Anesthesiologist, Author, Educator, Inventor. You’re never too smart to do something simple.
Milwaukee, WI
Joined May 2011
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Pinned Tweet
Excellent Summary of SALAD technique xitter.cf/emswami/status/9967927…
James DuCanto, M.D. retweeted
A French video game and cartoon store owner has his store looted in Nice.
He gets attacked from behind and then has rocks thrown at him while young rioters laugh
James DuCanto, M.D. retweeted
Classifying mask ventilation: current evidence supports the MASCAN score, not capnography
#anaesthesia #MedTwitter #MedX
doi.org/10.1111/anae.70402
James DuCanto, M.D. retweeted
...anything to contribute regarding the systematization of the grip`? @jducanto ???
James DuCanto, M.D. retweeted
James DuCanto, M.D. retweeted
But even "routine" saturday night intubations of our trauma pts typically involve full stomachs ( burritos, Mcnuggets, beef jerky) pressurized by a pitcher or two of beer. I would always recommend a large bore suction catheter for all ED and prehospital airway interventions rather than starting with a yank and then switching over if needed
James DuCanto, M.D. retweeted
PUMA 2026 doesn't ask for more technology. It asks for order: a standardized surgical airway kit, capnography on every intubation, videolaryngoscope as first choice — not the backup for the hard case. That's buildable in any public hospital ER, budget we already have.
🔗 associationofanaesthetists-p…
#Airway #PUMA
@AirwayMxAcademy @jducanto @UniversalAirway @NicholasChrimes @doctimcook @dasairway
James DuCanto, M.D. retweeted
I’m so old I can remember running 911 calls without gloves. So much blood, vomit, urine and shit to wash off. If you had to scrape shit from under your fingernails repeatedly you too would rethink your position on gloves. No way I’m touching anybody now without gloves.
James DuCanto, M.D. retweeted
Great start to the day: a GI CRNA emailed that her colleague tried the McMurray Airway, loved it, and wants it for his other practices. Her gastroenterologist even thanked her for bringing in safer equipment. ❤️
This is why we do it.
#mcmurraymed
#Endoscopy #anesthesiology
James DuCanto, M.D. retweeted
A patient in your care is being treated with High Flow Oxygen Therapy (HFOT) but may later transition to Continuous Positive Airway Pressure (CPAP) or Non-Invasive Ventilation (NIV).
Which partner in respiratory care would give you the flexibility to adapt treatment quickly while maintaining comfort and effectiveness?
Find the answer and explore our full range of Patient Interfaces at #ERSCongress, Stand Y.04 today!
📲 Explore our Patient Interfaces range: intersurgical.com/info/patie…
📧 [email protected]
#Intersurgical #RespiratoryCare
James DuCanto, M.D. retweeted
A doctor charged with negligent manslaughter through Unrecognised Oesophageal Intubation
-a tragedy all round
-Cayman islands
-British lawyer
-British medical expert
-sadly inevitable that such a charge would arise somewhere eventually
caymannewsservice.com/2026/0…
James DuCanto, M.D. retweeted
An American asked me what I did for work.
I told him.
He said, "Yeah, but what do you do?"
I told him again, slower.
He said, "No, I mean what do you actually love doing."
I have been asked my job a thousand times in Japan. Nobody has ever asked me a second question.
I said I liked writing. I said it apologetically, the way you admit a crime.
He said, "Then you're a writer."
I told him nobody pays me.
He said, "Didn't ask that."
In my country you become a thing after permission is granted. A company. A title. A card with your name and your rank printed in the correct order.
Here a stranger at a barbecue can hand you an identity while holding a paper plate.
I said I wasn't sure I was good enough yet.
He shrugged and said, "You'll get good. Everybody's bad first."
Then he went to check the grill, because to him the matter was closed.
That was fourteen months ago.
I have written every day since.
America, you have a terrible habit. You look at a man who has done nothing yet and describe him as the thing he might become, out loud, with total confidence, in front of witnesses.
It is not accurate.
But it works.
James DuCanto, M.D. retweeted
nice example of when videolaryngoscopy is used to look around a corner *without* proper positioning to allign the airway (ie not in sniffing position)
you get a terrific view of the glottis, but the acute angle between the ETT and the trachea (which is diving *downward* in this perspective view) impedes tube passage
this video appears to have been done with standard-geometry videolaryngoscopy, but the same error can occur with either standard-geometry or hyperangulated videolaryngoscopy. Using standard geometry videolaryngoscopy and NOT cheating by looking at the screen prematurely can prevent this error pattern (but the urge to look prematurely is strong and few can resist).
(PS- if you intubate you should follow this account)
🫁🎥 September 2026 Airway of the Month is live:
“GOOD VIEW. BAD GEOMETRY.” 👇
🔗 airwayofthemonth.com/aotm-cu…
The vocal cords are visible. The ETT is well directed. It still won’t advance. 🤨
Seeing the target is not the same as creating a path.
🦷 Secure dentures may improve the BVM seal. Remove them before laryngoscopy.
👀 Build the view progressively:
UVULA → EPIGLOTTIS → LARYNX
Here, the blade sits left of midline, producing an oblique view and asymmetric epiglottic lift. Workable? Yes. Optimized for tube delivery? Not quite.
