Game-Changer Alert: Essential Insights into Updated Emergency Airway Guidelines

The European Society for Emergency Medicine have published a statement commenting on recent airway management guidelines from the Society of Critical Care Medicine. This document contains a lot of sense and could be a useful resource for Emergency Departments in developing their airway management processes
Chapters:
00:00 Introduction
01:38 Training
01:56 Checklists
02:07 Team Composition
03:28 Plan for Failure
03:50 Positioning
04:27 Nasogastric Tube
04:50 Preoxygenation
05:50 Apneic Oxygenation
06:11 Vasopressors
07:35 Drugs
11:25 Omissions from SCCM Guidelines
11:49 Videolaryngoscopsy
12:55 Bougie
13:09 Suction
13:30 End-Tidal CO2
13:45 Post-Intubation Care
14:13 Conclusion
References and Full Text Links
Hohenstein, C. et al. Emergency airway management: an EUSEM statement with regard to the guidelines of the Society of Critical Care Medicine. Eur. J. Emerg. Med. 2024;31: 83-85
www.ncbi.nlm.nih.gov/pmc/arti...
Acquisto, N. M. et al. Society of Critical Care Medicine Clinical Practice Guidelines for Rapid Sequence Intubation in the Critically Ill Adult Patient. Crit. Care Med. 2023;51:1411-1430
journals.lww.com/ccmjournal/f...
Evidence in favour of high dose [2mg/kg] rocuronium:
Morton, S., Spurgeon, Z., Ashworth, C., Samouelle, J. & Sherren, P. B. Cardiorespiratory consequences of attenuated fentanyl and augmented rocuronium dosing during protocolised prehospital emergency anaesthesia at a regional air ambulance service: a retrospective study. Scand. J. Trauma, Resusc. Emerg. Med. 2024;32:12
sjtrem.biomedcentral.com/arti...
Heier, T. & Caldwell, J. E. Rapid tracheal intubation with large-dose rocuronium: a probability-based approach. Anesthesia and analgesia 2000;90:175-179
journals.lww.com/anesthesia-a...
Hayes‐Bradley, C. & Tarrant, M. Rocuronium less than or equal to 1.5 mg/kg versus greater than 1.5 mg/kg and inadequate paralysis in prehospital and retrieval intubation: A retrospective study. Emerg. Med. Australas. 2022;34:892-897
onlinelibrary.wiley.com/doi/1...

[@nirdosh22]

Excellent summary on EAM. My current airway management practice coincides more with the EUSEM statement except for a few things i.e. vasopressors for hypotension. As you said, I think they should describe it more in terms of clinical circumstances.

[@jamesducanto4998]

First off, thank you for creating this review. This publication gives the best summary of what we consider the best practices in airway management for emergency use at the current time. As you pointed out, there are some simplifications, but these only give us an opportunity to discuss the fighter points of superior management of the critically ill patient.

[@CliffReid]

Absolutely! Thanks Jim 👍🏻

[@zyadsaeed6229]

Excellent summary - and I believe applies to most ICU patients as well