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https://www.readbyqxmd.com/read/28915898/physician-staffed-helicopter-emergency-medical-service-has-a-beneficial-impact-on-the-incidence-of-prehospital-hypoxia-and-secured-airways-on-patients-with-severe-traumatic-brain-injury
#1
Toni Pakkanen, Antti Kämäräinen, Heini Huhtala, Tom Silfvast, Jouni Nurmi, Ilkka Virkkunen, Arvi Yli-Hankala
BACKGROUND: After traumatic brain injury (TBI), hypotension, hypoxia and hypercapnia have been shown to result in secondary brain injury that can lead to increased mortality and disability. Effective prehospital assessment and treatment by emergency medical service (EMS) is considered essential for favourable outcome. The aim of this study was to evaluate the effect of a physician-staffed helicopter emergency medical service (HEMS) in the treatment of TBI patients. METHODS: This was a retrospective cohort study...
September 15, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28895500/anesthetic-management-of-a-patient-with-tracheal-dehiscence-post-tracheal-resection-surgery
#2
Sang Kim, Maryna Khromava, Jeron Zerillo, George Silvay, Adam I Levine
We present a case of a patient with complete tracheal dehiscence and multiple false passages after recent tracheal resection and anastomosis. Loss of tracheal continuity after disruption of anastomosis with distal stump retraction presents a unique anesthetic challenge given lack of access to the trachea and the need for adequate anesthesia and analgesia for surgical neck dissection. Traditional airway management, including awake fiberoptic intubation, intubation via direct laryngoscopy, needle cricothyrotomy, and awake tracheostomy are not viable options...
September 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28895384/securing-the-airway-in-patients-with-cervical-spine-injury-the-pursuit-of-the-ideal-airway-gadget
#3
Maged Y Argalious
No abstract text is available yet for this article.
September 11, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28888309/head-and-neck-reconstruction
#4
REVIEW
Shannon Wong, Alyson Melin, Debra Reilly
Management of head and neck burns involves acute and intermediate phases. Acutely, the goals are establish a secure airway and treat life-threatening injuries. Then, optimize nutrition, assess extent of the burn, perform local wound care, and provide eye protection. Management depends on the degree of the head and neck burn. Postinjury splinting and rehabilitation are vital to healing. After the acute inflammation has resolved and the scars have matured, reconstruction begins with the goals of restoring both function and aesthetics...
October 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28885520/caring-for-trauma-patients-with-coexisting-heart-failure
#5
Karen Bergman Schieman, Kelley Pattison, Conor Early
The coexisting conditions of traumatic injury coupled with a comorbid condition such as heart failure create a complex scenario for the trauma nurse to manage. Initial care of the trauma patient includes following the Advanced Trauma Life Support guidelines and managing the airway, breathing, and circulation (ABC) of the patient. Once the airway is secure and breathing is managed, the team addresses circulation. At this point in the patient's care, the team typically does not know which, if any, comorbid conditions exist...
September 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28882637/successful-retrograde-intubation-after-failed-fiberoptic-intubation-and-percutaneous-cricothyrotomy
#6
Stephanie Brenman, Sachin Gupta, Stephanie Tseeng
BACKGROUND: An obstructive neck lesion presents an airway challenge for any emergency physician. Retrograde intubation is an infrequently used airway alternative that can be employed in the difficult airway algorithm that requires little training and is less invasive than surgical cricothyrotomy. CASE REPORT: We report a case of a 31-year-old male patient who presented with respiratory distress progressing to respiratory failure from upper airway obstruction. The patient had significant tracheal thickening at the level of the thyroid gland based on a computed tomography report from 3 weeks prior to his presentation...
September 4, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28874304/effect-of-cricoid-pressure-on-the-insertion-efficacy-of-six-supraglottic-devices-a-crossover-randomized-simulation-trial
#7
Fumihiro Ohchi, Nobuyasu Komasawa, Ryosuke Mihara, Kazuo Hattori, Toshiaki Minami
BACKGROUND: No study has ever compared the efficacy of various types of supraglottic devices (SGDs) for securing the airway under cricoid pressure. OBJECTIVE: This study aimed to evaluate the efficacy of six SGDs, LMA-ProSeal (ProSeal), LMA-Classic (Classic), Laryngeal Tube (LT), LMA-Supreme (Supreme), air-Q (air-Q), and i-gel (i-gel), in airway management under cricoid pressure using a manikin. METHODS: Fifteen novice doctors and 16 experienced doctors used the six SGDs under cricoid or sham pressure on an adult manikin...
