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Nicholas Chrimes

@chrimesy.com
1K followers 345 following 1.1K posts

Anaesthetist | Creator Vortex Approach | Co-founder Safe Airway Society | Director Universal Airway (PUMA) Guidelines | ANZCA/ASA/NZSA Airway SIG Executive Member VortexApproach.org UniversalAirway.org SafeAirwaySociety.org EZDrugID.org

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Reposted by Nicholas Chrimes
Project for Universal Management of Airways @universalairway.org · 29/08/2026
Technique for cricoid pressure From PUMA Guidelines for providing a foundation for airway management Full free text forever in @anaesjournal.bsky.social at associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/...
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Reposted by Nicholas Chrimes
Project for Universal Management of Airways @universalairway.org · 29/08/2026
Technique for hyperangulated videolaryngoscopy (Part 2) From PUMA Foundation Guidelines 1st page of graphic on prev post Full free text of guideline in @anaesjournal.bsky.social at associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/...
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Reposted by Nicholas Chrimes
Project for Universal Management of Airways @universalairway.org · 29/08/2026
Technique for hyperangulated videolaryngoscopy. From PUMA Guidelines for providing a foundation for airway management 2nd page of graphic on next post Full free text of guideline in @anaesjournal.bsky.social at associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/...
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Reposted by Nicholas Chrimes
Project for Universal Management of Airways @universalairway.org · 29/08/2026
Universal guidelines for providing a foundation for airway management now available for download. Free full text forever in @anaesjournal.bsky.social 🔑🔓♾ associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/...
associationofanaesthetists-publications.onlinelibrary.wiley.com
Project for Universal Management of Airways: guidelines for providing a foundation for airway management
Introduction Before commencing airway management in any individual patient, a foundation should be provided that establishes the capability of organisations, departments and practitioners to underta...
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Reposted by Nicholas Chrimes
Project for Universal Management of Airways @universalairway.org · 29/08/2026
Technique for neck rescue From the PUMA Foundation Guidelines Download high res images & more detailed description of tech at universalairway.org/downloads Full free text forever in @anaesjournal.bsky.social at associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/...
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Reposted by Nicholas Chrimes
Anaesthesia @anaesjournal.bsky.social · 27/08/2026
Components of a tracheal extubation strategy Project for Universal Management of Airways: guidelines for tracheal extubation #AnSky #MedSky doi.org/10.1111/anae...
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Reposted by Nicholas Chrimes
Anaesthesia @anaesjournal.bsky.social · 27/08/2026
Here are the components of Protective Sequence Extubation! Project for Universal Management of Airways: guidelines for tracheal extubation #AnSky #MedSky doi.org/10.1111/anae...
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Reposted by Nicholas Chrimes
Anaesthesia @anaesjournal.bsky.social · 27/08/2026
Preconditions for considering tracheal extubation Project for Universal Management of Airways: guidelines for tracheal extubation @universalairway.org @Chrimesy.com #AnSky #MedSky #ICUSky doi.org/10.1111/anae...
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Reposted by Nicholas Chrimes
Anaesthesia @anaesjournal.bsky.social · 27/08/2026
Launch of the Project for Universal Management of Airways: guidelines for tracheal extubation! #AnSky doi.org/10.1111/anae...
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Reposted by Nicholas Chrimes
Anaesthesia @anaesjournal.bsky.social · 27/08/2026
What factors should be considered prior to extubation? • airway-related (history & evaluation) • non-airway-related (respiratory, neurological/behavioural, trajectory/stability) Project for Universal Management of Airways: guidelines for tracheal extubation #AnSky #MedSky doi.org/10.1111/anae...
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Reposted by Nicholas Chrimes
Anaesthesia @anaesjournal.bsky.social · 27/08/2026
What processes occur after intubation and alter anatomical risk? • airway trauma • evolving airway pathology • dependent positioning • fluid shifts • impaired airway access Project for Universal Management of Airways: guidelines for tracheal extubation #AnSky doi.org/10.1111/anae...
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Reposted by Nicholas Chrimes
Anaesthesia @anaesjournal.bsky.social · 27/08/2026
EXTUBATION GUIDELINES LAUNCH Project for Universal Management of Airways: guidelines for tracheal extubation @universalairway.org @Chrimesy.com 2026 Airway Management SIG meeting @anzca.bsky.social @asa-australia.bsky.social #AnSky @sthjournalclub.bsky.social doi.org/10.1111/anae...
