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https://www.readbyqxmd.com/read/28630743/comparison-of-five-video-assisted-intubation-devices-by-novice-and-expert-laryngoscopists-for-use-in-the-aeromedical-evacuation-environment
#1
Matthew C Wallace, SSgt Tyler Britton, Robbie Meek, Sharon Walsh-Hart, Col Todd E Carter, Steven J Lisco
BACKGROUND: The critically ill or injured patient undergoing military medical evacuation may require emergent intubation. Intubation may be life-saving, but it carries risks. The novice or infrequent laryngoscopist has a distinct disadvantage because experience is critical for the rapid and safe establishment of a secured airway. This challenge is compounded by the austere environment of the back of an aircraft under blackout conditions. This study determined which of five different video-assisted intubation devices (VAIDs) was best suited for in-flight use by U...
2017: Military Medical Research
https://www.readbyqxmd.com/read/28599040/intubation-of-the-right-atrium-during-an-attempted-modified-surgical-airway-in-a-pig
#2
Jason Bowman, Andrew Juergens, Matthew McClure, Dave Spear
In modern medicine, the surgical cricothyrotomy is an airway procedure of last resort. In austere environments, however, its simplicity may make it a more feasible option than carrying a full complement of laryngoscopes. To create a Transportation Security Agency-compliant compact first-response bag, we attempted to establish a surgical cricothyrotomy in a pig, using trauma shears, basic medical scissors, a pocket bougie, and an endotracheal tube. Bougies can provide tactile feedback via the "tracheal ring sign" and "stop sign" to indicate positive tracheal placement during orotracheal intubation...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28582298/flail-mandible-and-immediate-airway-management-traumatic-detachment-of-mandibular-lingual-cortex-results-in-obstructive-dyspnea-and-severe-odynophagia
#3
Ioannis Papadiochos, Lampros Goutzanis, Vasileios Petsinis
Isolated mandibular fractures usually represent themselves as non-life-threatening injuries and are not treated in emergency setting. However, some rare patterns of them may result in airway obstruction as a result of displacement of bony fragments. The authors report a patient of an open comminuted fracture of mandibular symphysis which exhibited an uncommon split pattern with retrogression of lingual cortical plate, and thereby induced glossoptosis, painful deglutition, and obstruction of the upper airway within a few hours...
June 2, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28579789/a-retrograde-y-stenting-of-the-trachea-for-treatment-of-mediastinal-fistula-in-an-unusual-situation
#4
Wolfgang Hohenforst-Schmidt, Paul Zarogoulidis, Michael Steinheimer, Thomas Schneider, Naim Benhassen, Holger Rupprecht, Lutz Freitag
INTRODUCTION: Stents have been used for quite some time for the treatment of benign and malignant airway stenosis. Silicon stents are preferred for benign situations, whereas metallic self-expanding stents are preferred for malignant comorbidities. PATIENT AND METHODS: In general, stents can be placed in different approach directions, although in pulmonary medicine it is logical to apply only antegrade techniques - until now. A 63-year-old patient, 168 cm height and 53 kg weight on referral, suffered chronical diseases...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28570294/blind-intubation-through-self-pressurized-disposable-supraglottic-airway-laryngeal-intubation-masks-an-international-multicenter-prospective-cohort-study
#5
Kurt Ruetzler, Sandra Esther Guzzella, David Werner Tscholl, Tanja Restin, Marco Cribari, Alparslan Turan, Jing You, Daniel I Sessler, Burkhardt Seifert, Tomasz Gaszynski, Michael T Ganter, Donat R Spahn
INTRODUCTION: Supraglottic airway devices commonly are used for securing the airway during general anesthesia. Occasionally, intubation with an endotracheal tube through a supraglottic airway is indicated. Reported success rates for blind intubation range from 15 to 97%. The authors thus investigated as their primary outcome the fraction of patients who could be intubated blindly with an Air-Qsp supraglottic airway device (Mercury Medical, USA). Second, the authors investigated the influence of muscle relaxation on air leakage pressure, predictors for failed blind intubation, and associated complications of using the supraglottic airway device...
