Atropínico

Some impressions of Amsterdam Airways Festival 2026 Theme Complex Airways 🆒27 nationalities 👉12 complex case masterclasses 🚑 mass casualty prehospital scenarios of a plane rash in the stadium 🫆an airway escape room 👨‍🎓international airway cases 🫁workshops ✍️Teach the Airway Teacher course 👌key note lectures 🫶🏼great teamwork “I am - because we are” #AAF26

Countdown 10 days #AAF26

BRIC BRAC airway and bronchoscopy course in Cambridge next month 1-2 September 2026 Register here: [email protected] A few places left I will CU there😎 @Respitudoc @BrICcourse @NaveenEipe @DaveOlvera1 @dasairway @dr_imranahmad @maffygirl @HouthoffKavita @SafeAirway @AnRocad #airway #bronchoscopy

Almost too fast to see it with your own eyes. This can happen when you intubate a kid with propofol and remifentanil but do not use a muscle relaxant. Larynx rigidity caused by remifentanil or larygospasm triggered by a drop of 🩸 Easily fixed with a bit of extra propofol iv in this case. 25 kg, 7 year old, BMI 22, nasal intubation Gaseous induction with sevoflurane, followed by bolus propofol and remifentanil iv. The cords oscillate at very high frequency and it almost looks like a web During laryngospasm, the structures that move most importantly are the true vocal folds, but the mechanism involves several parts of the glottic closure apparatus. What actually moves? True vocal folds — the primary structures They undergo forceful adduction, closing the rima glottidis. The posterior part of the glottis may remain slightly open initially, producing the characteristic inspiratory noise. With severe/complete laryngospasm, the true cords can become tightly apposed along their entire length. Arytenoid cartilages The arytenoids rotate medially through action of the lateral cricoarytenoid muscles. This brings the posterior vocal processes together and contributes substantially to posterior glottic closure. False vocal folds (vestibular folds) These can also adduct, particularly during a strong laryngospasm. They contribute to the multilayered closure of the laryngeal inlet but are not usually considered the primary mechanism. Aryepiglottic folds These may also contract and contribute to narrowing of the supraglottic inlet. The important clinical distinction A useful conceptual model is: Stimulus → reflex adduction of true vocal folds → arytenoid medial rotation → progressive glottic closure → possible supraglottic closure So, if you’re looking through a flexible scope during laryngospasm, you’re primarily watching the true vocal folds moving medially, with the arytenoids coming together posteriorly. In a severe episode, the view may progress from a narrow posterior chink to complete glottic closure. For airway management: laryngospasm is therefore fundamentally a dynamic, reflex closure of the glottis, rather than simply “the vocal cords moving.” This distinction is useful when deciding whether an airway maneuver, CPAP, deepening anaesthesia, or neuromuscular blockade is addressing the underlying problem. #laryngospasm

Only a few seats left Amsterdam Airway Festival 24-26 September 2026 At Olympic Stadium #AAF26

Coming soon to the major podcast platforms AIRWAY UNSCRIPTED #airwayunscripted #airwaymanagement #airwaychallenges #airwaymanagementacademy