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This page is a public service of the SLAM Airway Training Institute (SATI) Our goal at SATI is to make the most current airway management information available to you Deciding on the right course of treatment and being able to provide that treatment is paramount in dealing effectively with airway emergencies Please contact us at scherrone@att.net with your comments (pro or con) regarding not only this page but any page on www.slamairway.com. 1. Outline of Knowledge on Emergency Airway Management 1a. The SLAM Emergency Airway Flowchart – A 21st century guide for advanced airway practitioners 1b. Peer-Reviewed Literature: Airway Management Articles @ AirwayEducation.com 1c. Books on Airway Management 1d. Web-Based Resources in Airway Management i. Airway Management Organizations, E-Journals, and Website Links 1. Organizations whose members practice airway management 2. E-Journals and printed journals available online 3. Airway Management Website Links ii. The Virtual Handbook of Emergency Airway Management – Offerings from the National SLAM Conference (2000-20004)-- Coming Soon iii. Topics in Airway Management 1. Adjuncts and Techniques for Airway Management 2. Airway Management Basics 3. Decision Making in Airway Management 4. Rapid Sequence Induction and Intubation (RSI) 5. Pharmacology of Airway Management 6. Confirmation of Tracheal Intubation and Monitoring of Lung Ventilation 7. Difficult Airway Management: Preventing and Rescuing Failed Intubation 8. Difficult Airway Management: Rescue Ventilation 9. Difficult Airway Management: Traumatized Airway and Cervical Spine Injury 10. Difficult Airway Management: Cricothyrotomy iv. Topics in Prehospital Airway Management 1. General Topics in Prehospital Airway Management 2. Prehospital Tracheal Intubation (T.I.) 3. Prehospital Primary and Rescue Ventilation 4. Prehospital Confirmation of Tracheal Intubation and Monitoring of Lung Ventilation 5. Prehospital Cricothyrotomy 2. Videos on Airway Management 2a. Street Level Airway Management (SLAM) and the SLAM Universal Emergency Airway Flowchart (Flash plug-in required) 2b. Airway Cadaver Video #1: Fastrach-LMA (Intubating Laryngeal Mask Airway) Insertion 2c. Airway Cadaver Video #2: Combitube Insertion using direct laryngoscopy. 2d. Charge! Like the cavalry rescuing you from a perilous situation.

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1a. The SLAM Universal Emergency Airway Flowchart - A 21st Century Guide for Airway Practitioners

Winner of the NYSSA 2003 Best Exhibit for Clinical Application James M. Rich, CRNA, MA accepts the 2003 Best Exhibit for Clinical Application award from Andrew Rosenberg, M.D. of the New York State Society of Anesthesiologists (NYSSA) at the NYSSA's 57th Postgraduate Assembly of Anesthesiologist in New York City on December 15, 2003. Click here to view the SLAM Universal Emergency Airway Flowchart

1b. Peer-Reviewed Literature: Airway Management Articles @ AirwayEducation.com

Click here to view Rich J. Recognition and management of the difficult airway with special emphasis on the intubating LMA-Fastrach whistle technique: a brief review with case reports.  BUMC Proceedings 2005:18;220-227. Copyright BUMC Proceedings - posted with permission. Click here to view Rich JM, Mason AM, Ramsay MAE. AANA Journal Course: The SLAM Emergency Airway Flowchart: A new guide for advanced airway practitioners. AANA J 2004:72;431-439. Copyright AANA Journal 2004 - all rights reserved. This article is posted with the permission of the AANA Journal.

Rich JM, Mason AM, Ramsay MAE, Beeson J, Hancock R. SLAM Emergency Airway Flowchart: Preventing Accidents Associated with Emergency Airway Management. Abstract and poster session presented at State of the Science Meeting at AANA Convention in Boston, MA, August 2003.

Click here to view Rich J, Mason A, Bey T, Krafft P, Frass M. The critical airway, rescue ventilation and the Combitube: Part 1. AANA J. AANA 2004: 72;17-27. Copyright AANA Journal 2004 - all rights reserved. This article is posted with the permission of the AANA Journal.