June 1, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28556897/claims-for-compensation-after-injuries-related-to-airway-management-a-nationwide-study-covering-15-years
#6
I Fornebo, K A Simonsen, I R K Bukholm, U E Kongsgaard
BACKGROUND: Securing the airway is one of the most important responsibilities in anaesthesia. Injuries related to airway management can occur. Analysis from closed claims can help to identify patterns of injury, risk factors and areas for improvement. METHODS: All claims to The Norwegian System of Compensation to Patients from 1 January 2001 to 31 December 2015 within the medical specialty of anaesthesiology were studied. Data were extracted from this database for patients and coded by airway management procedures...
May 30, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28551485/spontaneous-submental-hematoma-a-pseudo-ludwig-s-phenomenon-in-101-year-old-patient-case-report-and-literature-review
#7
Uthman Alamoudi, Yasser Alsallumi, Matthew H Rigby, S Mark Taylor, Jonathan R B Trites, Robert D Hart
OBJECTIVE: Submental hematoma or pseudo-Ludwig's phenomenon, is a rare entity seen in anticoagulated patients and can precipitate upper airway obstruction. Our objective is to present a rare case of spontaneous submental hematoma due to poorly controlled hypertension in elderly patient and to perform a literature review. CASE REPORT: 101-year-old female presented to emergency room with sudden painful swelling in the floor of mouth and slurred speech. Not on anticoagulation and no history of trauma or known allergies...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28539578/drug-induced-inhibition-of-angiotensin-converting-enzyme-and-dipeptidyl-peptidase-4-results-in-nearly-therapy-resistant-bradykinin-induced-angioedema-a-case-report
#8
Janina Hahn, Susanne Trainotti, Thomas K Hoffmann, Jens Greve
BACKGROUND Bradykinin is an underestimated mediator of angioedema. One subgroup of bradykinin induced angioedema is angioedema triggered by treatment with angiotensin converting enzyme (ACE) inhibitors. Due to its localization in the head and neck region and its unpredictable course, it is a possibly life-threatening condition. There is not an officially approved treatment for ACE inhibitor induced angioedema. CASE REPORT We present a case of an 83-year-old woman, who presented to our ENT department because of acute swelling of the tongue...
May 25, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28513831/avoidance-versus-use-of-neuromuscular-blocking-agents-for-improving-conditions-during-tracheal-intubation-or-direct-laryngoscopy-in-adults-and-adolescents
#9
REVIEW
Lars H Lundstrøm, Christophe Hv Duez, Anders K Nørskov, Charlotte V Rosenstock, Jakob L Thomsen, Ann Merete Møller, Søren Strande, Jørn Wetterslev
BACKGROUND: Tracheal intubation during induction of general anaesthesia is a vital procedure performed to secure a patient's airway. Several studies have identified difficult tracheal intubation (DTI) or failed tracheal intubation as one of the major contributors to anaesthesia-related mortality and morbidity. Use of neuromuscular blocking agents (NMBA) to facilitate tracheal intubation is a widely accepted practice. However, because of adverse effects, NMBA may be undesirable. Cohort studies have indicated that avoiding NMBA is an independent risk factor for difficult and failed tracheal intubation...
May 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28511807/does-the-novel-lateral-trauma-position-cause-more-motion-in-an-unstable-cervical-spine-injury-than-the-logroll-maneuver
#10
Per Kristian Hyldmo, MaryBeth Horodyski, Bryan P Conrad, Sindre Aslaksen, Jo Røislien, Mark Prasarn, Glenn R Rechtine, Eldar Søreide
OBJECTIVE: Prehospital personnel who lack advanced airway management training must rely on basic techniques when transporting unconscious trauma patients. The supine position is associated with a loss of airway patency when compared to lateral recumbent positions. Thus, an inherent conflict exists between securing an open airway using the recovery position and maintaining spinal immobilization in the supine position. The lateral trauma position is a novel technique that aims to combine airway management with spinal precautions...
