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https://www.readbyqxmd.com/read/29334569/assessment-of-prehospital-hemorrhage-and-airway-care-using-a-simulation-model
#1
Mariya E Skube, Seth Witthuhn, Kristine Mulier, Bonnie Boucher, Elizabeth Lusczek, Greg J Beilman
BACKGROUND: The quality of prehospital care impacts patient outcomes. Military efforts have focused on training revision and the creation of high fidelity simulation models to address potentially survivable injuries. We sought to investigate the applicability of models emphasizing hemorrhage control and airway management to a civilian population. METHODS: Prehospital healthcare providers (PHPs) undergoing their annual training were enrolled. A trauma scenario was simulated with two modules: hemorrhage control and airway management...
January 12, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29316004/comparison-of-intubation-conditions-with-cmac-miller-videolaryngoscope-and-conventional-miller-laryngoscope-in-lateral-position-in-infants-a-prospective-randomized-trial
#2
Divya Jain, Swati Mehta, Komal Gandhi, Suman Arora, Badal Parikh, Muneer Abas
BACKGROUND: Endotracheal intubation in lateral position in infants is a challenge. This difficulty may be surmounted to some extent by using videolaryngoscopes but the routine use of these devices as a tool to secure the airway in lateral position remains unevaluated. Therefore, we conducted a prospective, randomized controlled trial to compare the intubation conditions achieved with the CMAC videolaryngoscope and the Miller Laryngoscope in lateral position in infants. We hypothesized that CMAC videolaryngoscope would provide a better laryngoscopic view and reduce the time to intubation compared to the Miller blade...
January 9, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29284884/airway-considerations-in-case-of-a-large-multinodular-goiter
#3
Harpreet Kaur, Amar Parkash Kataria, Magila Muthuramalingapandian, Harjinder Kaur
Patients with large goiters pose a great challenge to the anesthesiologist regarding securing the airway without compromising the safety of the patient. The technique of intubation depends on the choice and expertise of anesthesiologist. Awake fiberoptic intubation (AFOI) is the preferred technique. We present the case of large multinodular goiter with difficult airway in which AFOI was successfully used to secure the airway. Proper assessment, planning, and preparation for airway management should be done preoperatively to ensure patient safety...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284880/securing-a-difficult-airway-tracheal-intubation-achieved-after-deliberate-placement-of-an-endotracheal-tube-in-esophagus-a-new-approach
#4
Vanilla Chopra, Nandita Mehta, Mohd Reidwan Dar
Enlarged thyroid gland with retrosternal extension has an increased incidence of difficult intubation, and it poses real airway challenge for the anesthesiologists. Here, we present a case of successful management of a difficult airway in a female patient of enlarged thyroid gland, planned for open reduction and internal fixation of the upper end of humerus. Endotracheal intubation was achieved after deliberate insertion of an endotracheal tube in esophagus. The patient was extubated over a ventilating bougie, with uneventful postoperative course...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284851/comparison-of-i-gel-versus-endotracheal-tube-in-patients-undergoing-elective-cesarean-section-a-prospective-randomized-control-study
#5
Manohar Panneer, Saravana Babu, Prakash Murugaiyan
Background and Aim: Physiological changes during pregnancy and the sympatho adrenalstimulation during larynoscopy and intubation leads to evaluation of safe devices to secure airway during cesarean section under general anesthesia. I-gel, recently emerging effective supra glottic device found safe during general anesthesia in cesarean section. Aim of the study is to compare the hemodynamic disturbances and airway related complications of I-gel and Endotracheal tube in patients undergoing cesarean section under general anesthesia...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284832/application-of-discharge-criteria-for-home-readiness-using-bispectral-and-supraglottic-airway-devices-in-day-care-surgery-without-using-muscle-relaxants
#6
Joginder Pal Attri, Manjit Singh, Hemchandra Bhatt, Kamal Jyoti, Harjinder Kaur
Introduction: The availability of rapid and short-acting intravenous and volatile anesthetics has facilitated early recovery that is why nowadays ambulatory surgery is becoming more common. If the criteria used to discharge patients from the Postanesthesia Care Unit (PACU) are met in the operating room (OR), it would be appropriate to consider bypassing the PACU and transferring the patient directly to the step-down unit. This process is known as "fast-tracking" after ambulatory surgery...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29262440/who-is-safe-to-extubate-in-the-neuroscience-intensive-care-unit
#7
Julian Bösel
Patients admitted to the neuroscience intensive care unit (NICU) may have respiratory compromise from either central or peripheral neurological pathology, and may hence require intubation and mechanical ventilation for very diverse reasons. Liberation from invasive ventilation, that is, extubation, at the earliest possible time is a widely accepted principle in intensive care. For this, classic extubation criteria have been established in the general critical care setting, mainly targeting pulmonary function and cooperativeness of the patient...
