| dc.description.sponsorship | In this issue, we will continue with the recent airway management publication, which were recommended by the EAMS Board of Directors. We will present 3 papers. Two of them are about awake intubation and one is about the VivaSight tracheal tubes with an integrated camera. - A comparison of the Enk Fiberoptic Atomizer Set™ with boluses of topical anaesthesia for awake fibreoptic intubation. Pirlich N et al. [1] . During awake intubation, usually the spray-as-you-go technique is used for topical anaesthesia. In this original article, the Enk Fiberoptic Atomizer Set™, which is a topicalizing spray using high flow oxygen is compared with classical bolus application of local anaesthetics. This study shows that the need for local anesthetics is reduced by 50% in the atomizer group. In the first postoperative day, comfort evaluation scores were also better in this group. Besides, there were less complication observed. There were no differences between the groups in oxygen saturation, heart rate, blood pressure, and depth of sedation or BIS throughout the study. Therefore, the authors conclude that patients may safely and successfully undergo awake fibreoptic intubation using either the atomizer or classical spray-as-you-go technique. - A retrospective study of success, failure and time needed to perform awake intubation. Joseph TT et al. [2] . In this retrospective study the authors evaluate the reasons for avoiding awake intubation in spite of clinical indication and a good safety and success profile. The authors analysed 1085 awake intubations. Videolaryngoscopes were used in a few patients but on the other side 1055 involved the use of a flexible bronchoscope. Two groups were established: the awake intubation group and the asleep intubation group (n = 2170) consisted of a matched subset of the postanaesthesia induction intubations, by any method, conducted or supervised by an anaesthesiologist during the same time period. For each awake intubation case, two asleep intubation cases were matched and compared. The median time to intubation for patients intubated post induction was 16.0 min from entry into the operating room. The median time to intubation for awake patients was 24.0min (p < 0.001). The rate of failed awake intubation by flexible bronchoscopy was 1% (n = 10). The most common complications were related with mucous plug, cuff leak and inadvertent extubation after induction. Furthermore, the hemodynamic parameters were found to be comparable. The authors discuss and conclude that awake intubations are nearly always successful and the rates of serious complications or hemodynamic perturbations are fairly low. - VivaSight: a new era in the evolution of tracheal tubes. Saracoglu A et al. [3] . This systematic review highlights the available data describing the use of single and double lumen VivaSight tracheal tubes. The authors discuss in detail the costs, the need for a flexible bronchoscope during the use of a VivaSight double-lumen tube and the possible complications. The readers can also find valuable information about the structure and dimensions, the use in normal and difficult airway and the limitations of VivaSight single and double-lumen tubes. 3rd European Airway Congress. The Congress you expect. The Congress we offer to you. The main commitment of a scientific society is to contribute and to spread knowledge and experiences not only among its members but to all professionals who usually work in a specific field. In this sense, the European Airway Management Society (EAMS) was founded in 2003 in Glasgow during Euroanaesthesia . The purpose of the founders was to organize a common point for all European anaesthesiologists interested in airway management - to meet, to work together and to offer an encounter of different professionals who were interested in this field. The idea was also to have a chance to teach, to learn and to share daily clinical experiences in order to improve the management of the patient's airway. EAMS is a young and expanding scientific society that unites members from all around Europe. In this way, EAMS has been organizing airway management training courses in conjunction with ESA Subcommittee 19 at the annual meetings of the European Society of Anaesthesiology (ESA) over the last years. To acquire better visibility and to attract more members to the society, but also to improve and disseminate knowledge and skills, EAMS decided to periodically organize meetings. After the foundation and first congress in Glasgow in 2003, the 2nd European Airway Congress (EAC) was held in Istanbul in 2013. Now, the 3rd EAC will take place in Valencia this December 2016. To teach the airway teachers is a key educational goal of EAMS. In 2013, before the Euroanaesthesia conference, the 1 st Teach Airway Teachers (TAT) Course certified the elected