{"id":5320,"date":"2011-07-17T20:15:18","date_gmt":"2011-07-17T20:15:18","guid":{"rendered":"http:\/\/crashtext.org\/misc\/emcrit-airway-curriculum.htm\/"},"modified":"2020-11-26T18:45:37","modified_gmt":"2020-11-26T23:45:37","slug":"emcrit-airway-curriculum","status":"publish","type":"post","link":"https:\/\/crashingpatient.com\/resuscitation\/airway\/emcrit-airway-curriculum.htm\/","title":{"rendered":"EMCrit Airway Curriculum"},"content":{"rendered":"

<\/span>How Many Tubes do Average ED Docs do and How Many do they Need to<\/span><\/h2>\n

Ann Emerg Med.<\/a><\/span> 2019 Jun 24. doi: 10.1016\/j.annemergmed.2019.04.025. [Epub ahead of print]<\/p>\n

 <\/p>\n

West J Emerg Med. 2019 Jul;20(4):601-609. doi: 10.5811\/westjem.2019.6.42946. Epub 2019 Jul 2.
\nSkill Proficiency is Predicted by Intubation Frequency of Emergency Medicine Attending Physicians.
\nGillett B1, Saloum D1, Aghera A1, Marshall JP1.
\nAuthor information<\/p>\n

1
\nMaimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York.<\/p>\n

Abstract
\nIntroduction:<\/p>\n

Airway management is a fundamental skill of emergency medicine (EM) practice, and suboptimal management leads to poor outcomes. Endotracheal intubation (ETI) is a procedure that is specifically taught in residency, but little is known how best to maintain proficiency in this skill throughout the practitioner’s career. The goal of this study was to identify how the frequency of intubation correlated with measured performance.
\nMethods:<\/p>\n

We assessed 44 emergency physicians for proficiency at ETI by direct laryngoscopy on a simulator. The electronic health record was then queried to obtain their average number of annual ETIs and the time since their last ETI, supervised and individually performed, over a two-year period. We evaluated the strength of correlation between these factors and assessment scores, and then conducted a receiver operator characteristic (ROC) curve analysis to identify factors that predicted proficient performance.
\nResults:<\/p>\n

The mean score was 81% (95% confidence interval, 76% – 86%). Scores correlated well with the mean number of ETIs performed annually and with the mean number supervised annually (r = 0.6, p = 0.001 for both). ROC curve analysis identified that physicians would obtain a proficient score if they had performed an average of at least three ETIs annually (sensitivity = 90%, specificity = 64%, AUC = 0.87, p = 0.001) or supervised an average of at least five ETIs annually (sensitivity = 90%, specificity = 59%, AUC = 0.81, p = 0.006) over the previous two years.
\nConclusion:<\/p>\n

Performing at least three or supervising at least five ETIs annually, averaged over a two-year period, predicted proficient performance on a simulation-based skills assessment. We advocate for proactive maintenance and enhancement of skills, particularly for those who infrequently perform this procedure.<\/p>\n

<\/span>Best Validated First Pass Success Rate<\/span><\/h2>\n

Systematic review and meta-analysis of first-pass success rates in emergency department intubation: Creating a benchmark for emergency airway careAuthorsFirst published: 27 October 2016Full publication historyDOI: 10.1111\/1742-6723.12704View\/save citationCited by: 0 articles<\/p>\n

<\/span>Ramp Position is Good for Everyone<\/span><\/h2>\n
\u00a0J Clin Anesth\u00a02012;24:104-8.<\/div>\n

<\/a><\/p>\n

<\/a><\/p>\n

<\/span>DAsH1A<\/span><\/h2>\n

Bill Hinckley elaborated our goal for airway management<\/p>\n

Definitive Aiway sine Hypoxemia on the 1st Attempt<\/strong><\/p>\n

<\/a><\/p>\n

<\/a><\/p>\n

<\/span>Airway Progression<\/span><\/h2>\n

 <\/p>\n

\"modified<\/a><\/p>\n

Validation study of the algorithm<\/a><\/p>\n

<\/a><\/p>\n

<\/a><\/p>\n

<\/span>Absorption Atelectasis during Preoxygenation<\/span><\/h2>\n

Even preox with 100% did not seem to affect FRC (J Anesth\u00a0DOI 10.1007\/s00540-012-1547-7)<\/p>\n

