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Basic airway management

Benjamin Ziegler, Christoph Hirche, Johannes Horter, Jurij Kiefer, Paul Alfred Grützner, Thomas Kremer, Ulrich Kneser, Matthias Münzberg
INTRODUCTION: Initial therapy of severe burns in specialized burn trauma centers is a challenging task faced by the treating multi-professional and interdisciplinary team. A lack of consistent operating procedures and varying structural conditions was recently demonstrated in preliminary data of our group. These results raised the question on how specific treatment measures in acute burn care are met in the absence of standardized guidelines. MATERIAL AND METHODS: A specific questionnaire containing 57 multiple-choice questions was sent to all 22 major burn centers in Germany, Austria and Switzerland...
September 21, 2016: Burns: Journal of the International Society for Burn Injuries
Su-Ling Loo, Peter A B Wark
This review highlights the important articles published in the area of asthma research from January 2015 to July 2016. In basic science, significant advances have been made in understanding the link between the innate immune response and type II acquired immune responses in asthma and the role of the airway epithelium. Novel information continues to emerge with regard to the pathogenesis and heterogeneity of severe asthma. There have been important translational clinical trials in the areas of childhood asthma, treatment of allergy to improve asthma outcomes, and improving drug delivery to optimize the management of asthma...
2016: F1000Research
Tina L Palmieri
Children have unique physiologic, physical, psychological, and social needs compared with adults. Although adhering to the basic tenets of burn resuscitation, resuscitation of the burned child should be modified based on the child's age, physiology, and response to injury. This article outlines the unique characteristics of burned children and describes the fundamental principles of pediatric burn resuscitation in terms of airway, circulatory, neurologic, and cutaneous injury management.
October 2016: Critical Care Clinics
David E Rosow, Eric Barbarite
PURPOSE OF REVIEW: Adult laryngotracheal stenosis (LTS) is a potentially life-threatening disorder that can be difficult to diagnose and treat. Much is unknown regarding the etiology of airway stenosis, and while many patients do well with standard surgical management, the recurrence rate is significant. Few medical therapies exist, but there is a growing need. RECENT FINDINGS: Several basic science studies have shown a role of inflammatory signaling pathways in the development of LTS...
August 31, 2016: Current Opinion in Otolaryngology & Head and Neck Surgery
Bryan Choi, Nicholas Asselin, Catherine C Pettit, Max Dannecker, Jason T Machan, Derek L Merck, Lisa H Merck, Selim Suner, Kenneth A Williams, Gregory D Jay, Leo Kobayashi
INTRODUCTION: Effective resuscitation of out-of-hospital cardiac arrest (OHCA) patients is challenging. Alternative resuscitative approaches using electromechanical adjuncts may improve provider performance. Investigators applied simulation to study the effect of an experimental automation-assisted, goal-directed OHCA management protocol on EMS providers' resuscitation performance relative to standard protocols and equipment. METHODS: Two-provider (emergency medical technicians (EMT)-B and EMT-I/C/P) teams were randomized to control or experimental group...
August 9, 2016: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
Seungmin Jeong, Ki Ok Ahn, Sang Do Shin
OBJECTIVE: The objective of this meta-analysis was to compare the benefits of prehospital advanced airway management (AAM) and basic airway management (BAM) for out-of-hospital cardiac arrest (OHCA) patients. METHODS: Two investigators performed a systematic review of PubMed, EMBASE, and the Cochrane Database to identify all peer-reviewed articles relevant to this meta-analysis. We included all articles describing emergency medical system-treated nontraumatic OHCAs; specifically, all articles that described intervention of the prehospital AAM type were considered...
July 19, 2016: American Journal of Emergency Medicine
Preeti Vyas, Divya Vohora
The inadequate benefits of the existing therapies and the new insights into the pathophysiology of inflammatory airway diseases like chronic obstructive pulmonary disease (COPD) and asthma have led to the breakthrough of newer targets and innovative compounds as the treatment alternatives. The enhanced interpretation of immune cell signalling and signal transduction pathways at the molecular level involved in this process allows the selection of new therapeutic targets and designing of new molecules to combat such multifactorial diseases...
