So you couldn’t get enough, huh? Back for more tips and tricks to help you with your airways? Here they are!
6) Modify Your Blade.
Instead of trying to hold down a slippery, wet tongue against smooth metal, line your blade with a thin strip of cloth tape. This grips the tongue and stops you from fighting an unneeded battle.
7) Don’t Pin Your Tongue Down Mid-Line.
Pinning the tongue square in the middle of the airway is right in your line of site. Your light is on the right hand side. Your tube needs to pass on the right hand side. Pin your tongue to the left. Insert your blade in at an angle so its facing the right shoulder. Once all the way in, turn it to the left shoulder, lift, and Bam! Tongue is pinned out of your way.
8) Two Person Intubation.
Instead of trying to push that airway open with all your might, have your EMT grab hold of the handle and pull up toward themselves. They have more leverage than you ever will with your position at the head, opening the airway better, and giving you a better visual.
9) Shoot The J!
Make a drastic J hook with your intubation tube. Aim the point of your tube so it’s going upward onto the epiglottis. Have your partner slowly retract the stylet. If you do this outside the body it will scorpion tail and you will see the end move up and up. However, in the body, as your partner pulls, it will advance forward into the windpipe while maintain anterior pressure.
10) Use That Fancy ETCO2!
I’ve seen a failed intubation still pass the auscultation, visual confirmation, and chest movement tests. Whenever intubating, use your end-tidal carbon dioxide detection for confirmation. It will even work in most cardiac arrest cases. If you have a colorimetric ETCO2 detector, these are a little less useful in cardiac cases. However, they are 100% accurate in confirming tube placement in non-cardiac arrest patients (1).
Do you have any tricks up your sleeve? Please share!
(Editor’s Note: The views expressed above do not necessarily reflect the views of EMS Wire)
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- Walls RM, Murphy MF. Chapter 12: Direct Laryngoscopy. Manual of Emergency Airway Management, 4th ed. Philadelphia: Lippincott, Williams & Wilkins, 2012.
In addition to three separate associates degrees, Tim became a nationally certified EMT in 2008 and continues to use his certification to this day. His work experience spans from physical therapy and nursing tech to the ER, donor organ procurement, and Search and Rescue.
As a self proclaimed grease monkey and gym rat, Tim enters his self re-built cars into shows and competes in bodybuilding competitions for fun.
Tim has been an instructor for EMS University since 2014, works at the UA as a biosafety officer, and now sets his sights on becoming a Physician Assistant.
