Carolinas Core Concepts Core Concepts in EM; a repository for Carolinas lecture summaries.


Airway Management Case Studies

Michael Gibbs, MD


  • To easily find the cricothyroid membrane in patients with poor landmarks, try placing 4 fingers in a row on the anterior neck with the pinkie finger in the sternal notch.  Your other 3 fingers should be positioned up the neck and your index finger should then fall on the membrane.
  • Nasotracheal Intubation: Try putting the tube in the nose first part way down then load the fiberoptic scope through the tube and you will be looking directly at the glottis.
  • If your nasopharyngeal scope is not long enough to pass through the cords then put the scope in one nostril and put the tube through the other nostril. This will still allow you to visualize the cords and intubate under direct visualization.
  • If you must intubate an asthmatic then make sure to maximize preload with IV fluids. Bag slowly to allow for complete exhalation.
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