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Upper airway emergency

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https://www.readbyqxmd.com/read/28239576/cut-throat-injury-our-experience-in-rural-set-up
#1
Debdulal Chakraborty, Chiranjib Das, Arvind Kumar Verma, Rajesh Hansda
Cut throat injuries are one of the emergency conditions managed by ENT specialists. If not treated in time, they may lead to death. Prevention of these complications depends on immediate resuscitation by securing the airway by tracheostomy or intubation, prompt control of hemorrhage and blood replacement. The present study was conducted to study the sociodemographic profile of patients of cut throat injury, motives behind cut throat injury, site and depth of the injury, treatment given at our hospital and outcome...
March 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/28237950/emergency-cricothyroidotomy-following-tracheobronchial-stenting
#2
Simon Robert Cavinato, Mike Denning, Brendan P Madden
A man aged 51 years was referred for tracheobronchial stenting after a poorly differentiated oesophageal carcinoma had progressed to cause stridor. Bronchoscopy revealed a left vocal cord palsy and tumour infiltration into the trachea. A tracheobronchial stent was placed, and after distal migration was endoscopically resited. Returning from theatre, the patient developed severe upper airway obstruction that progressed to cause CO2 narcosis and loss of consciousness. A rapid sequence induction was initiated, and a Glidescope revealed bilateral vocal cord palsy with severe oedema causing an inability to pass a tube or stylet...
February 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28226944/3d-force-torque-characterization-of-emergency-cricothyroidotomy-procedure-using-an-instrumented-scalpel
#3
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/28225496/impact-of-nasal-symptoms-on-the-evaluation-of-asthma-control
#4
Chien-Chia Huang, Po-Hung Chang, Pei-Wen Wu, Chun-Hua Wang, Chia-Hsiang Fu, Chi-Che Huang, Hsiao-Jung Tseng, Ta-Jen Lee
The united airways concept suggests that patients with asthma typically exhibit parallel inflammation in the upper airway. The resulting nasal symptoms should reduce quality of life and substantially affect the evaluation of asthma control among these patients. This study aimed to assess the association of nasal symptoms with the evaluation of asthma control.Fifty-eight patients with asthma and persistent nasal symptoms were prospectively recruited for evaluations of their sinonasal symptoms and asthma control in a cross-sectional study from August 2013 to June 2016...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28225162/mandibular-position-and-movements-suitability-for-diagnosis-of-sleep-apnoea
#5
Jean-Benoit Martinot, Jean-Christian Borel, Valérie Cuthbert, Hervé Jean-Pierre Guénard, Stéphane Denison, Philip E Silkoff, David Gozal, Jean-Louis Pepin
BACKGROUND AND OBJECTIVE: Mandibular movements (MMs) and position during sleep reflect respiratory efforts related to increases in upper airway resistance and micro-arousals. The study objective was to assess whether MM identifies sleep-disordered breathing (SDB) in patients with moderate to high pre-test probability. METHODS: This was a prospective study of 87 consecutive patients referred for an in-laboratory sleep test. Magnetometer-derived MM signals were incorporated into standard polysomnography (PSG)...
November 6, 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28213068/an-unusual-cause-of-severe-dyspnea-a-laryngeal-live-leech-case-report
#6
Said Anajar, Rachid Ansari, Jawad Hassnaoui, Reda Abada, Mohammed Roubal, Mohammed Mahtar
INTRODUCTION: Foreign bodies in the upper airways are one of the most challenging otolaryngology emergencies, leeches present a very rare cause of airway foreign bodies around the world. CASE REPORT: A 6-year-old girl was referred to our otolaryngology department at a tertiary university hospital with a severe dyspnea and hemoptysis. Nasofibroscopy revealed a dark living leech in the supraglottic area which extends to the glottis. The patient was urgently admitted to the operating room, the leech was grasped and removed with a foreign body forceps with a full length of more than 6cm...