Click here to view Rich J, Mason A, Bey T, Krafft P, Frass M. The critical airway, rescue ventilation and the Combitube: Part 2. AANA J 2004: 72;115-124. Copyright AANA Journal 2004 - all rights reserved. This article is posted with the permission of the AANA Journal.

Click here to view Smith C.  Cervical spine injury and tracheal intubation: a never ending conflict. TraumaCare. 2000;10:20-26. Click here to view Rich J. Street Level Airway Management (SLAM): If your patient can't breathe, nothing else matters! Anesthesia Today. 2005;16:13-22. (Used by permission of Anesthesia Today). Click here to view Rich J. Dexmedetomidine as a sole sedating agent with local anesthesia in a high-risk patient for axillofemoral bypass graft: A case report AANA J 2005: 73;357-360. Copyright AANA Journal 2005 - all rights reserved. This article is posted with the permission of the AANA Journal. Combitube, Self-Inflating Bulb, and Colorimetric Carbon Dioxide Detector to Advance Airway Management in the First Echelon of the Battlefield, The Military Medicine, May 2006 by Rich, James M, Thierbach, Andreas, Frass, Michael

1c. Books on Airway Management

·Airway Management: Principles and Practice. Jonathan l. Benumof. Mosby, St. Louis. 1996. ·Atlas of the Difficult Airway, Second Edition. Martin L. Norton. Mosby. St. Louis, 1996. ·Difficulties in Tracheal Intubation, Second Edition. I.P. Latto & R.S. Vaughan, editors. W.B. Saunders Company Ltd. London. 1997. ·SLAM - Street Level Emergency Airway Management. James M. Rich. Brady Prentice Hall Publishers, Upper Saddle River,New Jersey. 2007. ·Fiberoptic Endoscopy and the Difficult Airway, Second Edition. Andranik Ovassapian. Lippincott – Raven Publishers, Philadelphia. 1996. ·Handbook of Difficult Airway Management. Carin A. Hagberg. Churchill Livingstone, Philadelphia. 2000. ·Manual of Emergency Airway Management. Ron M. Walls, editor-in-chief. Lippincott Williams & Wilkins. Philadelphia. 2000. ·Principles of Airway Management, Third Edition. Brendan T. Finucane and Albert H. Santora. Springer-Verlag, New York. 2003. ·The Airway: Emergency Management. Robert H. Dailey, Barry Simon, Gary P. Young, Ronald D. Stewart, editors. Mosby Year Book, St. Louis. 1992.