⚠️ The ETT bevel repeatedly appears to engage the rigid anterior tracheal rings. Resistance is information—not an invitation to push harder. More forward pressure preserves the same collision.
↩️ First, come back. Withdraw slightly, flatten the trajectory, then re-advance.
If rotating:
LARYNX LEFT
RINGS RIGHT
But disengage before corkscrewing.
🛑 After 1–2 gentle ETT advances, change something meaningful:
✅ Re-center the blade and contain the tongue
✅ Suction
✅ Change the blade
✅ Restyle or downsize the ETT
✅ Use a bougie
🧹 DuCanto suction produces a cleaner, nearly grade-I view on the second attempt—but nearly identical geometry recreates the same problem.
Suction clears the view. It doesn’t fix the pathway.
🌅 Repeated manipulation also begins to pull the epiglottis into view. A good view can deteriorate while we keep trying to make a bad trajectory work.
The successful sequence:
STYLET OUT → SLIGHT RETRACTION → FLATTEN → ADVANCE 🎯
⏱️ Quick jumps:
0:52—Dentures
1:19—Progressive laryngoscopy
2:00—ETT hang-up
3:25—Time to pivot
5:20—Successful reset
September’s sequence:
REMOVE → RECENTER → RETRACT → FLATTEN → ADVANCE 🔄
Resistance is information. Repetition is not a plan.
Keep pushing airway education forward—just don’t keep pushing the ETT. 😉
#AirwayOfTheMonth #AirwayManagement #FOAMed #EmergencyMedicine #VideoLaryngoscopy #DifficultETTpassage
Northern Suburban Chicago Illinois EMS Services—I’ll have a train-the-trainer event September 21st at the Evanston FD
🤖 Made with AI
James DuCanto, M.D. retweeted
We are delighted to announce that Intersurgical has been awarded the EcoVadis Bronze Medal, a globally trusted provider of business sustainability ratings.
This year, we achieved a 30% increase in our sustainability score, placing Intersurgical in the top 35% of companies assessed globally and the top 10% within our industry!
At Intersurgical, we are proud of the progress we continue to make and remain committed to delivering our products to the highest quality in the most sustainable, responsible and ethical way.
As we move forward, we will continue working towards our ambitious sustainability goals, ensuring our customers, value chain and stakeholders can continue to trust in our commitments.
Explore our dedicated sustainable development landing page:
📲 intersurgical.com/info/susta…
✉️ [email protected]
#Intersurgical #Respiratorycare #ecointersurgical
James DuCanto, M.D. retweeted
Amen brother. RIP Dolly
Dolly Parton is dead, and the church never knew what to do with her.
Half my feed is posting rhinestones today. The other half never trusted her, because she would not wear the uniform.
She never preached a sermon.
She just did the works.
One man. Fifty-eight years. In an industry that eats marriages. No scandal reel, no reality show, no trading up. Just Carl, and a promise kept until death did them part.
She could have built towers in Nashville. Instead she built in the mountains she came from, so the people she came from could work.
Two hundred million books. Given away to children, free, no strings, while the rest of us argued about what to read.
A million dollars for a vaccine in the middle of a plague, and she called it what it was: helping.
She was a feminist who never used the word, a superstar who never left home, and a believer who never made you watch her pray.
"Yea, a man may say, Thou hast faith, and I have works: shew me thy faith without thy works, and I will shew thee my faith by my works." James 2:18.
We spent years asking whether she was one of ours.
She never asked whether we were one of hers. She was too busy feeding children.
I do not know her heart. That was never my job. I know her works, because the whole county she came from lives on them.
"Wherefore by their fruits ye shall know them." Matthew 7:20.
You want to honor her today? Put down the tribute post. Put a book in a kid's hands. Stay married. Do the works.
That was the whole sermon. She just never said it out loud.
James DuCanto, M.D. retweeted
Great data-driven reminder from @doctimcook et al: with VL, "I can see" and "I can intubate" are two different skills. 1 in 10 easy Cormack-Lehane views still needed >1 attempt — and it wasn't blade geometry (D-blade wasn't worse), it was operator experience. The bottleneck has shifted from glottic view to tube delivery mechanics ("acceso traqueal" in Spanish). Time our training curricula caught up. #AirwayEd #FOAMed #DynamicIntroductor
@italo05airway @Dcs_AwUS @airwayneuro @JamesPM88 @jducanto @AirwayC76055 @CursoEMIVA @ProtectedAirway @airwayGladiator @intubatiem – at Santiago de Surco, Peru
James DuCanto, M.D. retweeted
Back from another rural locum in The Riverland, South Australia.
We have had a lot of rain so canola and other crops look amazing.
By going rural it allows higher risk patients to have surgery near home.
With @urethroplasty
#MyHappyPlace
James DuCanto, M.D. retweeted
Hey @KangarooBeach ... idea for a mobile Health Care Clinic?
Australians crossed a strait on a homemade barge with a toilet to save money
Two Australian residents built a homemade barge with an outdoor toilet, a motor, and a barbecue to avoid paying more than 2,000 Australian dollars to deliver a toilet to Kangaroo Island.
Instead of a 45-minute ferry ride, they spent around four hours crossing the water. Along the way, they grilled sausages and ribs, and used the toilet for its intended purpose.
A video of the unusual journey went viral a year after the trip.