<\/a><\/p>\n

<\/a><\/p>\n

<\/span>Levitan\u2019s Complexity Article<\/span><\/h2>\n

Complexities of Tracheal Intubation (Ann Emerg Med 2011;57(3):240)<\/p>\n

<\/a><\/p>\n

<\/a><\/p>\n

<\/span>Formulation of a CICO Algorithm<\/span><\/h2>\n

From Heard in Australia<\/a><\/p>\n

<\/a><\/p>\n

<\/a><\/p>\n

<\/span>Each Attempt Makes Things Worse<\/span><\/h2>\n

Hasegawa et al. showed at 3 attempts, things got bad (Ann Emerg Med 2012;60:749)<\/p>\n

Sackles JC et al. showed that >1 attempt radically increased complications (ACADEMIC EMERGENCY MEDICINE 2013; 20:71\u201378)<\/p>\n

Mort demonstrated this in the ICU, after two attempts risk of crit desat (70%) is huge and assoc. with cardiopulm arrest (Anesth Analg 2004;99:607)<\/p>\n

Mort has further elaboration re: the dangers of intubation in the critically ill (J Inten Care Med 2007;22(4):208)<\/p>\n

Heffner et al. showed a 4% cardiac arrest rate in ED intubations (Incidence and factors associated with cardiac arrest complicating\u00a0emergency airway management. Resus 2013)<\/p>\n

Duggan showed >1 attempt<\/p>\n

 <\/p>\n

\u00a0<\/a><\/p>\n

 <\/p>\n

\"Duggan<\/a><\/p>\n

= badness<\/p>\n

<\/a><\/p>\n

<\/a><\/p>\n

<\/span>Cricothyrotomy<\/span><\/h2>\n

Prehospital Meta-analysis (Prehosp Emerg Care 2010;14:515)<\/p>\n

Surgical cric is sig. better!<\/p>\n

Can we find the membrane with a needle? Not so much (Anaesthesia, 2010, 65, pages 889\u2013894)<\/p>\n

Bougie-Aided Cricothyrotomy (Air Medical J 28(4):191<\/p>\n

 <\/p>\n

\u00a0<\/a><\/p>\n

 <\/p>\n

\"\"<\/p>\n

 <\/p>\n

 <\/p>\n

<\/h2>\n

<\/a><\/p>\n

<\/a><\/p>\n

<\/span>Need for Preoxygenation<\/span><\/h2>\n

If the saturation was 93% or less at the start, the patient is very likely to desaturate and the rapidity of desaturation is predicted by this initial starting sat (Davis PREHOSPITAL EMERGENCY CARE 2008;12:46\u201351)<\/p>\n

 <\/p>\n

<\/a><\/p>\n

<\/a><\/p>\n

<\/span>Tube Depth<\/span><\/h2>\n

Conclusion<\/strong> Less experienced clinicians should rely more on tube insertion depth than on auscultation to detect inadvertent endobronchial intubation. But even experienced physicians will benefit from inserting tubes to 20-21 cm in women and 22-23 cm in men, especially when high ambient noise precludes accurate auscultation (such as in emergency situations or helicopter transport). The highest sensitivity and specificity for ruling out endobronchial intubation, however, is achieved by combining tube depth, auscultation of the lungs, and observation of symmetrical chest movements. (BMJ 2010; 341:c5943 )<\/cite><\/p>\n

 <\/p>\n

then get a chest xray<\/cite><\/p>\n

 <\/p>\n

<\/a><\/p>\n

<\/a><\/p>\n

<\/span>Roc Vs. Sux<\/span><\/h2>\n

Same when dosed high (Academic Emergency Medicine Volume 18, Issue 1, pages 10-\u009614, January 2011)<\/p>\n

Ketamine-Fentanyl-Roc for prehospital intubations (Lyon. Critical Care 2015; 19:134. doi:10.1186\/s13054-015-0872-2<\/strong>)<\/p>\n