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Reposted by Nicholas Chrimes
Anaesthesia @anaesjournal.bsky.social · 27/08/2026
Here's the new Extubation Algorithm from PUMA! @universalairway.org @Chrimesy.com #AnSky #MedSky doi.org/10.1111/anae...
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Reposted by Nicholas Chrimes
Safe Airway Society @safeairwaysociety.org · 08/07/2026
The SAS Airway Workshop roadshow is coming to Christchurch! 12/9/26 For more information and to register: vist.ly/5ain7
Safe Airway Society Airway Workshop promotional poster with event details.
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Reposted by Nicholas Chrimes
Anaesthesia @anaesjournal.bsky.social · 06/07/2026
Here's a good one! The criteria for excluding oesophageal intubation are different from those for confirming tracheal intubation. Thoughts? #AnSky #MedSky @chrimesy.com doi.org/10.1111/anae...
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Safe Airway Society @safeairwaysociety.org · 07/05/2026
A few places still available for our Gosford Airway Workshop this Sat morning (& optional Airway Ally Workshop on Fri pm for airway assistants). Station Leads: Neck Rescue: Adam Rehak HAVL/VAFI: Nicholas Chrimes Trachy/lary emergencies: Jon Gatward Register here: vist.ly/53bcg
Promotional flyer for the Safe Airway Society Workshop in Gosford Hospital, NSW on May 9, 2026. Registrations open, includes workshop details and a scenic image of a dock at sunset.
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Reposted by Nicholas Chrimes
Safe Airway Society @safeairwaysociety.org · 07/04/2026
Registrations are now open for all SAS 2026 workshops and the annual meeting in Noosa (held back-to-back with the Airway SIG meeting) Don't miss out. See the website for more details vist.ly/4xi9e
safeairwaysociety.org
SAS Events
SAS Events
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Reposted by Nicholas Chrimes
Safe Airway Society @safeairwaysociety.org · 07/04/2026
SAS 2026 - The Safe Airway Society Annual Event - NOW OPEN FOR REGISTRATION 28th August 2026 Elysium Noosa Resort BOOK NOW TO AVOID MISSING OUT! sas-sas2026-annual-meeting.eventsai…
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Reposted by Nicholas Chrimes
Safe Airway Society @safeairwaysociety.org · 27/04/2026
Separate registrations required for Airway Management SIG & SAS Annual Meeting: Airway management SIG Meeting: vist.ly/4zvyy SAS Annual Meeting: vist.ly/4zvz4
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Reposted by Nicholas Chrimes
Safe Airway Society @safeairwaysociety.org · 27/04/2026
Australia & New Zealand's leading airway education organisations come together for the 1st time for back-to-back meetings at the Elysium Resort Noosa. Speakers include DAS President Al McNarry, SAS President Louise Ellard, Airway SIG Chair Rani Chahal, Anaesthesia EIC Matt Wiles, Cliff Reid & more!
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Safe Airway Society @safeairwaysociety.org · 17/03/2026
Calling clinicians and managers involved in airway management! Take part in a Safe Airway Society study on clinical governance and help shape safer airway practice across Australia and New Zealand. To find out more and to participate, visit: vist.ly/4v94a
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The Association of Anaesthetists @assocanaes.bsky.social · 05/02/2026
New: Guidelines for anaesthesia and sedation in patients who are breastfeeding Anaesthetic, sedative & analgesic medicines are transferred to breastmilk in only very small amounts. Patients should be advised that discarding of breastmilk after anaesthesia is not necessary Download: buff.ly/KNnL8gR
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Reposted by Nicholas Chrimes
Anaesthesia @anaesjournal.bsky.social · 04/02/2026
Semaglutide, fasting and gastric ultrasound Nearly 50% of patients receiving semaglutide treatment had a full stomach on pre-operative gastric ultrasound, regardless of dose, duration, route of administration or withholding time. #AnSky doi.org/10.1111/anae...
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Dr Gavin Sullivan A.N.A.E.S.T.H.E.T.I.S.T 🇳🇿🇦🇺🇬🇧 @lotusgav.bsky.social · 04/02/2026
Be interested to know what their starvation time was? Patients on GLP here are now getting 24 hour fast pre-op.
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Reposted by Nicholas Chrimes
Anaesthesia @anaesjournal.bsky.social · 06/02/2026
Some correspondence from a retired academic lawyer on consent! "... the law, while dynamic, is almost always reactive. Expecting it to change to fit a particular narrative is likely to end in disappointment." #AnSky #LawSky doi.org/10.1111/anae...