May 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28504991/tablet-e-logbooks-four-thousand-clinical-cases-and-complications-e-logged-by-14-nondoctor-anesthesia-providers-in-nepal
#11
Shristi Shah, Oliver Ross, Stephen Pickering, Stephen Knoble, Indra Rai
BACKGROUND: To meet the need for essential surgery across rural Nepal, anesthesia at district level is delivered by nondoctor anesthetists. They require support to maintain confidence and competence, and upgraded professional registration to secure their status. To meet these needs, a distance-blended learning course was pioneered and delivered. A core course requirement was to log all clinical cases; these were logged on a new e-logbook. METHODS: Fourteen nondoctor anesthesia providers working in 12 different districts across Nepal were enrolled in the 1-year course...
May 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28460700/airways-and-injuries-protecting-our-pediatric-patients-from-respiratory-device-related-pressure-injuries
#12
REVIEW
Laura J Miske, Molly Stetzer, Melissa Garcia, Judith J Stellar
Pressure injury prevention is required in all health care environments. Respiratory technology includes invasive and noninvasive positive pressure ventilation methods of support and life-saving equipment. Pressure injury can occur from tracheostomy tubes and their securement devices, or use of noninvasive positive pressure ventilation interfaces or the head gear. Methods instituted to decrease hospital-acquired pressure injury related to noninvasive positive pressure ventilation and tracheostomy securement devices are discussed...
June 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28445377/first-lower-two-thirds-osteomyocutaneous-facial-allograft-perfused-by-a-unilateral-facial-artery-outcomes-and-vascularization-at-1-year-after-transplantation
#13
Sebastian Fischer, Thomas C Lee, Nicco Krezdorn, Muayyad Alhefzi, Maximilian Kueckelhaus, Ericka M Bueno, Bohdan Pomahac
BACKGROUND: Facial allotransplantation provides a unique opportunity to restore facial form and function in severely disfigured patients. Using a single unilateral facial artery for vascularization can significantly reduce surgical duration and thus facilitate the practice of face transplantation. METHODS: A 33-year-old man with a history of high-energy ballistic trauma received a facial allograft comprising the lower two-thirds of the face, including maxilla and mandible...
May 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28443290/comparison-of-a-supraglottic-airway-device-v-gel-%C3%A2-with-blind-orotracheal-intubation-in-rabbits
#14
Sarah Engbers, Amy Larkin, Nicolas Rousset, Melanie Prebble, Mahesh Jonnalagadda, Cameron G Knight, Daniel S J Pang
INTRODUCTION: Achieving a secure airway in rabbits is generally considered more difficult than in cats or dogs. Their relatively large tongue, small oropharyngeal cavity and glottis limit direct visualization. A rabbit-specific supraglottic airway device (SGAD) may offer benefits over blind orotracheal intubation. ANIMALS AND METHODS: Fifteen adult New Zealand white rabbits were randomized to SGAD or orotracheal intubation (ETT). All animals were sedated with dexmedetomidine (0...
2017: Frontiers in Veterinary Science
https://www.readbyqxmd.com/read/28404450/does-lying-in-the-recovery-position-increase-the-likelihood-of-not-delivering-cardiopulmonary-resuscitation
#15
Miguel Freire-Tellado, Rubén Navarro-Patón, Maria Del Pilar Pavón-Prieto, Marta Fernández-López, Javier Mateos-Lorenzo, Ivan López-Fórneas
BACKGROUND: Resuscitation guidelines endorse unconscious and normally breathing out-of-hospital victims to be placed in the recovery position to secure airway patency, but recently a debate has been opened as to whether the recovery position threatens the cardiac arrest victim's safety assessment and delays the start of cardiopulmonary resuscitation. AIM: To compare the assessment of the victim's breathing arrest while placed in the recovery position versus maintaining an open airway with the continuous head tilt and chin lift technique to know whether the recovery position delays the cardiac arrest victim's assessment and the start of cardiopulmonary resuscitation...