Better mortality with Roc in TBI? (PMID 26799349)<\/p>\n

<\/a><\/p>\n

<\/a><\/p>\n

<\/span>BVMs cannot be used for Spont Ventilation<\/span><\/h2>\n

They can so long as they don\u2019t have duckbill valves like Mercury Medical. (Fact or Fiction: the patient cannot spontaneously breathe via the bag valve mask apparatus. Arekapudi A., et al. SAM 2012)<\/p>\n

<\/a><\/p>\n

<\/a><\/p>\n

<\/span>Mask Ventilation<\/span><\/h2>\n

When rocuronium was adminsitered compared to placebo, mask ventilation got better (Anaesthesia, 2011, 66, pages 163\u0096167)<\/p>\n

You need two hands on the mask (One Hand, Two Hands, or No Hands)<\/a><\/p>\n

<\/a><\/p>\n

<\/a><\/p>\n

<\/span>Gastric Tubes<\/span><\/h2>\n

My practice is to place gastric tubes prior to intubating GI bleeders or alcoholics. The question is whether this decreases the esophageal sphincter opening pressure<\/p>\n

Answer is it doesn\u2019t (Gastroenterology 1976;70:301; Arch Surg 1978;113:721)<\/p>\n

 <\/p>\n

<\/a><\/p>\n

<\/a><\/p>\n

<\/span>Ketamine-Only Intubation<\/span><\/h2>\n

Emerg Med J 2011;28:521 71 Patients, 18 didn\u2019t get paralysis<\/p>\n

Injury 1997;28:41<\/p>\n

Am J Emerg Med 2007;25:977<\/p>\n

<\/a><\/p>\n

<\/a><\/p>\n

<\/span>Complications of the airway management of the critically Ill<\/span><\/h2>\n

Start worrying at 70%, pt may die below 60% (J Intensive Care Med 2007 22: 208 Mort)<\/p>\n

Hemodynamics (J Intensive Care Med 2007 22: 157)<\/p>\n

Complications rise at the 3 mor more attempt mark (Anesth Analg 2004;99:607\u009613)<\/p>\n

Tube passage attempts are worse than blade passage attempts<\/p>\n

Patients who start off on vasopressors have a high risk of peri-intubation codes (Anesthesiol 1995;82:367) and assoc of hypotension post-tube and death (J Crit Care. 2012 Aug;27(4):417)<\/p>\n

Most recent study shows a dismally high rate of complications in a French ICU (Early Identi\ufb01cation of Patients at Risk for Dif\ufb01cult Intubation in the Intensive Care Unit Am J Respir Crit Care Med. 2013 Apr 15;187(8):832-9)<\/p>\n

 <\/p>\n

<\/a><\/p>\n

<\/a><\/p>\n

<\/span>Prehospital Intubations<\/span><\/h2>\n

Resuscitation.<\/a> 2011 Apr;82(4):378-85. Epub 2011 Feb 1. Out-of-hospital airway management in the United States. Wang HE<\/a>, Mann NC<\/a>, Mears G<\/a>, Jacobson K<\/a>, Yealy DM<\/a>.<\/p>\n

<\/span>Source<\/span><\/h3>\n

Department of Emergency Medicine, University of Alabama at Birmingham, Birmingham, AL 35249, United States. hwang@uabmc.edu<\/p>\n

<\/span>Abstract<\/span><\/h3>\n

OBJECTIVE:<\/h4>\n

Prior studies describe airway management by single EMS agencies, regions or states. We sought to characterize out-of-hospital airway management interventions, outcomes and complications across the United States.<\/p>\n

METHODS:<\/h4>\n

Using the 2008 National Emergency Medical Services Information System (NEMSIS) Public-Release Data Set containing data from 16 states, we identified patients receiving advanced airway management, including endotracheal intubation (ETI), alternate airways (Combitube, Laryngeal Mask Airway (LMA), King LT, Esophageal-Obturator Airway (EOA)), and cricothyroidotomy (needle and open). We examined airway management success and complications in the full cohort and in key subsets (cardiac arrest, non-arrest medical, non-arrest injury, children<\/p>\n

