After rescuing an airway with a supraglottic airway device, a method to convert it to a cuffed tracheal tube is often needed. The best method to do this has never been directly studied. We compared three techniques for conversion of a standard LMA Unique airway to a cuffed endotracheal tube using a fibrescope. The primary endpoint was time to intubation, with secondary endpoints of success rate, perceived difficulty and preferred technique. We also investigated the relationship between level of training and prior training and experience with the techniques on the primary outcome. The mean (95% CI) time to intubation using a direct tracheal tube technique of 37 (31-42) s was significantly shorter than either the Aintree intubation catheter technique at 70 (60-80) s, or a guidewire technique at 126 (110-141) s (p < 0.001). Most (13/24) participants rated the tracheal tube as their preferred technique, while 11/24 preferred the Aintree technique. In terms of perceived difficulty, 23/24, 21/24 and 9/24 participants rated the tracheal tube technique, Aintree technique and guidewire technique, respectively, as either very easy or easy. There was no relationship between prior training, prior experience or level of training on time to completion of any of the techniques. We conclude the tracheal tube and Aintree techniques both provide a rapid and easy method for conversion of a supraglottic airway device to a cuffed tracheal tube. The guidewire technique cannot be recommended.

Introduction: In today’s post COVID 19 world, many healthcare systems have been pushed past the brink of economic sustainability. With Total Hip (THR) and Knee Replacements (TKR) being a few of the biggest ticket items, the need to adopt methods that improve quality of care & reduce unnecessary costs, is imperative. In this context, we report our experience with a Short Stay / Overnight joint replacement model using an ERAS (Enhanced Recovery After Surgery) Protocol which promotes rapid post-operative recovery and a decreased LOS without an increase in complications or readmission rates.   Method: Retrospective collection of clinical & demographic data was undertaken for 114 consecutive patients undergoing primary THR or TKR by a single surgeon between 1 January 2018 and 19 March 2020 at 2 hospitals (1 public, 1 private). The data was analyzed for LOS, complications & readmission rates within 90 days after surgery.   Results: In THR (n=93) and TKR (n=21), mean LOS was1.54 nights (range 0 - 4). 8 patients were discharged to a rehabilitation facility, the remaining 106 were discharged home. 2 patients were readmitted within 90 days of surgery - one with a periprosthetic fracture and the other for an unrelated respiratory illness.   Conclusion: The implementation of a Short Stay model and associated ERAS protocols in both the public and private hospital settings reduced LOS without a concomitant increase in postoperative complications or readmission rates.