participants. Since then TAT courses with EAMS certificates run parallel to the EAMS congresses. EAC 2016 in Valencia is organized to update your knowledge on airway management with worldwide recognized lecturers, to improve your skills on handling airway devices in workshops taught by the dedicated and selected airway experts. The learner-friendly atmosphere enhances learning and meeting colleagues, which is as important as coffee and lunch breaks to continue interactions with airway professionals, well recognized professors and inventors of airway devices or strategies. In addition, the 3rd EAC provides participants with the opportunity to present their own scientific work and to disseminate it among their peers. While some might think there is an overload of courses, meetings and congresses, the following words provide some of the reasons why the 3rd EAC sticks out among the plethora of congresses and why it is organized in Valencia, Spain by the local Spanish airway enthusiasts. Here's the brief history. Local Spanish airway enthusiasts have been involved in EAMS as it started, first as founding members of the society then continuing as council and board members. Valentin Madrid led the group very enthusiastically, promoting airway projects, maintaining relationship with SAM and DAS, designing the VAMA cannula for oral fiberoptic intubation, developing the first European Lab & Training Center to teach airway management and organizing dozens of courses not only in Spain but also in other European and Latin American countries. Members of the Spanish airway team founded FIDIVA (Formación Internacional para la Docencia e Investigación de la Vía Aérea [International Foundation for Teaching and Investigation in Airway]), honoring his legacy in airway management; and they implemented the Subcommittee of Airway Control in SEDAR (Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor [Spanish Society of Anaesthesiology, Critical Care and Pain]) Pedro Charco as Vice-President, opened new Airway Training Centers outside Spain (Portugal, USA, Israel, Italy, Argentina, Brazil, Mexico, Peru and Chile). FIDIVA currently gathers more than 50 active Members involved in educational and research all over the world, it has organized more than 150 courses attended by more than 2.000 participants from the field of anaesthesiology, emergency medicine and critical care medicine. FIDIVA is proud to have been organizing the Airway Subcommittee in two World Anaesthesia congresses (Paris 2004 and Argentina 2012). Starting in 2016, FIDIVA runs the first European University Master Program in Airway Management with recognition for 64 ETCs (educational credits for Graduate Medical Doctors). There are a lot of reasons to trust in the capabilities to organize the 3rd European Airway Congress by this group. It follows that FIDIVA members play a special role in the relationship of Spanish airway experts with EAMS. This is very different from airway enthusiasts from the UK or the US who are organized and represented in their own scientific societies DAS and SAM. For the development of the 3rd EAC, FIDIVA uses its well-developed experience in organizing its airway courses: an efficient distribution between lectures and workshops with close interaction between attendants and experts to achieve the main objectives: to learn and to enjoy new insights into cutting-edge airway management during the congress. The 3rd EAC offers a unique and attractive opportunity to attend every workshop as these workshops will be offered repeatedly and run parallel to each other. That allows to interact with more of the highly specialized expert instructors, and also to attend the key lectures. A major factor to come to the congress is to meet with colleagues and friends to become engaged in discussions and arguments during breaks and social events. To provide a lot of time for hands-on engagement with airway devices, strategies or new approaches the 3rd EAC will have only a few but very newsworthy key lectures: 1) Airway assessment; 2) Airway education; 3) Preoxygenation; 4) From guidelines to management; 5) Extubation and Critical Care. A recognized panel of international expert speakers will teach and share their experiences with you: R. Greif (CH), F. Petrini (It), A. Patel (UK), T. Cook (UK), K. Gil (USA), M. Sorbello (It), L. Theiler (CH), M.K. Bruggeney (UK), T. Riva (CH), T. Saracoglu (Tr), A. López (E), L. Gaitini (Is) among them. Each one of the workshop stations will be held by airway experts from EAMS, DAS or SAM and has predefined learning goals as follow: 1)The Fiberoptics for beginners and for advanced users workshop will clarify the indications and contraindications of fiberoptic uses. It provides insights into preparation, maintenance and basic care of the fiberscope and auxiliary material (e.g. Frey-Mask, Aintree catheter, different ET tubes, oral cannulas for FOB …). Opportunities will be provided to train on manikins nasal and oral intubation techniques, exchange of oral to nasal ET tube and identifying the anatomic structures. Also the practice of the correct sequence of double lumen placement, right and left tubes and to get insights into the characteristics of the different types of bronchial blockers: Univent, Arndt, Cohen, Coopdech and EZ-blocker for pulmonary isolation. 