RESULTS:<\/h4>\n

Among 4,383,768 EMS activations, there were 10,356 ETI, 2246 alternate airways, and 88 cricothyroidotomies. ETI success rates were: overall 6482\/8418 (77.0%; 95% CI: 76.1-77.9%), cardiac arrest 3494\/4482 (78.0%), non-arrest medical 616\/846 (72.8%), non-arrest injury 417\/505 (82.6%), children<\/p>\n

CONCLUSIONS:<\/h4>\n

In this study characterizing out-of-hospital airway management across the United States, we observed low out-of-hospital ETI success rates. These data may guide national efforts to improve the quality of out-of-hospital airway management.<\/p>\n

 <\/p>\n

and more likely to cause VAP (Eur J Emerg Med 2013;20:61)<\/p>\n

<\/a><\/p>\n

<\/a><\/p>\n

<\/span>Number of Tubes to be Competent<\/span><\/h2>\n

Probably close to 200 (Acta Anaesthesiol Scand 2012; 56: 164\u2013171)<\/p>\n

To plateau at 90% success rate took 57 in this study(Anesth Analg 1998;86:635)<\/p>\n

<\/a><\/p>\n

<\/a><\/p>\n

<\/span>Pulse Ox Lag<\/span><\/h2>\n

Latency of up to 120 s has been demonstrated in conditions producing peripheral vasoconstriction (doi:10.1016\/j.jemermed.2011.06.127)<\/p>\n

<\/a><\/p>\n

<\/a><\/p>\n

<\/span>Shock Dosing of Sedative Agents<\/span><\/h2>\n

No reduction to get same brain levels of etomidate, 50% for fentanyl, 80-90% for propofol (Anesthesio 2004;101:567)<\/p>\n

 <\/p>\n

\u00a0<\/a><\/p>\n

 <\/p>\n

\"\"<\/p>\n

<\/a><\/p>\n

<\/a><\/p>\n

<\/span>Predicting Obstructive Sleep Apnea (OSA)<\/span><\/h2>\n

STOP-Bang Score (Br J Anaes 2012;108(5):768)<\/p>\n

Advantages of an awake look using remifentanil (J Clin Anesthesia 2012;24:19)<\/p>\n

<\/a><\/p>\n

<\/a><\/p>\n

<\/span>A clarification on when the crit ill risk of sux kicks in<\/span><\/h2>\n

Anesth Analg. 2012 Jul 4. [Epub ahead of print] The Limits of Succinylcholine for Critically Ill Patients. Blani\u00e9 A<\/p>\n

~16 days<\/p>\n

<\/a><\/p>\n

<\/a><\/p>\n

<\/span>An Abstract demonstrating that with Some Bags\u2013No Spont Breathing<\/span><\/h2>\n

Abstract from SAM <\/a><\/p>\n

<\/a><\/p>\n

<\/a><\/p>\n

<\/span>Bougie Use for Trauma MILS Intubation<\/span><\/h2>\n

Less force required with the bougie (Eur J Anaesthesiol 2013; 30:1\u20134)<\/p>\n

<\/a><\/p>\n

<\/span>Bougie FPS<\/span><\/h2>\n

Ann Emer Med October 2017Volume 70, Issue 4, Pages 473\u2013478.e1<\/p>\n

<\/span><\/a>LMA will succeed when Mask and ETI Fail<\/span><\/h2>\n

Parmet et al studied this (Anesth Analg 1998;87:661)<\/p>\n

<\/a><\/p>\n

<\/a><\/p>\n

<\/span>Ultrasound for Difficult Neck Anatomy for Needle Cric<\/span><\/h2>\n

European Journal of Anaesthesiology: July 2011 \u2013 Volume 28 \u2013 Issue 7 \u2013 p 506\u2013510 doi: 10.1097\/EJA.0b013e328344b4e1<\/p>\n

