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Jummy

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Everything posted by Jummy

  1. Great discussion! I work in a level 2 unit with many experienced intubators but I worry proficiency is on the decline in line with the concerns raised by the authors. So how are we mitigating this? 1. Use of vIdeolaryngoscope to allow a team/shared view, it’s very satisfying as it always feel like team success. We also do our LISA using the VL. I must however say it doesn’t always work as the catheter doesn’t always obey instructions 😂 The blade is also wide and doesn’t work well for smaller babies. 2. We’re investing into the Mac blade laryngoscopes which could be used for smaller babies and is quite sleek. 3. Junior doctors rotate between tertiary and a district hospital like ours and are often skilled in intubation from their tertiary experience. 4. We’ve adopted the BAPM difficult airway guidelines which limits the number of attempts at intubation before trying things like LMA or asking for help from anaesthetist/ENT. It’s a brilliant ‘challenge and response’ approach. This means a simple airway is unlikely to be converted to difficult airway from multiple attempts and subsequent laryngeal oedema. We’ve stocked up size 1 i-gels which theoretically could be used on babies as little as 1.5kg. They are easy to use. 5. We do 1-2 weekly neonatal simulation for junior doctors, they increase confidence and team working as well as keeping up to date with what works 6. Quarterly skills training for consultants- likely group to lose skills as not rotating to tertiary centres. Hope that helps Jummy
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