September 2, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28859912/establishment-of-nasal-breathing-should-be-the-ultimate-goal-to-secure-adequate-craniofacial-and-airway-development-in-children
#8
Carlos Torre, Christian Guilleminault
No abstract text is available yet for this article.
August 28, 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28846011/how-to-overcome-the-challenges-of-non-detachable-connector-tubes-in-submental-intubation-for-panfacial-fractures
#9
Sahand Samieirad, Hussein Khalife, Mehrdad Noroozi, Elahe Tohidi, Maryam Alsadat Hashemipour
INTRODUCTION: Armored removable connector tubes are not always available in operating rooms for routine Altemir submental intubation (SMI) technique. The present study addresses a fiber-optic glidoscopy assisted 2-tubes modification of Green & Moore sequence for submandibular intubation. METHODS: The sample was composed of 11 patients (8 males and 3 females) with panfacial fractures where neither the oral and nasal intubation techniques nor tracheostomy were feasible...
August 2017: Archives of Iranian Medicine
https://www.readbyqxmd.com/read/28831315/an-unexpected-case-of-black-mamba-dendroaspis-polylepis-bite-in-switzerland
#10
Verena Quarch, Lukas Brander, Luca Cioccari
Mambas (genus Dendroaspis) are among the most feared venomous African snakes. Without medical treatment, mamba bites are frequently fatal. First-aid treatment includes lymphatic retardation with the pressure immobilization technique. Medical management comprises continuous monitoring, securing patency of the airway, ensuring adequate ventilation, symptomatic measures, and administration of specific antivenin. We report an unusual case of a snake breeder bitten by a black mamba in Switzerland, report the clinical course, and review the lifesaving emergency management of mamba bites...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28829988/anaesthetic-and-surgical-management-of-airway-penetrating-injuries-in-children-in-resource-poor-setting-case-reports
#11
Bassey E Edem, Amali Adekwu, Michael E Efu, Joseph Kuni, Gerald Onuchukwu, Johnbosco Ugwuadu
INTRODUCTION: Impacted penetrating foreign body (FB) in the airway especially the postnasal space presents with management challenges. The challenges are worsened by lack of modern equipment in resource-poor settings. Two suchlike cases were managed in this report. PRESENTATION OF CASES: Case 1: A 4-year-old girl who fell on a metal rod in her mouth while playing alone. Examination revealed an agitated child in open mouth posture, with a silvery straight metallic object impacted on the hard palate and projecting from the mouth...
August 3, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28827261/evaluation-of-the-mcgrath-mac-and-macintosh-laryngoscope-for-tracheal-intubation-in-2000-patients-undergoing-general-anaesthesia-the-randomised-multicentre-emma-trial-study-protocol
#12
Marc Kriege, Christian Alflen, Irene Tzanova, Irene Schmidtmann, Tim Piepho, Ruediger R Noppens
INTRODUCTION: The direct laryngoscopy technique using a Macintosh blade is the first choice globally for most anaesthetists. In case of an unanticipated difficult airway, the complication rate increases with the number of intubation attempts. Recently, McGrath MAC (McGrath) video laryngoscopy has become a widely accepted method for securing an airway by tracheal intubation because it allows the visualisation of the glottis without a direct line of sight. Several studies and case reports have highlighted the benefit of the video laryngoscope in the visualisation of the glottis and found it to be superior in difficult intubation situations...
August 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28818179/multiple-trauma-and-emergency-room-management
#13
Michael Frink, Philipp Lechler, Florian Debus, Steffen Ruchholtz
BACKGROUND: The care of severely injured patients remains a challenge. Their initial treatment in the emergency room is the essential link between first aid in the field and definitive in-hospital treatment. METHODS: We present important elements of the initial in-hospital care of severely injured patients on the basis of pertinent publications retrieved by a selective search in PubMed and the current German S3 guideline on the care of severely and multiply traumatized patients, which was last updated in 2016...
July 24, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28818177/angioedema
#14
Janina Hahn, Thomas K Hoffmann, Bastian Bock, Melanie Nordmann-Kleiner, Susanne Trainotti, Jens Greve
BACKGROUND: Acute angioedema of the upper airways can be life-threatening. An important distinction is drawn between mast-cell-mediated angioedema and bradykinin-mediated angioedema; the treatment of these two entities is fundamentally different. METHODS: This review is based on pertinent articles retrieved by a selective search in PubMed and on guidelines concerning the treatment of angioedema. The authors draw on their own clinical experience in their assessment of the literature...
