Coda Change Airway Innovators 2 - VAFI and FARSI
May 26, 2024
Explore the confusion surrounding advanced airway techniques as Adam Rehak breaks down the revolutionary combined use of video laryngoscopes and flexible bronchoscopes. He defines VAFI and FASI, highlighting their critical roles in navigating airway challenges, especially with suspected tracheal disruptions. Get ready for step-by-step demonstrations on the practical applications of these methods, along with insights on resource availability in emergency departments. It’s a deep dive into the future of airway management!
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Two Distinct Problems, Two Techniques
- Combining video laryngoscopy and flexible bronchoscopy addresses two distinct airway problems: above-cord navigation and below-cord tracheal disruption.
- Neither combined technique replaces awake intubation when that is the safer option.
Use VAFI Only When Awake Is Contraindicated
- Do not use VAFI as a substitute for awake intubation; reserve it for patients who are non-compliant or when awake technique is contraindicated.
- Use the flexible bronchoscope as a steerable bougie when tube passage with a hyperangulated blade is difficult.
Perform FASI Rapidly And Precisely
- For suspected tracheal disruption perform a rapid sequence induction and stop with the tube bevel at the cords before introducing the bronchoscope.
- Pass the scope quickly beyond the disruption, then advance the tube over it and inflate the cuff before ventilating.