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Excellent 1 pager from Dr Levitan in the new ACEP now newspaper.
I have been trying to get the residents to implement the nasal cannula, and to a lesser extent the LMA, for years. Pearl: nasal cannula plus mandible traction opens the nasopharynx and allows oxygen to diffuse to the alveoli (due to gradient made by hemoglobin absorbing oxygen). This is apnea oxygenation, increased safe apnea time. See the pure gold article by Levitan/Weingart, apparently 4th most read annals of EM article.
Add the cannula and mandible thrust to a properly positioned patient, ear to sternal notch or even well above sternal notch, and you will be amazed how long it takes to desat. OOPS (Oxygen On, Pull the mandible, Sit the patient up.
Read this brief article a few times and change how you practice.
Anyone who has worked with me knows I love me some LMAs when it comes to BVV. In the paralyzed patient, I noticed you get better seal, 2 sets of hands aren’t in your field and it is easy to insert. Once seated properly, you are free to prep for your next definitive airway technique. No fumbling around with the BVM.
Helpful hint: awake people don’t tolerate LMAs, keep them paralyzed when using.
Helpful hint#2. Don’t deflate the balloon when removing. This helps create a dam effect for the secretions/blood etc to be removed with the LMA instead of pooling in the oropharynx around the deflated balloon.