July 25, 2016: Infectious Disorders Drug Targets
Elizabeth Vue, Juan Davila, Tracey Straker
Osteogenesis imperfecta (OI) is an inherited disorder of the connective tissues caused by abnormalities in collagen formation. OI may present many challenges to the anesthesiologist. A literature review reveals a wide range of implications, from basic positioning to management of the difficult airway. We present the anesthetic management of a 25-year-old gravid woman with OI, fetal demise, and possible uterine rupture, admitted for an exploratory laparotomy.
2016: Case Reports in Medicine
Marissa G Vadi, Elizabeth A Ghazal, Bryan Halverson, Richard L Applegate
BACKGROUND: Gaining proficiency with various airway management tools is an important goal for anesthesiology training. Indirect video laryngoscopes facilitate tracheal intubation in adults, but it is not clear whether these findings translate to children. This study evaluates the total time to successful intubation when performed by anesthesiology trainees using GlideScope Cobalt® video laryngoscopy (GlideScope), Storz DCI® video laryngoscopy (Storz), or direct laryngoscopy (Direct) in children <2 years old with normal airway anatomy...
February 2016: Middle East Journal of Anesthesiology
Sarah Derieg
Care of pediatric surgical patients is not limited to pediatric facilities, and all perioperative RNs should have a basic understanding of the specialized care that children require. This knowledge set includes an understanding of the basic terminology used to describe this patient population as well as the developmental stages of pediatric patients. Preoperatively, the nurse should conduct a thorough assessment and evaluation and address the anxieties and questions of the patient and his or her parent or guardian...
July 2016: AORN Journal
Hiroko Kitaoka, Haruhiko Hirata, Takashi Kijima
Although pneumodynamics is the most basic research field in the respiratory management, the number of the researchers is rapidly decreasing in this century. This is not because of the maturing of pneumodynamics but because the conventional theory has been wrong. The authors have been investigating this area theoretically and experimentally for more than ten years and propsed novel pneumodynamics based on dynamic imaging technique during breathing and computational fluid dynamics. In this paper, we first indicate the dynamic collapse of the intra-mediastinal airway during maximum forced expiration in emphysematous patients visualized by 4D-CT images, and explain its mechanism in terms of fluid dynamics where the turbulence of airflow in the large airway plays an important role...
May 2016: Masui. the Japanese Journal of Anesthesiology
Juan L Antón-Pacheco
Tracheobronchial obstruction is infrequent in children and still remains a challenging matter of concern. Management alternatives vary from conservative treatment to complex surgical techniques or endoscopic interventional procedures. Airway stenting in children is relatively recent and follows the trail of the experience in adult patients. Nevertheless, there are basic differences between both age groups like the benign nature of most obstructions and the small size of the pediatric airway. These specific features raise the issues of the precise role of tracheobronchial stenting in children and the selection of the most adequate device...
June 2016: Seminars in Pediatric Surgery
Zekeriyya Alanoğlu, Süheyla Karadağ Erkoç, Çiğdem Yildirim Güçlü, Başak Ceyda Orbey Meço, Volkan Baytaş, Özlem Selvi Can, Neslihan Alkiş
Obstetric anesthesia is one of the high risk subspecialties of anesthesia practice. Anesthesia related complications are the sixth leading cause of maternal mortality. Difficult or failed intubation following induction of general anesthesia for CS remains the major contributory factor to anesthesia-related maternal complications. The airway management of obstetric patients is a challenging issue for several reasons. Anatomic and physiologic changes related to pregnancy may increase the difficult and failed intubation rates compared to the general surgical population...
March 2016: Acta Clinica Croatica
Massimiliano Sorbello, Giulio Frova, Ivana Zdravković
Airway management is basic for anesthesia practice, and sometimes it can represent a really dramatic scenario for both the patient and the physicians. Laryngoscopy has been the gold standard of airway visualization for more than 60 years, showing its limitations and failure rates with time. New technology has made available an opportunity to move the physician's eye inside patient airways thanks to video laryngoscopy and video assisted airway management technique. Undoubtedly, we have entered a new era of high resolution airway visualization and different approach in airway instrumentation...
