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https://www.readbyqxmd.com/read/28226944/3d-force-torque-characterization-of-emergency-cricothyroidotomy-procedure-using-an-instrumented-scalpel
#1
Adam Ryason, Ganesh Sankaranarayanan, Kathryn L Butler, Marc DeMoya, Suvranu De, Adam Ryason, Ganesh Sankaranarayanan, Kathryn L Butler, Marc DeMoya, Suvranu De, Suvranu De, Marc DeMoya, Kathryn L Butler, Ganesh Sankaranarayanan, Adam Ryason
Emergency Cricothyroidotomy (CCT) is a surgical procedure performed to secure a patient's airway. This high-stakes, but seldom-performed procedure is an ideal candidate for a virtual reality simulator to enhance physician training. For the first time, this study characterizes the force/torque characteristics of the cricothyroidotomy procedure, to guide development of a virtual reality CCT simulator for use in medical training. We analyze the upper force and torque thresholds experienced at the human-scalpel interface...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28217065/unsuspected-subglottic-web-in-a-child-managed-for-severe-respiratory-obstruction
#2
Reena, Arun Kumar, Shrawin Kumar Singh, Vineet Agrawal
Subglottic stenosis is a known complication of a traumatic and prolonged intubation. In a child, subglottic area is narrower and more prone to damage by an oversized or overinflated endotracheal tube. The stenosis can present with complaints of change in voice, croup, or respiratory obstruction. Those presenting with respiratory obstruction require immediate diagnosis under direct laryngoscopy and timely corrective intervention under general anesthesia. A 4-year-old child came to the emergency department with severe respiratory obstruction...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28216702/evaluation-of-simple-pre-determined-length-insertion-technique-split-with-conventional-method-for-oral-fibreoptic-intubation-a-randomised-cross-over-study
#3
Elangovan Muthukumar, Lenin Babu Elakkumanan, Prasanna Udupi Bidkar, Mvs Satyaprakash, Sandeep Kumar Mishra
BACKGROUND AND AIMS: The difficulty during flexible fiber-optic bronchoscopy (FOB) guided tracheal intubation could be because of inability in visualising glottis, advancing and railroading of endotracheal tube. Several methods are available for visualising glottis, but none is ideal. Hence, this randomised controlled study was designed to evaluate the simple pre-determined length insertion technique (SPLIT) during oral FOB. METHODS: Fifty-eight patients were randomised into Group C and Group P...
January 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28195860/challenging-airway-secondary-to-purpura-fulminans-with-face-and-neck-bullae-in-a-premature-infant-a-case-report
#4
Rhashedah A Ekeoduru, Matthew R Greives, Eric A Nesrsta
A former 25-week-old neonate presented at 34 weeks postconceptual age with necrotizing fasciitis and purpura fulminans because of Group B Streptococcus infection. He was septic and coagulopathic when he was intubated, and the endotracheal tube was secured with adhesives. When he subsequently developed large purpuric, bullous lesions on the face and neck, he presented to the operating room for excision and debridement of his facial lesions. No change was made in how the endotracheal tube was secured. Midprocedure, an unintentional extubation occurred...
February 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28194529/a-randomized-clinical-study-on-postoperative-pain-comparing-between-the-supraglottic-airway-device-and-endotracheal-tubing-in-transabdominal-preperitoneal-repair-tapp
#5
Y Nagahisa, K Hashida, R Matsumoto, R Kawashima, M Okabe, K Kawamoto
BACKGROUND: Transabdominal preperitoneal (TAPP) repair is the most widely used laparoscopic technique for the treatment of inguinal hernia in Japan. Many studies have shown that in comparison with open hernia repair, laparoscopic repair results in less pain and a shorter convalescence. However, postoperative pain remains a concern. One possible cause of postoperative pain in the early postoperative phase is strain or cough on removal of the endotracheal tube. Use of a supraglottic airway (SGA) device helps to avoid such complaints...
February 13, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/28194479/-airway-management-in-intensive-care-units-in-rhineland-palatinate-evolution-over-five-years
#6
T Piepho, T Härer, L Ellermann, R R Noppens
BACKGROUND: Securing the airway in severely ill patients is associated with a high rate of complications. So far, no information exists about the equipment readily available for airway management in German intensive care units (ICUs). It is also unknown if the range of material has improved over time. OBJECTIVES: In the present trial the availability of equipment for airway management in ICUs in Rhineland-Palatinate was evaluated at two different times. MATERIALS AND METHODS: Using a structured questionnaire, all ICUs in the state were contacted in the years 2010 and 2015...
February 13, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28190872/upper-airway-obstruction-requiring-emergent-tracheostomy-secondary-to-laryngeal-sarcoidosis-a-case-report
#7
Changwan Ryu, Erica L Herzog, Hongyi Pan, Robert Homer, Mridu Gulati
BACKGROUND Laryngeal sarcoidosis is a rare extrapulmonary manifestation of sarcoidosis, accounting for 0.33-2.1% of cases. A life-threatening complication of laryngeal sarcoidosis is upper airway obstruction. In this report we describe our experience in the acute and chronic care of a patient who required an emergent tracheostomy, with the aim to provide further insight into this difficult to manage disease. CASE REPORT A 37-year-old African American female with a 10-year history of stage 1 sarcoidosis presented with severe dyspnea...