<\/a><\/p>\n

<\/a><\/p>\n

<\/span>Higher Height of Table Improves Success<\/span><\/h2>\n

Xiphoid is the ideal height<\/p>\n

Higher operating tables provide better laryngeal views for tracheal intubation. (Br J Anaesth. 2013 Dec 18) Lee HC et al. and (Br. J. Anaesth <\/abbr>2014;112\u00a0(4):749-755.)<\/p>\n

<\/a><\/p>\n

<\/a><\/p>\n

<\/span>Scissor Maneuver<\/span><\/h2>\n

\"by<\/a><\/p>\n

<\/a><\/p>\n

<\/a><\/p>\n

<\/span>Intubating the Patient with Head Injury<\/span><\/h2>\n

A clinically significant hemodynamic response to laryngoscopy and intubation is common in patients with head injuries and is not effectively attenuated by increasing head injury severity. The need to attenuate the hemodynamic response should be assessed independently of head injury severity.\u00a0(J Trauma Acute Care Surg. 2013 Apr;74(4):1074)<\/p>\n

<\/a><\/p>\n

<\/a><\/p>\n

<\/span>Predicting Difficult Intubation<\/span><\/h2>\n

This issue was brilliantly summed up by Yentis in a 2002 Editorial2<\/sup>:<\/p>\n

\u201cI dare to suggest that attempting to predict difficult intubation is unlikely to be useful \u2013 does that mean one shouldn\u2019t do it at all? To this I say no, for there is another important benefit of this ritual: it forces the anaesthetist at least to think about the airway, and for this reason we should encourage our trainees (and ourselves) to continue doing it<\/em>.\u201d<\/p>\n

1. Diagnostic accuracy of anaesthesiologists\u2019 prediction of difficult airway management in daily clinical practice: a cohort study of 188 064 patients registered in the Danish Anaesthesia Database<\/strong>
\nAnaesthesia. 2014 Dec 16. doi: 10.1111\/anae.12955. [Epub ahead of print]<\/a><\/p>\n

2. Predicting difficult intubation\u2013worthwhile exercise or pointless ritual?<\/strong>
\nAnaesthesia. 2002 Feb;57(2):105-9<\/a><\/p>\n

3. Anaesthesia. 2015 Mar;70(3):272-81.
\nDiagnostic accuracy of anaesthesiologists’ prediction of difficult airway management in daily clinical practice: a cohort study of 188 064 patients registered in the Danish Anaesthesia Database.<\/p>\n

<\/a><\/p>\n

<\/a><\/p>\n

<\/span>It is Safe to Pull Back Inflated Cuffs<\/span><\/h2>\n

Tracheal rapid ultrasound saline test (T.R.U.S.T.) for confirming correct endotracheal tube depth in children Mark O Tessaro, Evan P Salant, Alexander C Arroyo, Lawrence E Haines, and Eitan Dickman\u00a0 Resuscitation 89:8 (2015)\u00a0 Objective We evaluated the accuracy of tracheal ultrasonography of a saline-inflated endotracheal tube (ETT) cuff for confirming correct ETT insertion depth.\u00a0 DOI: 10.1016\/j.resuscitation.2014.08.033 Advertisements<\/p>\n

<\/a><\/p>\n

<\/a><\/p>\n

<\/span>Head Elevation does indeed improve View<\/span><\/h2>\n
\n
Journal of Clinical Anesthesia Volume 27, Issue 2, March 2015, Pages 153\u2013158<\/div>\n

<\/a><\/p>\n

<\/a><\/p>\n

<\/span>Intentional Esophageal Intubation if Massive Vomiting<\/span><\/h2>\n
\n
Journal of Clinical Anesthesia Volume 27, Issue 2, March 2015, Pages 168\u2013169<\/div>\n

<\/a><\/p>\n

<\/a><\/p>\n

<\/span>Time Perception<\/span><\/h2>\n

fpsyg-03-00196<\/a><\/p>\n

fpsyg-05-00209<\/a><\/p>\n

pone.0001295<\/a><\/p>\n

<\/span>CMAC is superior to direct for rescue of 1st pass failure<\/span><\/h3>\n