March 2016: Acta Clinica Croatica
M Rehn, P K Hyldmo, V Magnusson, J Kurola, P Kongstad, L Rognås, L K Juvet, M Sandberg
BACKGROUND: The Scandinavian society of anaesthesiology and intensive care medicine task force on pre-hospital airway management was asked to formulate recommendations following standards for trustworthy clinical practice guidelines. METHODS: The literature was systematically reviewed and the grading of recommendations assessment, development and evaluation (GRADE) system was applied to move from evidence to recommendations. RESULTS: We recommend that all emergency medical service (EMS) providers consider to: apply basic airway manoeuvres and airway adjuncts (good practice recommendation); turn unconscious non-trauma patients into the recovery position when advanced airway management is unavailable (good practice recommendation); turn unconscious trauma patients to the lateral trauma position while maintaining spinal alignment when advanced airway management is unavailable [strong recommendation, low quality of evidence (QoE)]...
August 2016: Acta Anaesthesiologica Scandinavica
Matthew Hansen, Garth Meckler, Kerth OʼBrien, Phillip Engle, Caitlin Dickinson, Kathryn Dickinson, Jonathan Jui, William Lambert, Erika Cottrell, Jeanne-Marie Guise
OBJECTIVE: The objective of this study was to determine what aspects of prehospital pediatric airway management may contribute to patient safety events. METHODS: We conducted a 3-phase Delphi survey in prehospital professionals across the United States to identify potential contributors to patient safety events. Respondents ranked how likely factors were to contribute on a 9-point Likert-type scale and were allowed to elaborate through open-ended questions. Analysis was conducted using a mixed-methods approach, including Likert-type responses and open-ended questions which were analyzed for specific themes...
September 2016: Pediatric Emergency Care
Michael Tien, Christopher M Aiudi, Hans P Sviggum, Timothy R Long
STUDY OBJECTIVE: The objective of this study was to design and implement a preclinical elective (termed selective) in anesthesiology, critical care, and perioperative medicine and to report survey results assessing the impact of the selective on first- and second-year medical students' understanding of basic concepts, comfort with procedural skills, and interest in the specialty. DESIGN: Preinvention and postintervention survey evaluation was used as the design of this study...
June 2016: Journal of Clinical Anesthesia
Anahat K Dhillon, Suzanne Strom
BACKGROUND: Advancement from 1:1 to 1:2 (attending to resident) supervision at the beginning of a CA-1 (clinical anesthesia) year can serve as a model for transition to milestone-based curricula. Currently most programs have an individual mixture of training and advancement criteria formed at the discretion of educational leadership. We designed a questionnaire to evaluate degree of variability at programs nationally. METHODS: After obtaining IRB approval, an anonymous survey was sent via Survey Monkey to all Anesthesiology Residency Program Directors with a link for faculty members...
January 2014: Journal of Education in Perioperative Medicine: JEPM
Mario Serafini, Elliot Palmer
BACKGROUND: Medical students often have limited opportunities for clinical exposure in the first and second years of training, especially in the operating room setting. We describe one approach designed to address this deficiency. The West Virginia University externship in anesthesia provides students with first-hand experience observing and performing common procedures. METHODS: Six externs worked with the anesthesia department for four weeks, learning the basics of anesthesia, anesthetic drugs, airway management, and intravenous line placement...
January 2013: Journal of Education in Perioperative Medicine: JEPM
Ben Boedeker, W Bosseau Murray
BACKGROUND: During a mass casualty scenario (whether manmade or natural disaster), healthcare providers could likely be overwhelmed by patients, many of whom would need airway support. In such a situation, medical personnel from a wide variety of backgrounds may be called upon to provide airway management. Such personnel could include emergency medical technicians, nurses, physician's assistants and physicians from all specialties. In our current practice, a similar mix of medical providers are being tasked with increased airway management to support conscious sedation delivery...
January 2008: Journal of Education in Perioperative Medicine: JEPM
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