This week I am highlighting two airway discussion points which have recently come to my attention: cuffed vs. non-cuffed endotracheal tubes (ETTs) in pediatric patients and the possible, negative side effects of supraglottic airways.
See my first post on cuffed vs. non-cuffed endotracheal tubes: Part 1
Supraglottic Airways: Help or Harm?
Health Care Providers (HCPs), working in multi-disciplinary, team oriented environments, are able to achieve rapid and early airway management without interrupting resuscitation efforts. However, the role of ETTs has been de-emphasized during cardiac arrest management and HCPs are encouraged to use alternate airway devices, such as supraglottic airways.
Supraglottic airways minimize interruptions in compressions and as a result, maximal blood flow to the brain. Or, so we thought…
A recent swine study shows evidence supraglottic devices may decrease cerebral blood flow in low output states. See the article below.
In the ACLS courses I instruct at Iridia, I have been strongly encouraging the use of supraglottic airway devices. Mainly because King Tubes or laryngeal mask airways can be inserted without stopping chest compressions and this allows for more blood to the brain. But, if these airway devices impede blood flow to the brain, should we be using them at all?
What is the future of airway management during cardiac arrests? Will newer, high-tech devices make it to market or will airway management go back to a head-tilt, chin-lift with oxygen from a simple mask?
I’d love to hear your thoughts and opinions. Let me know what you think about these discussion points.