A novel jaw thrust device

A novel jaw thrust device (JTD) was tested against oropharyngeal and nasopharyngeal airways in anaesthetised patients. The JTD enabled effective ventilation with less airway resistance than the traditional airways, and so provided greater tidal volumes during pressure controlled ventilation. It fits into the mouth, keeping the mouth open and the jaw thrusted forward, and has a standard sized connector for attachment to ventilation devices.

Optimising the unprotected airway with a prototype Jaw-Thrust-Device – a prospective randomised cross-over study
Anaesthesia. 2009 Nov;64(11):1236-40

Take bloods before giving Lipid Rescue

Intralipid therapy is recommended for local anaesthetic toxicity and in some overdoses. After large doses of Intralipid, the results of blood tests may be difficult to analyse, delayed, or spuriously abnormal. If possible, all blood tests should be taken before the administration of Intralipid. While laboratories will readily identify significant lipaemia, communication about the presence of Intralipid is important. In one case, the inability to obtain a haemoglobin result led to delay in the identification of haemorrhage which was the cause of deterioration initially thought to be local anaesthetic toxicity.

Possible side effects of Intralipid rescue therapy
Anaesthesia 2010;65(2):210-11

Best position for RIJV cannulation in kids

In a study of anaesthetised infants and children, the right internal jugular vein as assessed by ultrasonography was measured with the head in the neutral position, and then at 40 degrees and 80 degrees of rotation to the contralateral side. The 40 degree position resulted in an increase in IJV diameter but with less overlap with the carotid artery than the 80 degree position. The authors conclude that rotating the head 40 degrees to the left results in the best balance of increased IJV diameter versus overlap with the carotid.

Effects of head rotation on the right internal jugular vein in infants and young children
Anaesthesia Volume 65, Issue 3, Pages 272-276