So I love awake intubation. I've done a ton of previous stuff on the topic of Awake Intubation. My friend, George Kovacs, introduced me to some new gear at one of the AirwayCam course. This changed the way I performed awake intubation--it also made it MUCH faster. So here is how I currently perform awake intubation.

* If you want to see a full lecture by George, go to Podcast 194

Dissociated Awake is what I used to do when I had a time crunch (Pt needs to be tubed now)

EAT Awake is what I do now

* Suck & Pad

* Topicalize

* Analgese

* Intubate

* Sedate

EZ-Atomizer

use the EZ Atomizer to topicalize everything but through-the-cords

You must use 4% lidocaine. Give 10-14 mls (may want to dilute to 3% in patients with low body weight or liver failure)

Flow Rate is 8 lpm on oxygen or air

Topical Lidocaine Lollipop

As high a concentration as you can get

MADgic Device

Plus/Minus Sedation/Analgesia

 

You can never see too many demonstrations of the technique, so here is another video:

George Kovacs on Airway Topicalization

Updates

RCT of 10% spray vs. Nebs--10% spray much better (Chest 2020;157(1):198)

Now on to the Wee...