2)The workshop - First airway management revolution: Supraglottic Airway Devices will evaluate special features for different devices, the most common mistakes and how to correct them, as well as discuss particular difficulties for insertion. Instructors will facilitate the acquisition of skills in preparation and insertion techniques of supraglottic devices and indications according to clinical situations, and practice the best technique for assisted intubation through the supraglottic airway devices. 3)The workshop - Second airway management revolution: Videolaryngoscopes will go into the decision making to prepare the optimal laryngoscopy as the first approach. Features and indications of videolaryngoscopes in the market will be discussed: type and blade indications, clinical applications and limitations. Finally we will compare direct laryngoscopy with indirect laryngoscopy, insertion and assisted techniques to achieve the best view of the glottis. 4)The workshop - Forthcoming airway management revolution: Ultrasound will identify anatomical landmark structures of the larynx, neck and cricothyroid membrane using ultrasound in volunteers. Measure glottic structures to prepare tracheal intubation, identifying the position of tracheal tube for correct pulmonary ventilation and checking patterns of lung disease: pleural effusion, pneumothorax, pneumonia, consolidation, hematothorax, atelectasis. 5) Front of neck access workshop: Key is to identify anatomical landmarks for a front of neck approach. Train different techniques in animal specimen and simulators (percutaneous with Seldinger technique or cannula over needle) and become familiar with proper equipment for surgical airway. 6) Size matters: the paediatric airway : Differential airway features in children and preparation of paediatric patients for the airway approach. Peculiarities of the paediatric airway devices, importance of mask ventilation and differences in algorithms to manage the difficult airway; all that will be part of that workshop. 7) Fight under stress and learn coping strategies: Clinical simulation scenarios: This simulation workshop will get you familiar with difficult airway situations during simulated airway scenarios: acceptance of fidelity, briefing and debriefing, and how simulation can improve the implementation of the algorithm in the worse scenario to resolve a difficult airway. Developing an algorithm relevant for your own institution would be the ultimate goal of that workshop. 8) Safe Extubation – Strategies to avoid re-intubation problems : Factors of difficult and failed extubation and how to prevent it need to be discussed, as well as predictors of an incidental extubation and conditions needed for safe extubation of a difficult airway. 9) Special DAS Workshop: THRIVE (Transnasal Humidified Rapid-Insufflation Ventilation Exchange) : Get familiar with the theoretical concept behind this new apnoeic oxygenation approach in adults and children. Discussing the “nuts and bolts” with experts who disseminated and studied the concept. 10) Special Workshop for the TAT-course: interactive Video-Debriefing on Airway Teaching (reserved for the Teaching the Airway Teachers Course participants). Among the above mentioned lecturers, the workshops will be conducted by: G. Frova (It), K. Toker (Tr), R. Noppens (CAN), A. Sarakoglu (Tr), A. Govaerts (CH), I. Hodovic (UK) and an extended expert faculty from all over Spain. Another incentive to attend the 3rd EAC is that accepted abstracts will be presented in the poster session as well as EAMS who will publish all accepted abstracts in the EAMS corner of Trends in Anaesthesia and Critical Care (TACC). Much more: The congress provides an oral presentation contest for the selected 6 best abstracts. One of the aims of EAMS is to standardize airway management education. In this sense, the 3rd EAC will offer a TAT-Course as a pre-conference course for selected practitioners involved in airway management and teaching. Finally, Valencia is an attractive Mediterranean city offering the visitor an exciting social life, multicultural heritage, impressive world-class unique architecture and friendly atmosphere in a usually sunny climate that will make your attendance at the 3rd EAC an unforgettable experience. Looking forward to you joining us this December in Valencia. 3 rd EAC organizing local EAMS and FIDIVA team from Valencia. 7 | en_US |