December 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29237658/emergency-salpingectomy-for-ruptured-ectopic-pregnancy-in-patient-with-melnick-needles-syndrome-a-rare-otopalatodigital-syndrome
#8
Mark Zachary Johnson, Cormac Francis Mullins, Declan Keane, Ingrid Browne
Melnick-Needles syndrome (M-NS) is a rare genetic disorder which primarily affects skeletal developments. M-NS may also affect the cardiorespiratory and renal systems. A 35 kg patient presented complaining of abdominal pain. Following a positive pregnancy test and ultrasound examination, she was diagnosed with a ruptured ectopic pregnancy. She had a significant background history of M-NS, obstructive sleep apnoea (with narrow gauge tracheostomy in situ), obstructive lung disease and scoliosis. She received fluid resuscitation, and the case was managed using an open salpingectomy and clot evacuation under combined spinal/epidural anaesthesia...
December 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29232352/case-report-of-a-5-year-old-with-epiglottitis-an-atypical-presentation-of-an-uncommon-disease
#9
Amanda J Kasem
Epiglottitis is a rarely encountered infection in pediatrics since the advent of the conjugate Haemophilus influenzae type b vaccine first introduced in the United States in 1985. However, the disease remains a much feared infection in pediatrics. The literature reiterates the importance of early recognition, avoidance of agitating the patient, and the need for securing the airway in the operating room as key and essential features to a good outcome. However, with only 1 case per 200,000 children reported in the United States in 2006, most practitioners have never encountered this infection...
December 11, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29230133/invasive-insular-thyroid-carcinoma-presenting-as-nonparalytic-dysphonia
#10
Blake S Raggio, Blair M Barton, Maria C Grant, Judith A Fornadley, Jeffrey P Marino
Background: Patients with suspected thyroid malignancy often undergo preoperative laryngeal examination with a focus on vocal fold mobility. We present the unique case of a patient with invasive thyroid carcinoma who presented with dysphonia despite intact vocal fold motion. Case Report: A 73-year-old female with a remote thyroid lobectomy presented with dysphonia. Thyroid ultrasound and fine-needle aspiration revealed a 1.1-cm nodule consistent with a colloid cyst...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/29223612/predictive-value-of-focused-assessment-with-sonography-for-trauma-fast-for-laparotomy-in-unstable-polytrauma-egyptians-patients
#11
Adel Hamed Elbaih, Sameh T Abu-Elela
PURPOSE: The emergency physicians face significant clinical uncertainty when multiple trauma patients arrive in the emergency department (ED). The priorities for assessment and treatment of polytrauma patients are established in the primary survey. Focused assessment with sonography for trauma (FAST) is very essential clinical skill during trauma resuscitation. Use of point of care ultrasound among the trauma team working in the primary survey in emergency care settings is lacking in Suez Canal University Hospitals even ultrasound machine not available in ED...
November 23, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/29210725/airway-management-in-a-patient-with-tracheal-disruption-due-to-penetrating-neck-trauma-with-hollow-point-ammunition-a-case-report
#12
Angela M Johnson, James L Hill, Dave J Zagorski, Joseph M McClain, Nicole C Maronian
Rapid sequence induction and intubation was performed for a patient in respiratory distress after a gunshot wound to the neck. Resistance was noted distal to vocal cords. With a bronchoscope unavailable, the endotracheal tube was advanced with a corkscrew maneuver. Subcutaneous emphysema had developed. The endotracheal tube was advanced into the right mainstem with adequate ventilation. Imaging illustrated tracheoesophageal injury. The patient was emergently explored. An intraluminal bullet was removed, lateral wall tracheal defect was repaired, and a tracheostomy was placed...
November 27, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29207815/anaesthetic-management-in-transoral-endoscopic-thyroidectomy
#13
Rajendra D Patel, Nisha Gowani, Manali Nadkarni, Sameer Rege, Priti Devalkar
Young females undergoing thyroid surgery are apprehensive about the surgical scar. This leads to the introduction of Transoral Endoscopic Thyroidectomy (TOET). TOET is gaining popularity for its minimally invasive and cosmetically sound approach to perform thyroidectomies in young patients. The surgical site being the mouth orifice poses a challenge to the anaesthesiologist to secure a definitive airway. The case report is that of a young female undergoing TOET for whom we have successfully performed nasal intubation with a North Pole ivory endotracheal tube (ET)...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29201636/laryngotracheoesophageal-cleft-type-3-and-severe-laryngotracheomalacia-delayed-surgical-repair-a-treatment-challenge-with-an-excellent-outcome
#14
Ahmad Khaleghnejad, Saeed Sadr, Seyyed Ahmad Tabatabaei, Nazanin Farahbakhsh, Payman Dabirmoghaddam, Saeed Saadat Mansori
Laryngotracheoesophageal clefts (LTEC) are rare malformations which involve the upper respiratory and digestive tract. Surgical repair should be undertaken promptly to maintain a secure airway and prevent serious pulmonary aspiration. This paper reports the first case of LTEC type 3 with severe laryngotracheomalacia that was brought to Mofid children's hospital in late infancy with a poor health status. Delayed defect correction was our team strategy for the patient when she had achieved good weight gain. At the age of 22 months in collaboration with the pediatric surgical and otolaryngologist team, the repair of the laryngeal cleft was done with lateral open approach method...