January 25, 2017: International Journal of Surgery Case Reports
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/28178173/screening-for-hereditary-angioedema-hae-at-13-emergency-centers-in-osaka-japan-a-prospective-observational-study
#8
Tomoya Hirose, Futoshi Kimbara, Masahiro Shinozaki, Yasuaki Mizushima, Hidehiko Yamamoto, Masashi Kishi, Takeyuki Kiguchi, Shigeru Shiono, Mitsuhiro Noborio, Akihiro Fuke, Hiroshi Akimoto, Takaaki Kimura, Shinichiro Kaga, Takahiko Horiuchi, Takeshi Shimazu
Hereditary angioedema (HAE) with deficiency of C1 inhibitor (C1-INH) is an autosomal-dominant disease characterized by recurrent episodes of potentially life-threatening angioedema. The objective is to study the incidence of HAE among patients who visit the emergency department.This was a 3-year prospective observational screening study involving 13 urban tertiary emergency centers in Osaka prefecture, Japan. Patients were included if they met the following criteria: unexplained edema of the body, upper airway obstruction accompanied by edema, anaphylaxis, acute abdomen with intestinal edema (including ileus and acute pancreatitis), or asthma attack...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28174033/acute-hypotonia-in-an-infant
#9
Jimme Sierakowski, Jason Arthur, Todd Wylie
BACKGROUND: Acute flaccid myelitis (AFM) is increasing in incidence in the United States and presenting to emergency departments (EDs) across the country. This clinical entity presents as acute paralysis, with magnetic resonance imaging changes in the gray matter only in children younger than 21 years of age. The etiology is unknown, although preceding viral illnesses are common. There are no consensus guidelines regarding treatment. CASE REPORT: A 4-month-old girl presented with decreased bilateral arm movement...
February 4, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28110857/phenotypic-approaches-to-obstructive-sleep-apnoea-new-pathways-for-targeted-therapy
#10
REVIEW
Danny J Eckert
People develop obstructive sleep apnoea (OSA) for different reasons. The ability to understand these reasons, easily identify them in individual patients, and develop therapies that target one or more of these reasons are the keys to unlocking new approaches for the treatment of OSA. In line with this approach, recent advances in OSA pathogenesis using upper airway and respiratory phenotyping techniques have identified four key causes of OSA. A narrow or collapsible upper airway ('impaired anatomy') is the primary cause...
December 18, 2016: Sleep Medicine Reviews
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/28059860/diagnosis-and-treatment-of-upper-airway-oedema-caused-by-acute-angio-oedema-in-the-emergency-department-a-french-consensus-statement
#12
Bernard Floccard, Nicolas Javaud, Alban Deroux, Isabelle Boccon-Gibod, Olivier Fain, Stéphanie Amarger, Claire Blanchard-Delaunay, Pierre Y Jeandel, Nicolas Marmion, Yann Ollivier, Pauline Pralong, Stéphane Gayet, Aurélie Du-Thanh, Fabien Pelletier, Laurent Sailler, Philip Robinson, David Launay, Laurence Bouillet
Angio-oedema is a transitory, localized, noninflammatory oedema of subcutaneous tissue or mucous. When the oedema affects the mouth, lips, tongue or larynx, it can result in fatal asphyxiation in the absence of specific treatment. Oedema secondary to plasma extravasation is usually mediated by either histamine or bradykinin. As laboratory tests are not available in an emergency setting, the implicated mediator cannot be readily determined. The challenge for the emergency physician is to determine the aetiological type, evaluate severity and initiate adapted treatment by means of a structured approach...
January 4, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/27924661/sleep-disordered-breathing-in-pregnancy-the-maternal-and-fetal-implications
#13
Shanthi Carnelio, Adam Morton, H David McIntyre
Sleep disordered breathing (SDB) which includes obstructive sleep apnoea (OSA) and upper airway resistance syndrome (UARS), has emerged as a risk factor for adverse maternal-foetal outcomes in pregnancy. Physiological changes of pregnancy predispose a woman 'at risk' towards developing SDB. The increasing incidence of OSA in pregnancy closely correlates with the population trends of obesity. Common screening tools validated in non-pregnant subjects including Epworth Sleepiness Scale (ESS) and Berlin Questionnaire (BQ) are poor predictors of SDB in pregnancy...
December 7, 2016: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/27899469/emergency-surgical-airways-following-activation-of-a-difficult-airway-management-team-in-hospitalized-critically-ill-patients-a-case-series
#14
REVIEW
Joseph M Darby, Gregory Halenda, Courtney Chou, Joseph J Quinlan, Louis H Alarcon, Richard L Simmons
INTRODUCTION: An emergency surgical airway (ESA) is widely recommended for securing the airway in critically ill patients who cannot be intubated or ventilated. Little is known of the frequency, clinical circumstances, management methods, and outcomes of hospitalized critically ill patients in whom ESA is performed outside the emergency department or operating room environments. METHODS: We retrospectively reviewed all adult patients undergoing ESA in our intensive care units (ICUs) and other hospital units from 2008 to 2012 following activation of our difficult airway management team (DAMT)...
