The EMBER Project

Have you noticed a change in your airway box recently?  No, it’s not the new McGrath or C-MAC or any other cool high-tech tool. It’s a more subtle change.

It used to be when you prepared for a sick patient to arrive that you opened up the box, grabbed a handle, and slapped on your go to metal blade to check the bulb before the patient arrived. If that patient didn’t need intubation the blade went back in the box.

Not anymore. Emerging concerns about cross-contamination  and increased scrutiny by regulatory groups has led to some changes in equipment and also a need for changes in practice. Blades need to be appropriately cleaned, sterilized and sealed; once opened they can’t be put back.

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The problem is that the traditional metal blades often had light issues related to multiple use and sterilization techniques – hence the habit all Emergency Physicians have of checking the blade prior to the arrival of a sick patient.

At my institution, the solution has been new disposable blades that are sealed and packaged (and look a lot like the old reusable metal blades) which is why the old habit is hard to break. These disposable blades rarely have bulb issues and there is more than one blade available if you happen to run across a broken one. We also added a non-sterile (not for patient use) blade to check the handle battery function.

So resist the urge to open that packaged blade and check the bulb, because now you can’t put it back in the box. Well, you can but you’ll just be asking for a JAHCO citation.


The Bundle – Clinical resources you can use

Five Things The Joint Commission Thinks You Should Know About Laryngoscopes and Endotracheal Tubes by Linda Hertzberg, M.D.

#Postards from the ED


There are educational courses and there are inspirational courses. I had the opportunity this weekend to participate at BASE Camp. The brainchild of Kevin Ching, it’s an amazing and unique two days of education.

For those of you who don’t know about this great opportunity, it is, as the website says:

a high-intensity, fully immersive weekend of simulated pediatric emergencies where fellows and nurses work together in multidisciplinary teams to manage critically ill and injured children and adolescents

BASE Camp certainly lives up to this, but perhaps the best aspect of the course is the amazing feedback participants get after each case.  By the end of the second day it was moving to see the sense of common purpose and renewed enthusiasm for what we do every day that was clearly visible in all the participants. As I said, there are educational courses and then there are inspirational ones.  This one is definitely both…

Postcard-basecamp

#Postcard from the ED

Hey, can I get a  jazz riff — New York style please?

Music everywhere 🗽🎁🎉😎🎺🎷🎺🎶 #music #busking #NYC #rtrain

A post shared by Jonathan St. George (@jstgeorge) on

I’m excited to announce that “The Protected Airway Course” now has a home, and the first of the teaching modules are coming online. Our annual Airway & Difficult Procedure Course lasts only two days (and is only available for our EM residents, critical care and PEM fellows) but this learning is 100% FOAM certified, farm to table fresh. And it’s available anytime!

In the coming months we will be translating airway knowledge from our experts around the EM and critical care world and posting it here for you to enjoy. We’re hard at work creating engaging, innovative, interactive tools to teach key topics in airway management that will augment the course and allow for self-paced learning. In each module you will find learner focused tools designed to make the content stick such as:

  • A self assessment quiz to get you started, and make your studying more focused.
  • Bundled multi-media learning tools covering all aspects of the topic.
  • Strategically placed bite sized notes, video clips, and slides to drive home and highlight core concepts.
  • A quick “Summary in 5” podcast from our knowledge leaders for a quick review on the subway home.
  • Guest posts and interviews with our airway experts from around the city, the country, and the world.
  • Some surprising and entertaining bonus airway goodness (I don’t want to spoil it, you’ll just have to check it out).

This month our flagship module is the emergent cricothyroidotomy. This procedure presents many educational challenges: It’s high stakes, low-frequency and performed in the stressful failed airway situation. If you don’t think about it, prepare for it, or feel confident doing it, you will fail to perform this lifesaving maneuver in a timely manner. The goal of this module is to get you on the path to learning not just the procedure but all the tangible and intangible skills required to master the failed airway scenario.

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But wait, that’s not all!  Since airway education should be all year long, and come in all shapes and sizes, we have several new resources for you to get airway pearls straight to your mobile devices.

  • Flipboard magazine to collect all the latest posts and curated airway content in one place.
  • A new “Airway Tools to Live By” page demonstrating new airway tools as we test them.
  • You can follow along on the Airway Tools page or directly on our Instagram account.

A Mac blade for the Glidescope. Cool #airway #nypem

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The next module should be out next month but we’re understaffed, overworked, and underpaid so be patient as we bring new content to you at regular intervals. 🙂


In the meantime. May the airway be ever in your favor!

Zen Airway and Poetry Inspired by Haiku Deck

There are many reasons to love Haiku Deck. For educators it’s an easy way to free your knowledge from the Powerpoint prison on your hard drive, but it also challenges you to get to the point and hone your educational pearls into shiny drops of educational poetry.  If you are using Haiku Deck to give a talk it also re-enforces the idea the slides are only for emphasis – if you’re reading of them you’ve got too much on your slides.


So here is my latest Haiku Deck, part of a teaching module for our airway course. I was so inspired I wrote a Haiku to start things off.

Airway Haiku

The Airway is hard

How sweet the Grade One view is!

Pearls for you there are

Enjoy

Oh, I don’t have any money invested in Haiku Deck (wish I did). I just really like it.

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