February 13, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28138763/-haemoptysis-intensive-care-management-of-pulmonary-hemorrhage
#8
J H Ficker, W M Brückl, J Suc, A Geise
There is a wide spectrum of severities in patients with pulmonary bleeding with a range from mild haemoptysis to severe bleeding with an acute risk of asphyxiation. For the management of acute pulmonary haemorrhage, it is essential to identify the underlying cause in order to initiate a target-oriented or causal therapy. The most common causes of localized pulmonary bleeding are lung cancer as well as infections, anticoagulant therapy or bronchiectasis. Diffuse alveolar haemorrhage is mostly due to pulmonary vasculitis or connective tissue disease, but may also occur in pulmonary metastasis, congestive heart failure, coagulation disorders and from many other causes...
January 30, 2017: Der Internist
https://www.readbyqxmd.com/read/28096586/comparison-of-intubating-laryngeal-mask-airway-and-fiberoptic-bronchoscopy-for-endotracheal-intubation-in-patients-undergoing-cervical-discectomy
#9
Kolli S Chalam, Jyothi Gupta
BACKGROUND AND AIMS: Direct laryngoscopy is hazardous in patients with cervical posterior intervertebral disc prolapse (PIVD) as it may worsen the existing cord compression. To achieve smooth intubation, many adjuncts such as fiberoptic bronchoscope (FOB), video laryngoscopes, lighted stylets, and intubating laryngeal mask airways (ILMAs) are available. However, there is a paucity of literature comparing ILMA with fiberoptic intubation in patients with PIVD. Hence, this study was designed to compare the effectiveness of ILMA technique with FOB to accomplish endotracheal intubation in patients undergoing cervical discectomy...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28094480/anesthetic-complications-during-general-anesthesia-without-intravenous-access-in-pediatric-ophthalmologic-clinic-assessment-of-5216-cases
#10
Chun W Hung, Lauren Licina, David H Abramson, Vittoria Arslan-Carlon
BACKGROUNDː General anesthesia utilizing inhalational agents without intravenous (IV) access for minor procedures is controversial1. Eliminating IV access increases efficiency and patient satisfaction; however, the ability to introduce rapid acting medications into the circulation during an unanticipated emergency becomes challenging. The objective of this study was to examine complication risk following pediatric ophthalmologic examinations under anesthesia (EUA) without IV placement. METHODSː A retrospective review of consecutive pediatric patients who underwent EUA for retinoblastoma management was performed from 2004 to 2014...
January 17, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28074798/proseal-laryngeal-mask-airway-as-an-alternative-to-standard-endotracheal-tube-in-securing-upper-airway-in-the-patients-undergoing-beating-heart-coronary-artery-bypass-grafting
#11
Kalpana Shah
BACKGROUND: ProSeal laryngeal mask airways (PLMAs) are routinely used after failed tracheal intubation as airway rescue, facilitating tracheal intubation by acting as a conduit and to secure airway during emergencies. In long duration surgeries, use of endotracheal tube (ETT) is associated with various hemodynamic complications, which are minimally affected during PLMA use. However, except for few studies, there are no significant data available that promote the use of laryngeal mask during cardiac surgery...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28065557/manual-laryngeal-fixation-facilitates-tracheal-intubation-during-chest-compression-a-randomized-crossover-manikin-study
#12
Takanobu Fujisawa, Nobuyasu Komasawa, Kazuo Hattori, Ryosuke Mihara, Toshiaki Minami
PURPOSE: We compared the effectiveness of external manual laryngeal fixation (MLF) for tracheal intubation during chest compression using three laryngoscopes, the Macintosh laryngoscope (McL), McGRATH® MAC (McGRGTH), and Pentax-AWS Airwayscope® (AWS) on an adult manikin. METHODS: Sixteen novice doctors and 15 experienced anesthesiologists performed tracheal intubation during chest compression on an adult manikin using the McL, McGRATH, and AWS with or without MLF...
December 30, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28059945/airway-management-with-a-stereotactic-headframe-in-situ-a-mannequin-study
#13
Melissa Brockerville, Zoe Unger, Nathan C Rowland, Francesco Sammartino, Pirjo H Manninen, Lashmi Venkatraghavan
BACKGROUND: Stereotactic headframe-based imaging is often needed for target localization during surgery for insertion of deep brain stimulators. A major concern during this surgery is the need for emergency airway management while an awake or sedated patient is in the stereotactic headframe. The aim of our study was to determine the ease of emergency airway management with a stereotactic headframe in situ. MATERIALS AND METHODS: We conducted an observational study using a mannequin...