J Emerg Med 2015;48(3):280<\/p>\n

<\/a><\/p>\n

<\/a><\/p>\n

<\/span>Intubation Duration<\/span><\/h2>\n

51-70 seconds in Dutton\u2019s STC RCT (Journal of Trauma and Acute Care Surgery Issue: Volume 75(2),\u00a0August 2013,\u00a0p 212\u2013219)<\/p>\n<\/div>\n

<\/a><\/p>\n

<\/a><\/p>\n

<\/span>IM Succinylcholine<\/span><\/h2>\n

On the basis of the available evidence, intramuscular administration of succinylcholine at 4 mg\/kg may produce muscle relaxation in a timeframe suitable for rapid sequence intubation. This dose consistently produced paralysis in 2\u00a0to 4 minutes in infants, children, and adults (Table<\/a><\/span>), with no clinically significant adverse effects in the patients studied. Additionally, intramuscular administration was less arrhythmogenic than intravenous administration (<\/sup>doi:10.1016\/j.annemergmed.2015.04.013)<\/a><\/p>\n

<\/a><\/p>\n

<\/a><\/p>\n

<\/span>Snail Trail Bougie Bending for Hyperangulated Blades<\/span><\/h2>\n<\/div>\n

DOI:\u00a010.1111\/anae.13052<\/p>\n

 <\/p>\n

\u00a0<\/a><\/p>\n

 <\/p>\n

\"snail-trail\"<\/p>\n

<\/a><\/p>\n

<\/a><\/p>\n

<\/span>Reflective Intubation Maneuver<\/span><\/h2>\n

 <\/p>\n

\u00a0<\/a><\/p>\n

 <\/p>\n

\"reflective\"<\/p>\n

Eur J Anaesth 2015;32:406<\/p>\n

<\/a><\/p>\n

<\/a><\/p>\n

<\/span>How Experts Hold a Laryngoscope compared to Novices<\/span><\/h2>\n

Zamora J et al. Laryngoscope manipulation by experienced versus novice laryngoscopists. Can J Anaesth 2014 Dec; 61:1075<\/p>\n

<\/a><\/p>\n

<\/span>Head-Up Position is Safer and Better<\/span><\/h2>\n

Lane et al. 2005.: \u00a8Mean (95% CI) apnoea time was 386 (343-429) s in the 20 degrees head-up position (n = 17) vs 283 (243-322) s in the supine position (n = 18; p = 0.002). Pre-oxygenation is significantly more efficacious and by inference more efficient in the 20 degrees head-up position than in the supine position.\u00a8<\/p>\n

Ramkumar et al. 2011: \u00a8Preoxygenation is clinically and statistically more efficacious and by inference more efficient in the 20\u00ba head-up position than with conventional technique in non-obese healthy adults. Although application of 5 cmH(2)O PEEP provides longer duration of non-hypoxic apnea compared to conventional technique, it is not statistically significant.\u00a8<\/p>\n

Altermatt et al.: \u00a8Pre-oxygenation in sitting position significantly extends the tolerance to apnoea in obese patients when compared with the supine position.\u00a8<\/p>\n

Dixon et al. 2005: \u00a8Preoxygenation in the 25 degrees head-up position achieves 23% higher oxygen tensions, allowing a clinically significant increase in the desaturation safety period\u2013greater time for intubation and airway control. Induction in the 25 degrees head-up position may provide a greater safety margin for airway control.\u00a8<\/p>\n

Boyce et al. 2003: \u00a8In morbidly obese patients, the 30 degrees Reverse Trendelenburg position provided the longest safe apnoea period when compared to the 30 degrees Back Up Fowler and Horizontal-Supine positions. Since on induction of general anesthesia morbidly obese patients may be difficult to mask ventilate and\/or intubate, this extra time may preclude adverse sequelae resulting from hypoxemia. Therefore, Reverse Trendelenburg is recommended as the optimal position for induction.\u00a8<\/p>\n

Lee et al. 2007: \u00a8During laryngoscopy, the laryngeal view, as assessed by POGO scores, improves significantly in the 25 degrees back-up position when compared with the flat supine position.\u00a8<\/p>\n