July 24, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28805620/ex-utero-intrapartum-treatment-for-extremely-low-birth-weight-neonates-requiring-resuscitation-at-birth
#15
Tai-Ho Hung, Ting-Xuan Huang, T'sang-T'ang Hsieh
OBJECTIVE: Difficulties often encountered during intubation in extremely low birth-weight (ELBW) neonates requiring resuscitation at birth because of the smaller airway and the pressure from the limited number of attempts before hemodynamic instability occurs. CASE REPORT: We evaluated two pregnant women at 26 weeks of gestation with premature rupture of membranes and evidence of chorioamnionitis and applied the concept of ex utero intrapartum treatment, which involved delaying cord clamping (DCC) after establishing a secured airway with adequate ventilation during cesarean delivery...
August 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28804685/percutaneous-dilatational-tracheostomy-through-paramedian-technique-and-lateral-approach-in-a-patient-with-cervical-esophagostomy-a-case-report
#16
Kapil D Soni, Neha Garg, Richa Aggarwal, Ambuj Ambuj
BACKGROUND: Percutaneous dilatational tracheostomy (PDT) is a common surgical procedure and established as first choice for securing the airway in critically ill patients needing prolonged mechanical ventilation. There are case reports of open tracheostomy through paramedian approach without complications. This case report presents a case of PDT through paramedian approach. CASE REPORT: An 18 year old female, case of firearm injury underwent cervical esophagostomy on the left side of neck approaching midline...
2017: International Journal of Burns and Trauma
https://www.readbyqxmd.com/read/28797305/improved-success-rates-using-videolaryngoscopy-in-unexperienced-users-a-randomized-crossover-study-in-airway-manikins
#17
Hendrik Eismann, Lion Sieg, Nicola Etti, Lars Friedrich, Christian Schröter, Philipp Mommsen, Christian Krettek, Christian Zeckey
BACKGROUND: Videolaryngoscopy has been proven to be a safe procedure managing difficult airways in the hands of airway specialists. Information about the success rates in unexperienced users of videolaryngoscopy compared to conventional laryngoscopy is sparse. Therefore, we aimed to evaluate if there might be more success in securing an airway if the unexperienced provider is using a videolaryngoscope in simulated airways in a randomized manikin study. Differences between commonly used videolaryngoscopes were elucidated...
August 10, 2017: European Journal of Medical Research
https://www.readbyqxmd.com/read/28793002/laryngeal-tube-suction-for-airway-management-during-in-hospital-emergencies
#18
Haitham Mutlak, Christian Friedrich Weber, Dirk Meininger, Colleen Cuca, Kai Zacharowski, Christian Byhahn, Richard Schalk
OBJECTIVE: The role of supraglottic airway devices in emergency airway management is highlighted in international airway management guidelines. We evaluated the application of the new generation laryngeal tube suction (LTS-II/LTS-D) in the management of in-hospital unexpected difficult airway and cardiopulmonary resuscitation. METHODS: During a seven-year period, patients treated with a laryngeal tube who received routine anesthesia and had an unexpected difficult airway (Cormack Lehane Grade 3-4), who underwent cardiopulmonary resuscitation, or who underwent cardiopulmonary resuscitation outside the operating room and had a difficult airway were evaluated...
July 2017: Clinics
https://www.readbyqxmd.com/read/28791755/emergency-department-use-of-apneic-oxygenation-versus-usual-care-during-rapid-sequence-intubation-a-randomized-controlled-trial-the-endao-trial
#19
Nicholas Caputo, Ben Azan, Rui Domingues, Lee Donner, Mark Fenig, Douglas Fields, Robert Fraser, Karlene Hosford, Richard Iuorio, Marc Kanter, Moira McCarty, Thomas Parry, Andaleeb Raja, Mary Ryan, Blaine Williams, Hemlata Sharma, Daniel Singer, Chris Shields, Sandra Scott, Jason R West
OBJECTIVES: Desaturation leading to hypoxemia may occur during rapid sequence intubation (RSI). Apneic oxygenation (AO) was developed to prevent the occurrence of oxygen desaturation during the apnea period. The purpose of this study was to determine if the application of AO increases the average lowest oxygen saturation during RSI when compared to usual care (UC) in the emergency setting. METHODS: A randomized controlled trial was conducted at an academic, urban, level 1 trauma center...
August 9, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28767477/a-simple-and-effective-way-to-secure-a-laryngeal-mask-airway-mask-in-place
#20
Shahram Shokohi, Mir Mousa Aghdashi
No abstract text is available yet for this article.
August 1, 2017: A & A Case Reports
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