1d. Web-Based Resources in Airway Management

i.  Airway Management Organizations, E-Journals and Website Links 1. Organizations whose members practice airway management Air and Surface Transport Nurses Association American Association of Nurse Anesthetists American College of Emergency Physicians National Association of EMS Educators American Society of Anesthesiologists National Flight Paramedics Association Austrian Difficult Airway/Intubation Registry (ADAIR) Difficult Airway Society European Airway Management Society 2. E-Journals and printed journals available online Internet Journal of Airway Management (IJAM) Prehospital Emergency Care Online Trauma Care Journal 3. Airway Management Website Links Austrian Difficult Airway/Intubation Registry (ADAIR) Capnography.com Combitube - When Seconds Count SLAM Airway Training Institute The Airway Carnival Virtual Anaesthesia Textbook National Flight Paramedics Association National Association of EMS Educators Air and Surface Transport Nurses Association Emergency Nurses World   ii.  The Virtual Handbook of Street Level Airway Management–Offerings from the National SLAM Conference (2000 – 2007) -- COMING SOON   iii.  Topics in Airway Management 1. Adjuncts and Techniques for Airway Management Obesity, The Airway & Proper Positioning Using the Troop Elevation Pillow Cooper RM. Use of a new videolaryngoscope(GlideScope) in the management of a difficult airway.Can J Anaesth. 2003 Jun-Jul;50(6):611-3 Gum Elastic Bougie Assisted Intubation - Charles Smith, M.D. Using Lighted Stylets - UFL The laryngeal tube: A new adjunct for airway management 2. Airway Management Basics The Basic Technique of Endotracheal Intubation - CCM A Detailed Annotated Set of Slides - usuhs.mil A General Guide to Orotracheal Intubation 3. Decision Making in Airway Management Rich JM, Mason AM, Ramsay MAE, Beeson J, Hancock R. SLAM Emergency Airway Flowchart: Preventing Accidents Associated with Emergency Airway Management. - Abstract and poster session presented at State of the Science Meeting at AANA Convention in Boston, MA, August 2003. ASA Difficult Airway Algorithm ASA Guidelines for Management of the Difficult Airway SLAM (Street Level Airway Management) Emergency Airway Flowchart: A new guide for advanced airway practitioners Management of the Difficult Airway - slideshow - PalmerNet Difficult Airway Society guidelines for management of the unanticipated difficult intubation 4. Rapid Sequence Induction and Intubation (RSI) Intubation if the stomach is full - WFSA Technique of Rapid Sequence Intubation 5. Pharmacology of Airway Management Comparison of etomidate and midazolam for prehospital Rapid-sequence intubation Preventable morbidity and mortality from prehospital paralytic assisted intubation: Can we expect outcomes comparable to hospital-based practice? Succinylcholine: Can We Get By with Less? - R. Walls The effect of etomidate on airway management practices of an air medical transport service - PEC The use of etomidate for prehospital rapid-sequence intubation - PEC The utilization of midazolam as a pharmacologic adjunct to endotracheal intubation by paramedics - PEC 6. Confirmation of Tracheal Intubation and Monitoring of Lung Ventilation Verification of Endotracheal Tube Placement: ACEP Endotracheal Detector Devices - WFSA End-tidal carbon dioxide monitoring in the prehospital setting - PEC The effect of pulse oximetry on emergency medical technician decision making - PEC The esophageal detector bulb in the aeromedical setting. - Hendey GW, Shubert GS, Shalit M, Hogue B - PEC The esophageal detector device. Does it work? - Zaleski L, Abello D, Gold MI. - PubMed The Esophageal Detector Device: Summary of the current articles in the literature. - AMBU The oesophageal detector device - Assessment of a new method to distinguish oesophageal from tracheal intubation - Wee MY Comparison of a Colorimetric End-Tidal CO2 Detector and an Esophageal Aspiration Device for Verifying Endotracheal Tube Placement in the Prehospital Setting: A Six-Month Experience - Richard J. Schaller MD, J. Stephen Huff, MD, FACEP, Allan Zahn, MD Esophageal Detector Device: Accuracy and Reliability in Difficult Airway Settings - Christopher E. Kapsner, MD, David C. Seaberg, MD, FACEP, Charles Stengel, MD, Kaveh Ilkhanipour, MD, FACEP,James Menegazzi, PhD Esophageal detector device versus detection of end-tidal carbon dioxide level in