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Anaesthesia @anaesjournal.bsky.social · 25/01/2026
Come work with us!
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Safe Airway Society @safeairwaysociety.org · 01/02/2026
Save the date for the @SafeAirway 2026 Annual Meeting. Held in collaboration with the @anzca.bsky.social @asa-australia.bsky.social @thenzsa.bsky.social Airway Management SIG meeting, our shared theme is 'One Airway, One Team'. Get alerted when rego opens: sasevents.eventsair.site/contact-us
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Reposted by Nicholas Chrimes
Safe Airway Society @safeairwaysociety.org · 01/02/2026
Registrations are now open for our Gosford Airway Workshop. Come learn HAVL, VAFI, Neck Rescue & management of trache/lary emergencies on NSW's sunny Central Coast. Qualifies for @anzca.bsky.social CICO ERM sign off & for CICM airway CPD recognition. sasevents.eventsair.site/registration
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Reposted by Nicholas Chrimes
Anaesthesia @anaesjournal.bsky.social · 07/01/2026
Should we use fewer arterial catheters in critical care patients? It may prevent harm from non-infective and infective complications, lower financial and environmental costs and reduce iatrogenic blood loss and blood transfusions in individual patients. #AnSky #ICUSky doi.org/10.1111/anae...
doi.org
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Dr Michael Clifford @drmikeclifford.bsky.social · 10/12/2025
Pity they massively overdosed the ketamine arm - significant percentage > 2mg/kg / no ceiling dose ("rule of 1 ampoule") / dose per total body weight / and who gives > 0.5 mg/kg to a "sick" patient - great trial / wrong pharmacology / wrong conclusion = drugs are equivalent at equipotent doses
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Reposted by Nicholas Chrimes
Anaesthesia @anaesjournal.bsky.social · 10/11/2025
Hyperangulated videolaryngoscopy: stylet first until benefit of bougie is shown "...the current challenge for the wider community of anaesthetists ... is not mastery of HAVL but access to devices, routine use, gaining familiarly and developing competence." #AnSky ttps://doi.org/10.1111/anae.70062
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Reposted by Nicholas Chrimes
Safe Airway Society @safeairwaysociety.org · 06/01/2026
Registrations are now open for the 1st stop on the Safe Airway Society's 2026 #AirwayWorkshopRoadshow: MELBOURNE! ½ Day workshop Sun 22nd March at Peter Mac Stations: Neck Rescue @ANZCA.bsky.social CICO ERM sign off available) HAVL/VAFI Trache/Lary Emergencies Places will sell out fast.
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Reposted by Nicholas Chrimes
Stu Marshall @hypoxicchicken.medsky.social · 02/12/2025
Incidence of peri-operative nerve injuries appears to be decreasing over time - a result of meticulous attention to pressure areas? Increasing use of ultrasound for nerve blocks? What do you think? @dr-amit-pawa.bsky.social @jeffgadsden.bsky.social
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Reposted by Nicholas Chrimes
Safe Airway Society @safeairwaysociety.org · 28/11/2025
Save the dates for our 2026 #AirwayWorkshopRoadshow & annual meeting. This year our annual meeting will be held back-to-back with the @anzca.bsky.social @thenzsa.bsky.social @asa-australia.bsky.social Airway SIG meeting in Noosa Heads, QLD. Registrations open Jan 2026 More details to follow.
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Reposted by Nicholas Chrimes
ANZCA @anzca.bsky.social · 25/11/2025
Australasian Anaesthesia 2025 (also known as the Blue Book) has landed! You can read a digital version, or order a hard-copy version, here: bit.ly/49JzoxX
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Reposted by Nicholas Chrimes
Safe Airway Society @safeairwaysociety.org · 24/11/2025
“For clinicians who have abandoned cricoid force… the qtn to be answered is why they employ any element of RSI at all. Rather than selectively abandoning cricoid force as a component, it should perhaps be the only component we retain” From @chrimesy.com in @anaesjournal.bsky.social
associationofanaesthetists-publications.onlinelibrary.wiley.com
Cricoid force: therapeutic, prophylactic or routine
Click on the article title to read more.
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Reposted by Nicholas Chrimes
Anaesthesia @anaesjournal.bsky.social · 17/11/2025
"It is perverse that cricoid force has been abandoned selectively by many clinicians for not representing evidence-based practice when, compared with [other RSI elements], it is cost-free, better reasoned, has less potential for harm & more evidence of efficacy." #AnSky doi.org/10.1111/anae...
doi.org
Cricoid force: therapeutic, prophylactic or routine
Click on the article title to read more.
