Had a great time in Alice Springs and gave the guys a one day workshop. A great group and I hope their advanced airway skills have gone to the next level. Below you see everyone practicing the ‘3’ of the ‘3 – 3 – 2’ Rule. A great way to gain some insight into the degree of mouth-opening, that a patient has (crucial for getting the laryngoscope in and the ett), as well as the distance between the hyoid bone and the tip of the chin, which gives an indication of whether there is adequate room in the floor of the mouth to displace the tongue.
When I teach this material, I notice one thing, there is a fear of the airway. Remember the important stuff. If you can ventilate and oxygenate, but can’t tube, thats fine! The goal is not intubation, it’s oxygenation and ventilation. Sure, we need to protect the airway, but a little cricoid pressure and gentle bagging, ie., giving each breath over about 2 seconds (to not ventilate with pressures that may lead to gastric insufflation) and you’re fine. Remember the vocal cords are only about 8-10cm away from us, even less in the child, so think this way and you’ll act differently.