November 28, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27865221/-massive-upper-airway-bleeding-a-rare-case-of-aortobronchial-fistula
#15
Paola Gudiel Arriaza, Amparo Sánchez Serrano, Jorge Marques do Vale, Isabel Gil Pereira, António Simões Torres, Maria José Martín Sánchez
Clinical presentation of haemoptysis and haematemesis often generates confusion, becoming a difficult task to determine the source of upper airway bleeding. Aortobronchial fistula is a rare entity, but has been a reported complication in patients that have undergone aortic vascular surgery. A high clinical suspicion is fundamental to making this diagnosis. A 69 year old male, with a previous diagnosis of chronic gastritis, is admitted to the emergency room for vomiting blood. In the first 24 hours after admission, the patient develops respiratory insufficiency after an episode of massive bleeding from his mouth...
June 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/27849653/the-role-of-aspirin-desensitization-in-the-management-of-aspirin-exacerbated-respiratory-disease
#16
Bobby A Tajudeen, Joseph S Schwartz, John V Bosso
PURPOSE OF REVIEW: Aspirin-exacerbated respiratory disease (AERD) is a progressive inflammatory disease of the upper and lower airways characterized by marked eosinophilic nasal polyposis, asthma, and respiratory reactions to medications that inhibit the cyclooxygenase pathway. Aspirin desensitization has proven to be an effective tool in the management of this disease when used in a multidisciplinary setting. The purpose of this article is to review the current literature regarding AERD, aspirin desensitization, and share our opinion regarding the most optimal multidisciplinary approach to these complex patients...
February 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/27833745/advances-in-real-time-magnetic-resonance-imaging-of-the-vocal-tract-for-speech-science-and-technology-research
#17
Asterios Toutios, Shrikanth S Narayanan
Real-time magnetic resonance imaging (rtMRI) of the moving vocal tract during running speech production is an important emerging tool for speech production research providing dynamic information of a speaker's upper airway from the entire mid-sagittal plane or any other scan plane of interest. There have been several advances in the development of speech rtMRI and corresponding analysis tools, and their application to domains such as phonetics and phonological theory, articulatory modeling, and speaker characterization...
2016: APSIPA Transactions on Signal and Information Processing
https://www.readbyqxmd.com/read/27833699/point-of-care-sonographic-findings-in-acute-upper-airway-edema
#18
Michael Schick, Kendra Grether-Jones
We describe a case where a patient presented with acute angiotensin-converting enzyme inhibitor (ACE-I) induced angioedema without signs or symptoms of upper airway edema beyond lip swelling. Point-of-care ultrasound (POCUS) was used as an initial diagnostic test and identified left-sided subglottic upper airway edema that was immediately confirmed with indirect fiberoptic laryngoscopy. ACE-I induced angioedema and the historical use of ultrasound in evaluation of the upper airway is briefly discussed. To our knowledge, POCUS has not been used to identify acute upper airway edema in the emergency setting...
November 2016: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27810460/bystander-cricothyroidotomy-with-household-devices-a-fresh-cadaveric-feasibility-study
#19
Christian Braun, Ulrich Kisser, Astrid Huber, Klaus Stelter
INTRODUCTION: In various motion pictures, medical TV shows and internet chatrooms, non-medical devices were presented as tools for life-saving cricothyroidotomies. However, there is uncertainty about whether it is possible for a bystander to perform a cricothyroidotomy and maintain gas exchange using improvised household items. This study examines the ability of bystanders to carry out an emergency cricothyroidotomy in fresh human cadavers using only a pocket knife and a ballpoint pen...
January 2017: Resuscitation
https://www.readbyqxmd.com/read/27804108/tracheal-extubation-of-the-adult-intensive-care-patient-with-a-predicted-difficult-airway-a-narrative-review
#20
REVIEW
D J Sturgess, K B Greenland, S Senthuran, F A Ajvadi, A van Zundert, M G Irwin
Management of the difficult airway is an important, but as yet poorly-studied, component of intensive care management. Although there has been a strong emphasis on prediction and intubation of the difficult airway, safe extubation of the patient with a potentially difficult airway has not received the same attention. Extubation is a particularly vulnerable time for the critically ill patient and, because of the risks involved and the consequences of failure, it warrants specific consideration. The Royal College of Anaesthetists 4th National Audit Project highlighted differences in the incidence and consequences of major complications during airway management between the operating room and the critical care environment...
November 2, 2016: Anaesthesia
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