of Dr Nicholas Chrimes at

Register for SMACC please!


Now, onto the PODCAST!


Click and Choose Save-as to Download the


Filed under: airway, Emergency medicine and critical care, FOAMEd, Interviews of interesting people, Online critical airway training, prehospital and retrieval medicine podcast, Prehospital medicine Tagged: airway, itunes, prehospital

Auckland HEMS prehospital blood transfusion – coming soon to a helicopter near you

Originally posted on Auckland HEMS:

Bloody hell.

Pretty much summarizes the severe traumas that define the essence of our trade.

And sometimes, the answer to critical bleeding is to give blood.

We are grateful to our colleagues at Sydney HEMS, who advise: “blood is provided to transfuse patients with life-threatening bleeding after meticulous attention to hemorrhage control.”

Auckland HEMS is poised to begin providing prehospital blood as part of our bundle of critical clinical interventions. We are fortunate to collaborate with the New Zealand Blood Service and with our local District Health Board to provide this service.

Herein, please find our training video. We welcome your feedback.

Our draft Blood SOP is undergoing usability testing with our clinical teams. Once finalized, we will share this for FOAM.

This is an unsystematic review of the current literature. A few themes are emerging:

1. There is now evidence of survival benefit in the military and in…

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Photo courtesy of Dr Nicholas Chrimes

Photo courtesy of Dr Nicholas Chrimes

Have you ever wondered if NODESAT could be improved?

It Can!

Published in Journal of Emergency Medicine this month, this article!

A Dual-Use Laryngoscope to Facilitate Apneic Oxygenation


The cover picture is of an improvised laryngoscope with oxygen tubing that my mate Dr Nicholas Chrimes tweeted a year ago. It remarkably looks very similar to the device described in this article now!

So having nasal cannulae at 15 L/min as well as a laryngoscope with oxygen source at 6-8L/min flow, may well be the ultimate apnoeic oxygenation setup for intubation!

Filed under: airway, Emergency anaesthesia, Emergency medicine and critical care, Online critical airway training Tagged: apnoeic, laryngoscope, oxygenation