Anesth Analg. 2016 Apr;122(4):1101-7. Head-Elevated Patient Positioning Decreases Complications of Emergent Tracheal Intubation in the Ward and Intensive Care Unit. Khandelwal N1, Khorsand S, Mitchell SH, Joffe AM.<\/p>\n

 <\/p>\n

<\/span>Use Smallest Macintosh you can get away with<\/span><\/h2>\n

PMID 30142833<\/a><\/p>\n

<\/span>Rocuronium Dose affects 1st Pass Success<\/span><\/h3>\n

use greater than or equal to 1.4mg\/kg<\/p>\n

The Impact of Rocuronium Dose on First-Attempt Intubation Success
\nAuthor links open overlay panelN.LevinMD1M.L.FixMD1M.D.AprilMD, DPhil, MSc2A.AranaPhD2T.MadsenMD1A.FantegrossiMPH34C.A.BrownIIIMD34NEAR Investigators
\nhttps:\/\/doi.org\/10.1016\/j.jemermed.2020.07.064<\/p>\n","protected":false},"excerpt":{"rendered":"

Array<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[35],"tags":[],"yoast_head":"\nEMCrit Airway Curriculum - Crashing Patient<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/crashingpatient.com\/resuscitation\/airway\/emcrit-airway-curriculum.htm\/\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"CrashMaster\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"11 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/crashingpatient.com\/resuscitation\/airway\/emcrit-airway-curriculum.htm\/\",\"url\":\"https:\/\/crashingpatient.com\/resuscitation\/airway\/emcrit-airway-curriculum.htm\/\",\"name\":\"EMCrit Airway Curriculum - Crashing Patient\",\"isPartOf\":{\"@id\":\"https:\/\/crashingpatient.com\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/crashingpatient.com\/resuscitation\/airway\/emcrit-airway-curriculum.htm\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/crashingpatient.com\/resuscitation\/airway\/emcrit-airway-curriculum.htm\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/crashingpatient.com\/wp-content\/uploads\/2011\/07\/Duggan-LV-complications-after-more-than-1-attempt-at-ETT-600x459.png\",\"datePublished\":\"2011-07-17T20:15:18+00:00\",\"dateModified\":\"2020-11-26T23:45:37+00:00\",\"author\":{\"@id\":\"https:\/\/crashingpatient.com\/#\/schema\/person\/68373c312014141023ba30948675be1d\"},\"breadcrumb\":{\"@id\":\"https:\/\/crashingpatient.com\/resuscitation\/airway\/emcrit-airway-curriculum.htm\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/crashingpatient.com\/resuscitation\/airway\/emcrit-airway-curriculum.htm\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/crashingpatient.com\/resuscitation\/airway\/emcrit-airway-curriculum.htm\/#primaryimage\",\"url\":\"https:\/\/crashingpatient.com\/wp-content\/uploads\/2011\/07\/Duggan-LV-complications-after-more-than-1-attempt-at-ETT.png\",\"contentUrl\":\"https:\/\/crashingpatient.com\/wp-content\/uploads\/2011\/07\/Duggan-LV-complications-after-more-than-1-attempt-at-ETT.png\",\"width\":1146,\"height\":878},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/crashingpatient.com\/resuscitation\/airway\/emcrit-airway-curriculum.htm\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/crashingpatient.com\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"EMCrit Airway Curriculum\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/crashingpatient.com\/#website\",\"url\":\"https:\/\/crashingpatient.com\/\",\"name\":\"Crashing Patient\",\"description\":\"\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/crashingpatient.com\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"https:\/\/crashingpatient.com\/#\/schema\/person\/68373c312014141023ba30948675be1d\",\"name\":\"CrashMaster\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/crashingpatient.com\/#\/schema\/person\/image\/\",\"url\":\"https:\/\/secure.gravatar.com\/avatar\/df72275d57de87ddb0cfafc82b66d544?s=96&d=mm&r=g\",\"contentUrl\":\"https:\/\/secure.gravatar.com\/avatar\/df72275d57de87ddb0cfafc82b66d544?s=96&d=mm&r=g\",\"caption\":\"CrashMaster\"},\"url\":\"https:\/\/crashingpatient.com\/author\/emcrit\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"EMCrit