June 2017: Resuscitation
https://www.readbyqxmd.com/read/28400693/ludwig-s-angina-a-nightmare-worsened-by-adverse-drug-reaction-to-antibiotics
#16
Mohamed Hisham, Mundilipalayam N Sivakumar, R S Senthil Kumar, P Nandakumar
A 52-year-old obese gentleman presented to the hospital with complaints of fever and shortness of breath for 10 days. He was admitted in the ward and treated for acute exacerbation of asthma. He was shifted to the Intensive Care Unit (ICU) for persistent fever, neck swelling, airway obstruction and desaturation. Ludwig's angina was suspected and computed tomography of neck confirmed it. A difficult airway was anticipated and preceded with surgical tracheostomy. The patient had hypersensitivity reactions to piperacillin/tazobactam; hence, he was treated with clindamycin and metronidazole...
March 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28393433/nasal-high-flow-oxygen-delivery-in-children-with-abnormal-airways
#17
Susan Humphreys, Derek Rosen, Tessa Housden, Julia Taylor, Andreas Schibler
BACKGROUND: Transnasal Humidified Rapid-Insufflation Ventilatory Exchange has been shown to safely prolong the safe apnea time in well children post induction of anesthesia and is rapidly becoming a new standard for apneic oxygenation in adults. The same oxygenation technique is described as nasal high flow and can be used in infants and children at risk of apnea during anesthesia. AIM: We investigated the use of nasal high flow oxygen delivery during anesthesia in children with abnormal airways requiring tubeless airway assessment or surgery...
June 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28377879/membranous-tracheal-stenosis-in-a-patient-with-anorexia-nervosa-and-self-induced-vomiting-challenges-in-securing-the-airway
#18
Motohiro Nakamura, Masaki Hisamura, Masayuki Hashimoto, Makoto Sawano, Midori Joshita, Takahiro Toi, Yoshitaka Asano, Hideyo Matsueda, Fumihito Arima, Hidenori Oi, Takehiro Kitawaki, Yoji Ando, Kenji Koshimizu
We report a rare case of acquired membranous tracheal stenosis in a patient with anorexia nervosa and a history of self-induced vomiting, but without a history of tracheal intubation or tracheostomy. A 50-year-old woman presented with difficulty in breathing and swallowing, self-expectoration, and impaired consciousness due to acute benzodiazepine intoxication. Bronchoscopic examination was performed after tracheotomy and placement of a tracheostomy tube failed to secure her respiratory tract and ventilation continued to deteriorate...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28358178/time-to-intubation-in-obese-patients-a-randomized-study-comparing-direct-laryngoscopy-and-videolaryngoscopy-in-experienced-anaesthetists
#19
Fredrik Ander, Anders Magnuson, Lars Berggren, Rebecca Ahlstrand, Alex de Leon
BACKGROUND: Airway management may be difficult in obese patients. Moreover, during prolonged intubation, oxygen desaturation develops rapidly. Videolaryngoscopy improves the view of the larynx, and the Storz® C-MACTM has been shown to be superior to other videolaryngoscopes in terms of intubation time in obese patients. However, no effort has been made to compare the Storz® C-MACTM with direct laryngoscopy. The aim of the study was to evaluate if the use of Storz® C-MACTM may reduce intubation time when compared to direct laryngoscopy (classic Macintosh® blade)...
March 28, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28346007/lipid-emulsion-improves-survival-in-animal-models-of-local-anesthetic-toxicity-a-meta-analysis
#20
Michael R Fettiplace, Daniel J McCabe
INTRODUCTION: The Lipid Emulsion Therapy workgroup, organized by the American Academy of Clinical Toxicology, recently conducted a systematic review, which subjectively evaluated lipid emulsion as a treatment for local anesthetic toxicity. We re-extracted data and conducted a meta-analysis of survival in animal models. METHODS: We extracted survival data from 26 publications and conducted a random-effect meta-analysis based on odds ratio weighted by inverse variance...
February 17, 2017: Clinical Toxicology
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