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29187760/the-exit-ex-utero-intrapartum-treatment-procedure-from-the-paediatric-ent-perspective
#15
B Pucher, J Szydlowski, K Jonczyk-Potoczna, J Sroczynski
The main principle of the EXIT procedure is to maintain uteroplacental circulation with neonatal anaesthesia by controlled uterine hypotonia. This enables securing the foetal airways and decompress or resect large neck and mediastinal foetal masses. The authors present their experience with use of the EXIT procedure in 7 foetuses in whom evaluation and management of the airways were performed. In 4 patients, the neck mass was surgically removed in the neonatal period, in 1 the propranolol treatment was introduced...
November 30, 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/29173286/an-airway-rapid-response-system-implementation-and-utilization-in-a-large-academic-trauma-center
#16
Joshua H Atkins, Christopher H Rassekh, Ara A Chalian, Jing Zhao
BACKGROUND: Rapid response teams mobilize resources to patients experiencing acute deterioration. Failed airway management results in death or anoxic brain injury. A codified, systems-based approach to bring personnel and equipment to the bedside for multidisciplinary airway assessment and rescue was reflected in the initial implementation of an airway rapid response (ARR) team. METHODS: A retrospective review of records of 117 ARR events in a 40-month period (August 2011-November 2014) was undertaken at the Hospital of the University of Pennsylvania, a 789-bed, academic, urban, tertiary care, Level 1 trauma center...
December 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/29159491/-algorithm-for-securing-an-unexpected-difficult-airway-user-analysis-on-a-simulator
#17
T Ott, K Truschinski, M Kriege, M Naß, S Herrmann, V Ott, S Sellin
BACKGROUND: Critical incidents in difficult airway management are still a main contributory factor for perioperative morbidity and mortality. Many national associations have developed algorithms for management of these time critical events. For implementation of these algorithms the provision of technical requirements and procedure-related training are essential. Severe airway incidents are rare events and clinical experience of the individual operators is limited; therefore, simulation is an adequate instrument for training and evaluating difficult airway algorithms...
November 20, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29159029/case-report-unusual-cause-of-difficulty-in-intubation-and-ventilation-with-asthmatic-like-presentation-of-endobronchial-tuberculosis
#18
S Praveena Seevaunnamtum, Nazhan Afeef Mohd Ariff Ghazali, Wan Mohd Nazaruddin, Alwi Muhd Besari, N H Nik Fariza, Sanihah Che Omar, Saedah Ali, M Z Rhendra Hardy, Mohd Erham Mat Hassan, N M Nik Abdullah
Endobronchial Tuberculosis is hazardous in causing circumferential narrowing of tracheobronchial tree despite the eradication of tubercle bacilli in the initial insult from Pulmonary Tuberculosis. They may present as treatment resistant bronchial asthma and pose challenge to airway management in the acute setting. We present a 25 year-old lady who was newly diagnosed bronchial asthma with a past history of Pulmonary Tuberculosis that had completed treatment. She presented with sudden onset of difficulty breathing associated with noisy breathing for 3 days and hoarseness of voice for 6 months...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29149429/population-analysis-of-predictors-of-difficult-intubation-with-direct-laryngoscopy-in-pediatric-patients-with-and-without-thyroid-disease
#19
Aalap C Shah, William C K Ng, Sean Sinnott, Joseph P Cravero
PURPOSE: There are no data on the prevalence and predictors of difficult intubation (DI) in pediatric patients with thyroid disease. This study (1) assesses the prevalence of DI in patients with thyroid disease undergoing elective operations, (2) identifies other predictors of DI in children, and (3) evaluates the effect of DI on postoperative care and length-of-stay. METHODS: A single-center retrospective cohort analysis of procedures in patients assigned with an ICD-9 code for thyroid disease between June 2012 and February 2016...
November 17, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/29134423/perioperative-respiratory-complications-current-evidence-and-strategy-discussed-in-2017-ja-symposium
#20
K Hirota, M Yamakage, S Hashimoto, T Asai, S Isono
Respiratory management during general anesthesia aims to safely secure the airway and maintain adequate ventilation to deliver oxygen to the vital organs, maintaining homeostasis even during surgery. Despite its clinical importance, anesthesiologists often encounter difficulties in properly managing respiration during the perioperative period, leading to severe respiratory complications. In this year's JA symposium, 5 editorial board members of Journal of Anesthesia (JA) who are experts in the field of respiratory management in anesthesia discussed the following topics: quitting smoking before surgery: exposure to passive smoke is damaging to children, ventilator-associated pneumonia, high inspiratory oxygen concentration and lung injury, aspiration pneumonia, and postoperative respiratory management strategy in patients with obstructive sleep apnea...
November 13, 2017: Journal of Anesthesia
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