emergency intubation - Bozeman WP, Hexter D, Liang HK, Kelen GD Confirming proper intubation in the emergency setting: Abstract Summary The esophageal detector device (EDD) is unreliable when the stomach has been ventilated - Andres A., Langenstein H. Anesthesiology 1999,91 August Is the esophageal detector device or end-tidal CO2 measurement superior in confirming endotracheal tube placement? The Efficacy of Esophageal Detector Devices in Verifying Tracheal Tube Placement: A Randomized Cross-over Study of Out-Of-Hospital Cardiac Arrest Patients - Koichi Tanigawa, MD, Taku Takeda, MD, Eiichi Goto, MD, and Keiichi Tanaka, MD Secondary Confirmation of Endotracheal Tube: SEMAC Advisory The AMBU TubeCheck and TubeCheck B: manufacturer’s advertisement 7. Difficult Airway Management: Preventing and Rescuing Failed Intubation Intubation vs. Bag-Valve-Mask Ventilation in the Field: No Answers Here - John A. Marx, MD, FACEP Action-Plan for Airway Problems From Hell! - Tom Trimble, RN ASA Guidelines for Management of the Difficult Airway Difficult Airway Society guidelines for management of the unanticipated difficult intubation. Difficult Airway Society guidelines for management of the unanticipated difficult intubation. Management of the Difficult Airway - slideshow - PalmerNet Management of the Unanticipated Difficult Airway - R. Walls Salvaging the Difficult Airway - Richard Levitan, M.D. SLAM (Street Level Airway Management) Emergency Airway Flowchart: A new guide for advanced airway practitioners Management of the Difficult Airway in Closed Malpractice Claims 8. Difficult Airway Management: Rescue Ventilation The laryngeal mask airway reliably provides rescue ventilation in cases of unanticipated difficult tracheal intubation along with difficult mask ventilation - JL Parmet et al. The critical airway, rescue ventilation, and the Combitube: Part 1 - Rich et al. The critical airway, rescue ventilation, and the Combitube: Part 2 - Rich et al. Trans-Tracheal Jet Ventilation - TTJV SLAM (Street Level Airway Management) Emergency Airway Flowchart: A new guide for advanced airway practitioners Ventilation During CPR: Too Much of a Good Thing - James M. Christenson, MD, FRCPC 9. Difficult Airway Management: Traumatized Airway and Cervical Spine Injury The use of the McCoy laryngoscope in the patient with suspected cervical spine fracture SMJ June 1996 - Diagnosis and Management of Laryngeal Trauma in Sports Anaesthesia for airway trauma - Rashad Cervical spine injury and tracheal intubation: a never ending conflict - Charles Smith 10. Difficult Airway Management: Cricothyrotomy A standing-order protocol for cricothyrotomy in prehospital emergency patients   iv.  Topics in Prehospital Airway Management 1. General Topics in Prehospital Airway Management Recommended guidelines for uniform reporting of data from out-of-hospital airway management: Position statement of the national association of EMS physicians Preventable morbidity and mortality from prehospital paralytic assisted intubation: Can we expect outcomes comparable to hospital-based practice? The effect of pulse oximetry on emergency medical technician decision making 2. Prehospital Tracheal Intubation (T.I.) Drugs - Comparison of etomidate and midazolam for prehospital Rapid-sequence intubation Drugs - The effect of etomidate on airway management practices of an air medical transport service Drugs - The use of etomidate for prehospital rapid-sequence intubation Drugs - The utilization of midazolam as a pharmacologic adjunct to endotracheal intubation by paramedics T.I. Paramedic RSI: Incidence of Desaturation and Pulse Rate Changes - Susan B. Promes, MD, FACEP T.I. - Airway obstruction in children aged less than 5 years: The prehospital experience T.I. - An assessment of paramedic performance during invasive airway management T.I. - Association of out-of-hospital endotracheal intubation with adverse outcome after traumatic brain injury T.I. - Comparison of times to intubate a simulated trauma patient in two positions T.I. - Endotracheal intubation in a rural EMS state: Procedure utilization and impact of skills maintenance guidelines T.I. - Intubation success rates by air ambulance personnel during 12- versus 24-hour shifts: Does fatigue make a difference? T.I. - Misplaced endotracheal tubes after field intubation T.I. - Paramedic use of endotracheal tube introducers for the difficult