Airway Curriculum - Crashing Patient","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/crashingpatient.com\/resuscitation\/airway\/emcrit-airway-curriculum.htm\/","twitter_misc":{"Written by":"CrashMaster","Est. reading time":"11 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/crashingpatient.com\/resuscitation\/airway\/emcrit-airway-curriculum.htm\/","url":"https:\/\/crashingpatient.com\/resuscitation\/airway\/emcrit-airway-curriculum.htm\/","name":"EMCrit Airway Curriculum - Crashing Patient","isPartOf":{"@id":"https:\/\/crashingpatient.com\/#website"},"primaryImageOfPage":{"@id":"https:\/\/crashingpatient.com\/resuscitation\/airway\/emcrit-airway-curriculum.htm\/#primaryimage"},"image":{"@id":"https:\/\/crashingpatient.com\/resuscitation\/airway\/emcrit-airway-curriculum.htm\/#primaryimage"},"thumbnailUrl":"https:\/\/crashingpatient.com\/wp-content\/uploads\/2011\/07\/Duggan-LV-complications-after-more-than-1-attempt-at-ETT-600x459.png","datePublished":"2011-07-17T20:15:18+00:00","dateModified":"2020-11-26T23:45:37+00:00","author":{"@id":"https:\/\/crashingpatient.com\/#\/schema\/person\/68373c312014141023ba30948675be1d"},"breadcrumb":{"@id":"https:\/\/crashingpatient.com\/resuscitation\/airway\/emcrit-airway-curriculum.htm\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/crashingpatient.com\/resuscitation\/airway\/emcrit-airway-curriculum.htm\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/crashingpatient.com\/resuscitation\/airway\/emcrit-airway-curriculum.htm\/#primaryimage","url":"https:\/\/crashingpatient.com\/wp-content\/uploads\/2011\/07\/Duggan-LV-complications-after-more-than-1-attempt-at-ETT.png","contentUrl":"https:\/\/crashingpatient.com\/wp-content\/uploads\/2011\/07\/Duggan-LV-complications-after-more-than-1-attempt-at-ETT.png","width":1146,"height":878},{"@type":"BreadcrumbList","@id":"https:\/\/crashingpatient.com\/resuscitation\/airway\/emcrit-airway-curriculum.htm\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/crashingpatient.com\/"},{"@type":"ListItem","position":2,"name":"EMCrit Airway Curriculum"}]},{"@type":"WebSite","@id":"https:\/\/crashingpatient.com\/#website","url":"https:\/\/crashingpatient.com\/","name":"Crashing Patient","description":"","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/crashingpatient.com\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"en-US"},{"@type":"Person","@id":"https:\/\/crashingpatient.com\/#\/schema\/person\/68373c312014141023ba30948675be1d","name":"CrashMaster","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/crashingpatient.com\/#\/schema\/person\/image\/","url":"https:\/\/secure.gravatar.com\/avatar\/df72275d57de87ddb0cfafc82b66d544?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/df72275d57de87ddb0cfafc82b66d544?s=96&d=mm&r=g","caption":"CrashMaster"},"url":"https:\/\/crashingpatient.com\/author\/emcrit\/"}]}},"jetpack_featured_media_url":"","_links":{"self":[{"href":"https:\/\/crashingpatient.com\/wp-json\/wp\/v2\/posts\/5320"}],"collection":[{"href":"https:\/\/crashingpatient.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/crashingpatient.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/crashingpatient.com\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/crashingpatient.com\/wp-json\/wp\/v2\/comments?post=5320"}],"version-history":[{"count":0,"href":"https:\/\/crashingpatient.com\/wp-json\/wp\/v2\/posts\/5320\/revisions"}],"wp:attachment":[{"href":"https:\/\/crashingpatient.com\/wp-json\/wp\/v2\/media?parent=5320"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/crashingpatient.com\/wp-json\/wp\/v2\/categories?post=5320"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/crashingpatient.com\/wp-json\/wp\/v2\/tags?post=5320"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}