Airway management in critically ill patients. From International Studies to Clinical Practice - A summary from an EAMS webinar

Airway management, including tracheal intubation and tracheostomy, is the most commonly performed procedure in critically ill patients. The EAMS held a webinar in June 2021 focused on this subject. Vincenzo Russotto from Monza, Italy and Sheila Myatra from Mumbai, India presented the results of the "INternational observational study To Understand the impact and BEst practices of airway management in critically ill patients", the INTUBE study. The attendees of the EAMS webinar asked questions related to the study and the complications in critically ill patients. The present article summarises the discussion together with strategies to help clinicians prevent and treat these complications. Copyright © 2021 Elsevier Ltd

A survey by the european airway management society (EAMS) about online education

Backgrounds and Aims: The outbreak of the COVID-19 pandemic led to cancellation of nearly all physical conferences and workshops over the past 18 months. ON-line educational activities were offered all over. To get insight about anaesthetics preferences online activities specifically on airway management, the European Airway Management Society (EMAS) carried out a members survey in July 2020. Method: An e-survey on 'google forms' was sent to all society members asking their willingness to attend virtual events hosted by EAMS. A five point Likert scale asked about their preferred presentation format, their interest on different airway management topics, duration and periodicity of such activities. Results: From 623 addressed members, 274 opened the email and 118 (19% and 43% respectively) answered. Interestingly, 90% of respondents would attend a virtual EAMS conference, 92% were interested in attending shorter webinars. The preferred formats were webinars, pro-con-debates and sessions including audience response system. Recorded lectures were the least wanted. High rated topics of interest were: airway guidelines and devices, challenging cases, education, apnoeic oxygenation and the shared airway (Fig. 1). Short 60 to 90 minutes sessions distributed over several days and monthly sessions were found convenient. Suggested topics from the respondents were: human factors in airway management, including non-technical skills and teamwork. Conclusion: This survey provided EAMS solid grounds to organize and spend resources on a series of gratis, open accessible and interactive webinars of 75 minutes duration from November 2020 on. In 2021, an audience of about 180 participants from 40 countries attended these monthly webinars given by internationally recognized speakers. Topics covered were tracheostomy care, patient's safety, awake intubation, high-flow nasal oxygen and COVID-19, airway management in critically ill adults: the INTUBE study, the NECTARINE and PEDI children studies, briefing and debriefing in airway management.

EAMS Webinar March 2021: Pragmatic guide to awake videolaryngoscope guided Intubation

Awake tracheal intubation remains the gold standard for managing a predicted difficult airway. There is emerging evidence that supports the use of videolaryngoscope guided awake intubation. Videolaryngoscopes have become widely available and consequently easy to use and familiar to anaesthetists, allowing for observed tube placement and fixed wide view of the glottis throughout the intubation procedure. This article summarizes the key points and provides answers to the main audience questions from the EAMS March 2021 Webinar. Topics discussed include optimal patient and operator positioning, techniques of applying topical anaesthesia to the airway, testing for adequacy of airway anaesthesia, videolaryngoscope blade insertion and tracheal tube placement and sedation for awake intubation.

European Resuscitation Council COVID-19 guidelines executive summary.

Coronavirus disease 2019 (COVID-19) has had a substantial impact on the incidence of cardiac arrest and survival. The challenge is to find the correct balance between the risk to the rescuer when undertaking cardiopulmonary resuscitation (CPR) on a person with possible COVID-19 and the risk to that person if CPR is delayed. These guidelines focus specifically on patients with suspected or confirmed COVID-19. The guidelines include the delivery of basic and advanced life support in adults and children and recommendations for delivering training during the pandemic. Where uncertainty exists treatment should be informed by a dynamic risk assessment which may consider current COVID-19 prevalence, the person's presentation (e.g. history of COVID-19 contact, COVID-19 symptoms), likelihood that treatment will be effective, availability of personal protective equipment (PPE) and personal risks for those providing treatment. These guidelines will be subject to evolving knowledge and experience of COVID-19. As countries are at different stages of the pandemic, there may some international variation in practice.

International Liaison Committee on Resuscitation: COVID-19 consensus on science, treatment recommendations and task force insights.

Consensus on Science and Treatment recommendations aim to balance the benefits of early resuscitation with the potential for harm to care providers during the COVID-19 pandemic. Chest compressions and cardiopulmonary resuscitation have the potential to generate aerosols. During the current COVID-19 pandemic lay rescuers should consider compressions and public-access defibrillation. Lay rescuers who are willing, trained and able to do so, should consider providing rescue breaths to infants and children in addition to chest compressions. Healthcare professionals should use personal protective equipment for aerosol generating procedures during resuscitation and may consider defibrillation before donning personal protective equipment for aerosol generating procedures.

The Italian coronavirus disease 2019 outbreak: recommendations from clinical practice.

Novel coronavirus 2019 is a single-stranded, ribonucleic acid virus that has led to an international pandemic of coronavirus disease 2019. Clinical data from the Chinese outbreak have been reported, but experiences and recommendations from clinical practice during the Italian outbreak have not. We report the impact of the coronavirus disease 2019 outbreak on regional and national healthcare infrastructure. We also report on recommendations based on clinical experiences of managing patients throughout Italy. In particular, we describe key elements of clinical management, including: safe oxygen therapy; airway management; personal protective equipment; and non-technical aspects of caring for patients diagnosed with coronavirus disease 2019. Only through planning, training and team working will clinicians and healthcare systems be best placed to deal with the many complex implications of this new pandemic.