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Nicholas Chrimes @chrimesy.com · 15/11/2025
This one’s for @drmikeclifford.bsky.social Cricoid pressure has been selectively vilified out of RSI in many settings, yet it has less risks, a better rationale & more evidence for efficacy than any other cited component of RSI Why aren’t we doing it routinely for all adult tracheal intubations?
associationofanaesthetists-publications.onlinelibrary.wiley.com
Cricoid force: therapeutic, prophylactic or routine
Click on the article title to read more.
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Pete Hart @intensiveperson.bsky.social · 01/09/2025
Awful. I'm just going to leave this here: yes, bronchospasm can account for a flat capnograph, but no, you can't assume that's the reason and you must take the tube out or (if that's genuinely dangerous) exclude oesophageal intubation using a bronchoscope. onlinelibrary.wiley.com/share/author...
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Reposted by Nicholas Chrimes
accounts-leaving-x.bsky.social @accounts-leaving-x.bsky.social · 25/08/2025
Safe Airway Society (a not-for-profit org. in Australia & New Zealand; aiming to optimize safe, effective patient care through a collaborative, multidisciplinary approach to airway management across different healthcare roles & settings) leaves X (3.699 followers) Bluesky: @safeairwaysociety.org
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Nicholas Chrimes @chrimesy.com · 01/09/2025
International Consensus Guidelines for Preventing Unrecognised Oesophageal Intubation. Free full text in @anaesjournal.bsky.social Supported by @dasairway.bsky.social @safeairwaysociety.org @asahq.bsky.social @rcoanews.bsky.social & many more… www.universalairway.org/puoi/support
associationofanaesthetists-publications.onlinelibrary.wiley.com
Preventing unrecognised oesophageal intubation: a consensus guideline from the Project for Universal Management of Airways and international airway societies*
Across multiple disciplines undertaking airway management globally, preventable episodes of unrecognised oesophageal intubation result in profound hypoxaemia, brain injury and death. These events occ...
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Nicholas Chrimes @chrimesy.com · 01/09/2025
Yet another case of death from unrecognised oesophageal intubation. The circumstances of the case are tragically similar to previous cases: good clinicians succumbing to cognitive bias. Please familiarise yourself with the guidelines to avoid falling into the same trap. @anzca.bsky.social
1news.co.nz
Woman dies after breathing tube mistakenly inserted into food pipe
The 73-year-old suffered an unsurvivable brain injury after the error went unnoticed for 17 minutes during surgery.
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Dr Mary-Ann Fox BMBS FANZCA GChPOM @maffygirl.medsky.social · 30/08/2025
The most important use of VL is engaging the team. They can see what is happening. Your assistant can see if their airway manoeuvres are helping or hindering. DL is a lonely game.
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David Milner @davemilbo.bsky.social · 24/08/2025
Absolutely massive crowd in Naarm/Melbourne today. From the river to the sea.
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Just Jack @just-jack-1.bsky.social · 24/08/2025
He’s wanted to declare martial law from day one. Bypass all checks and rule as a tyrant. Many have speculated how he’d do it. Now his gambit is clear. DC was a test. He’s using manufactured crime stats to send troops into blue states & cities. This is not a drill. Democracy is at defcon 1.
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Robbie Erskine @drrobbieerskine.bsky.social · 21/08/2025
Oh..patients don’t complain when you don’t use LA they just accept it hurts! What I get is “Oh ..is it done?” Or “Wow..that was ok after all” Also they don’t move and , should you miss, they don’t get wound up if you have to redo!
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Dr Mary-Ann Fox BMBS FANZCA GChPOM @maffygirl.medsky.social · 20/08/2025
This is the midweek #MedSkyDebate thanks to @pieterpeach.com Do you use LA for your cannula insertions?
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Nicholas Chrimes @chrimesy.com · 18/08/2025
Not doing the right thing bc it’s too hard is simply not caring enough.
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David Milner @davemilbo.bsky.social · 18/08/2025
If the argument for why something - literally anything - should not be done, is that it's complicated, and hard, and you don't understand, blah blah, but good on you for caring... that's literally never a good point. It's always a deflection and never engages. It's PR for inertia
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Nicholas Chrimes @chrimesy.com · 17/08/2025
While CL has its issues (mainly that no one remembers what the gradings mean) POGO is a completely useless classification system. It can only subclassify easy views (CL 1 -2a) but is unable to discriminate bw challenging views (CL 2b - 4 are all potentially POGO 0%).
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