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Components of a tracheal extubation strategy Project for Universal Management of Airways: guidelines for tracheal extubation #AnSky #MedSky doi.org/10.1111/anae...

Reposted by Nicholas Chrimes

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

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

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

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...

Reposted by Nicholas Chrimes

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...

Reposted by Nicholas Chrimes

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

Safe Airway Society @safeairwaysociety.org · 08/07/2026

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

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

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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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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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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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Nicholas Chrimes @chrimesy.com · 27/04/2026

Conceptually the sloping sides of the funnel of the Vortex represent the potential for deteriorating SpO2 if alveolar O2 is not restored. When ventilation is interrupted in a patient with shunt physiology this descent would be more precipitous, and (theoretically) less so with ApOx.

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Nicholas Chrimes @chrimesy.com · 17/04/2026

Correct. Whereas ApOx w HFNO (in patients without shunt physiology) would make the sides less steep.

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Reposted by Nicholas Chrimes

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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Reposted by Nicholas Chrimes

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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Reposted by Nicholas Chrimes

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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Reposted by Nicholas Chrimes

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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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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Nicholas Chrimes @chrimesy.com · 30/11/2025

The term ‘TIVA’ is irrelevant to what’s being discussed. The question is should you deliver the induction meds for RSI through a syringe pump. The answer is no (until we get pumps that can deliver at 7200ml/hr).

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Nicholas Chrimes @chrimesy.com · 29/11/2025

“TIVA RSI” (whether pump assisted or not) is a stupid term. What makes the anaesthetic TIVA is whether IV agent is used for throughout. All RSI inductions are IV but many are not TIVA bc a volatile is subsequently given for maintenance. It’s just pump assisted RSI.

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Nicholas Chrimes @chrimesy.com · 29/11/2025

Specifics have evolved. Principles remain the same. I think the biggest issue w RSI is its binary nature. If someone is ‘at risk’ of aspiration, they get RSI even if elements of the technique (eg. no latency bw IA & NMBA) might cause them harm. Amounts to aspiration trumping all other concerns 🤔

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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.

ANZCA @anzca.bsky.social · 25/11/2025

Reposted by Nicholas Chrimes

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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Though there are plenty of other reasons to intubate head up.

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Steep head up decreases the risk of regurgitation but increases the risk of aspiration if regurgitation does occur. Conversely, steep head down makes regurgitation more likely but aspiration virtually impossible in an apnoeic patient. It’s a zero sum game. You can argue it either way.

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If you’re not going to use cricoid, you shouldn’t be doing RSI at all, just standard intubations on everyone.

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No one has shown *in a randomised controlled trial* that it does what they say it will do (which is true of all components of RSI) but there’s lots of other experimental evidence that it blocks passage of material bw stomach & pharynx (whereas no other component of RSI has any evidence at all!).

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