airway T.I. - Patient status and time to intubation in the assessment of prehospital intubation performance T.I. - Prehospital rapid-sequence intubation - NAEMSE Position Paper T.I. - Prehospital rapid-sequence intubation: A pilot training program T.I. - Prehospital Rapid-sequence Intubation - What Does the Evidence Show? T.I. - Time to intubation and survival in prehospital cardiac arrest T.I. Potential for facilitated intubation in an urban ALS system 3. Prehospital Primary and Rescue Ventilation Rescue Ventilation - Combitube - Endotracheal intubation and esophageal tracheal combitube insertion by regular ambulance attendants: A comparative trial Rescue Ventilation - Combitube - Successful Prehospital Airway Management By EMT-DS Using The Combitube Rescue Ventilation - LMA - Blind tracheal intubation by paramedics through the LMA-unique Rescue Ventilation - LMA - Prehospital airway management with the laryngeal mask airway in polytraumatized patients Rescue Ventilation - LMA - Subjective evaluation of prehospital LMA use by emergency medical technicians and paramedics Primary Ventilation - Concepts and application of prehospital ventilation Primary Ventilation - Effective ventilation and temperature control are vital to outborn resuscitation Primary Ventilation - Outcome following major hemorrhage: The confounding variable of ventilatory management Primary Ventilation - Ventilation During CPR: Too Much of a Good Thing - James M. Christenson, MD, FRCPC 4. Prehospital Confirmation of Tracheal Intubation and Monitoring of Lung Ventilation End-tidal carbon dioxide monitoring in the prehospital setting Evaluation of an electronic esophageal detector device in patients with morbid obesity and pulmonary failure The esophageal detector bulb in the aeromedical setting. Hendey GW, Shubert GS, Shalit M, Hogue B Confirmation of airway placement. Falk JL, Sayre MR. Comparison of a Colorimetric End-Tidal CO2 Detector and an Esophageal Aspiration Device for Verifying Endotracheal Tube Placement in the Prehospital Setting: A Six-Month Experience - Richard J. Schaller MD, J. Stephen Huff, MD, FACEP, Allan Zahn, MD Esophageal Detector Device: Accuracy and Reliability in Difficult Airway Settings - Christopher E. Kapsner, MD, David C. Seaberg, MD, FACEP, Charles Stengel, MD, Kaveh Ilkhanipour, MD, FACEP,James Menegazzi, PhD Esophageal detector device versus detection of end-tidal carbon dioxide level in emergency intubation - Bozeman WP, Hexter D, Liang HK, Kelen GD Confirming proper intubation in the emergency setting: Abstract Summary The esophageal detector device (EDD) is unreliable when the stomach has been ventilated - Andres A., Langenstein H. Anesthesiology 1999,91 August Is the esophageal detector device or end-tidal CO2 measurement superior in confirming endotracheal tube placement? The Efficacy of Esophageal Detector Devices in Verifying Tracheal Tube Placement: A Randomized Cross-over Study of Out-Of-Hospital Cardiac Arrest Patients - Koichi Tanigawa, MD, Taku Takeda, MD, Eiichi Goto, MD, and Keiichi Tanaka, MD Secondary Confirmation of Endotracheal Tube: SEMAC Advisory The AMBU TubeCheck and TubeCheck B: manufacturer’s advertisement 5. Prehospital Cricothyrotomy A standing-order protocol for cricothyrotomy in prehospital emergency patients 2a. Street Level Airway Management (SLAM) and the SLAM Universal Emergency Airway Flowchart (Flash plug-in required) 2b. Airway Cadaver Video #1: Fastrach-LMA (Intubating Laryngeal Mask Airway) Insertion 2c. Airway Cadaver Video #2: Combitube Insertion using direct laryngoscopy. 2d. Charge! Like the cavalry rescuing you from a perilous situation.

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Combitube, Self-Inflating Bulb, and Colorimetric Carbon Dioxide Detector to Advance Airway Management in the First Echelon of the Battlefield, The Military Medicine, May 2006 by Rich, James M, Thierbach, Andreas, Frass, Michael

Internet Journal of Airway Management (IJAM)

Prehospital Emergency Care Online

Trauma Care Journal

Austrian Difficult Airway/Intubation Registry (ADAIR)

The Airway Carnival

Virtual Anaesthesia Textbook

International Flight Paramedics Association

National Association of EMS Educators

Air and Surface Transport Nurses Association

Emergency Nurses World

Obesity, The Airway & Proper Positioning Using the Troop Elevation Pillow

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