January 4, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28032947/controversies-in-the-management-of-caustic-ingestion-injury-an-evidence-based-review
#14
J H Bird, S Kumar, C Paul, J D Ramsden
BACKGROUND: Caustic ingestion of acid or alkaline substances can cause damage to the upper respiratory and upper digestive tract. Initial presentation following caustic ingestion can include oropharyngeal pain, dysphagia and stridor. It is due to this clinical presentation that the resident otolaryngologist is consulted to review and examine these patients to assess for airway compromise and commence initial management and care until airway concern has passed. OBJECTIVE OF REVIEW: This review aims to provide evidence-based guidance in the management of those presenting with acute ingestion injury so that informed initial medical therapy can be commenced and appropriate investigations are arranged to optimize patient outcome...
December 29, 2016: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28024711/-progressive-hematoma-in-anterior-neck-after-endovascular-treatment-of-middle-cerebral-artery-aneurysm
#15
Aysun Ankay Yilbas, Cigdem Kanburoglu, Filiz Uzumcugil, Coskun Cifci, Ozge Ozen Saralp, Heves Karagoz, Seda Banu Akinci, Anil Arat
BACKGROUND: Cervical hematomas can lead to airway compromise, a life threatening condition, regardless of the cause. The following case is the first presentation of cervical hematoma as a complication of endovascular treatment of middle cerebral artery aneurysm. CASE REPORT: A 49 year-old woman was scheduled for stent placement under general anesthesia for middle cerebral artery aneurysm. Few days before intervention, acetyl salicylic acid and clopidogrel treatment was started...
December 23, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28004199/the-effect-of-esophagogastroduodenoscopy-probe-insertion-on-the-intracuff-pressure-of-airway-devices-in-children-during-general-anesthesia
#16
Onur Balaban, Mineto Kamata, Mumin Hakim, Dmitry Tumin, Joseph D Tobias
Given the size of the esophagogastroduodenoscopy (EGD) probe and the compressibility of the pediatric airway, the EGD probe may increase the intracuff pressure (IP) of an airway device. The current study evaluated IP changes during EGD examination under general anesthesia in pediatric patients. Following the induction of anesthesia, a laryngeal mask airway (LMA) or endotracheal tube (ETT) was placed without neuromuscular blockade. The IP was measured at baseline, during EGD probe insertion, while the EGD probe was in place, and after probe removal...
December 21, 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27968957/technique-for-improved-safety-in-the-endoscopic-management-of-subglottic-stenosis
#17
Stephanie Hulstein, Henry Hoffman
OBJECTIVE: To identify a safe approach to airway management during the endoscopic balloon dilation of subglottic stenosis BACKGROUND: Subglottic stenosis is an abnormal narrowing of the upper airway commonly managed by endoscopic technique performed on an unsecured airway. METHODS: Review of surgical treatment of subglottic stenosis cases by the senior author. TECHNIQUE: Following steroid injection and radial cuts performed either under jet anesthesia or mask ventilation with brief periods of apnea, a small endotracheal tube may be passed beyond the narrowing to permit adjacent balloon dilation with the airway secured...
November 2016: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/27941484/challenging-airway-secondary-to-purpura-fulminans-with-face-and-neck-bullae-in-a-premature-infant
#18
Rhashedah A Ekeoduru, Matthew R Greives, Eric A Nesrsta
A former 25-week-old neonate presented at 34 weeks postconceptual age with necrotizing fasciitis and purpura fulminans because of Group B Streptococcus infection. He was septic and coagulopathic when he was intubated, and the endotracheal tube was secured with adhesives. When he subsequently developed large purpuric, bullous lesions on the face and neck, he presented to the operating room for excision and debridement of his facial lesions. No change was made in how the endotracheal tube was secured. Midprocedure, an unintentional extubation occurred...
December 9, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27935771/preparing-anesthetists-to-manage-cannot-intubate-cannot-ventilate-situations
#19
Kenneth A Wofford
Cannot intubate/cannot ventilate (CICV) situations during anesthesia are rare, potentially catastrophic to the patient, and difficult to predict. Widely adopted practice guidelines advocate an algorithmic approach to CICV situations in which the anesthetist: (a) recognizes the CICV situation, (b) calls for help, (c) steadily progresses through a variety of methods to ventilate the patient and secure the airway, (d) restores ventilation via an infraglottic airway if the patient cannot be safely awakened prior to becoming moribund...
January 2017: Annual Review of Nursing Research
https://www.readbyqxmd.com/read/27928826/a-feasibility-study-of-awake-videolaryngoscope-assisted-intubation-in-patients-with-periglottic-tumour-using-the-channelled-king-vision-%C3%A2-videolaryngoscope
#20
L Markova, T Stopar-Pintaric, T Luzar, J Benedik, I Hodzovic
Airway management in patients with periglottic tumour is a high-risk procedure with potentially serious consequences. There is no consensus on how best to secure the airway in this group of patients. We conducted a feasibility study of awake tracheal intubation using a King Vision(®) videolaryngoscope with a channelled blade in a cohort of 25 patients, with a periglottic tumour requiring diagnostic or radical surgery. We used 10% and 4% lidocaine to topicalise the airway and midazolam and remifentanil for sedation...
December 7, 2016: Anaesthesia
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