Nick Mark MD pushes "Atomize don’t nebulize" for lidocaine in awake intubation, saying nebulized lidocaine misses the upper airway and proper topicalization is needed for safety.
Atomize don’t nebulize.
Nebulized lidocaine does a little for the bronchi but almost nothing for the upper airway.
If you want to do an awake intubation safely you need to properly topicalize the airway
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