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Advanced airway management

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https://www.readbyqxmd.com/read/29757778/a-contemporary-analysis-of-medicolegal-issues-in-obstetric-anesthesia-between-2005-and-2015
#1
Vesela P Kovacheva, Ethan Y Brovman, Penny Greenberg, Ellen Song, Arvind Palanisamy, Richard D Urman
BACKGROUND: Detailed reviews of closed malpractice claims have provided insights into the most common events resulting in litigation and helped improve anesthesia care. In the past 10 years, there have been multiple safety advancements in the practice of obstetric anesthesia. We investigated the relationship among contributing factors, patient injuries, and legal outcome by analyzing a contemporary cohort of closed malpractice claims where obstetric anesthesiology was the principal defendant...
May 10, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29708920/airway-management-in-a-patient-with-tracheal-disruption-due-to-penetrating-neck-trauma-with-hollow-point-ammunition-a-case-report
#2
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...
May 1, 2018: A&A practice
https://www.readbyqxmd.com/read/29707505/acute-airway-management
#3
Nikhil Panda, Dean M Donahue
Acute airway management has challenged clinicians for nearly four millennia. History underscores the discoveries of surgeons and anesthesiologists, whose advances in technology and surgical technique have transformed management algorithms from primarily surgical tracheostomy, to transoral endotracheal intubation under direct laryngoscopy. Despite this progress and a better understanding of airway anatomy, physiology and pathogenesis of disease, the acute airway, whether obstructed, traumatically disrupted, or externally compressed, remains a life-threatening challenge...
March 2018: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29707206/recent-advances-in-biologic-therapy-of-asthma-and-the-role-in-therapy-of-chronic-rhinosinusitis
#4
REVIEW
Rohit Divekar, Devyani Lal
Great strides have been made in the last five years in understanding the pathology of chronic rhinosinusitis (CRS). CRS is now accepted to be the end-stage manifestation of inflammation resultant from various pathogenetic mechanisms. This has resulted in increasing recognition of distinct CRS endotypes. Such endotypes encompass a cluster of patients with similar pathogenic mechanisms that may have common therapeutic targets and responsiveness to interventions. The elucidation of mechanisms leading to the development of chronic upper (sino-nasal) airway inflammation has to some extent paralleled investigations of aberrant pathways operant in asthma...
2018: F1000Research
https://www.readbyqxmd.com/read/29701428/anaesthetic-management-in-a-duchennne-muscle-dystrophy-patient-for-treatment-of-recurrent-pneumothorax
#5
Sara Mota, Liuba Germanova, Joana Cortesão, Teresa Paiva
INTRODUCTION: Duchenne muscular dystrophy (DMD) is an x linked recessive disorder. Long term prognosis is ominous, with development of respiratory distress and cardiomyopathy in advanced stage of the disease and expected death in the teens-to-mid 20s due to respiratory or cardiac failure. Peri-operative management of this patients is challenging due to difficult airway anatomy (macroglossia, limited neck and mandibular mobility). Additionally, they are at risk of developing malignant hyperthermia, rhabdomyolysis and hyperkalemic cardiac arrest when exposed to halogenated inhalational anaesthetics and depolarizing muscle relaxants...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29697466/perioperative-considerations-for-airway-management-and-drug-dosing-in-obese-children
#6
Jerrold Lerman, Karin Becke
PURPOSE OF REVIEW: Childhood obesity, a phenomenon that is increasing globally, holds substantial relevance for pediatric anesthesia. In particular, understanding the nuances of airway management and drug dosing in obese children can be daunting. RECENT FINDINGS: Respiratory adverse events and challenges in managing the airway may be anticipated. In addition, drug-dosing strategies for the obese child are complex and poorly understood although recent advances have clarified the optimal dosing for anesthetics in these children...
June 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29693940/the-peas-protocol-an-airway-ultrasound-technique
#7
Akihiro Suzuki
In the past ultrasound identification of the airway structure was rather difficult However, recent advancement of the high frequency linear type transducer allows us to visualize airway structure easily. Accordingly, now we have difficult airway society guideline 2015. resuscitation guideline 2015, and Australia and New Zealand Intensive Care Society guidelines for percutaneous dilatational tracheostomy which recommend use of ultrasound in airway management Airway ultrasound is an emerging technique for all physicians, and the author introduces perioperative evaluation of the airway via sonography, the PEAS protocol...
May 2017: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/29691106/impact-of-prehospital-airway-management-on-combat-mortality
#8
Garrett B Hardy, Joseph K Maddry, Patrick C Ng, Shelia C Savell, Allyson A Arana, Avery Kester, Vikhyat S Bebarta
INTRODUCTION: Analysis of modern military conflicts suggests that airway compromise remains the second leading cause of preventable death of combat fatalities. This study compares outcomes of combat casualties that received prehospital airway interventions, specifically bag valve mask (BVM) ventilation, cricothyrotomy, and supraglottic airway (SGA) placement. The goal is to compare the effectiveness of airway management strategies used in the military pre-hospital setting. METHODS: This retrospective chart review of 1267 US Army medical evacuation patient care records, compared outcomes of casualties that received prehospital advanced airway interventions...
February 8, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29689354/timing-of-advanced-airway-management-by-emergency-medical-services-personnel-following-out-of-hospital-cardiac-arrest-a-population-based-cohort-study
#9
Junichi Izawa, Taku Iwami, Koichiro Gibo, Masashi Okubo, Kentaro Kajino, Kousuke Kiyohara, Chika Nishiyama, Tatsuya Nishiuchi, Yasuyuki Hayashi, Takeyuki Kiguchi, Daisuke Kobayashi, Sho Komukai, Takashi Kawamura, Clifton W Callaway, Tetsuhisa Kitamura
BACKGROUND: Early prehospital advanced airway management (AAM) by emergency medical services (EMS) personnel has been intended to improve patient outcomes from out-of-hospital cardiac arrest (OHCA). However, few studies examine the effectiveness of early prehospital AAM. We investigated whether early prehospital AAM was associated with functionally favourable survival after adult OHCA. METHODS: We conducted a population-based cohort study of OHCA in Osaka, Japan, between 2005 and 2012...
April 21, 2018: Resuscitation
https://www.readbyqxmd.com/read/29684315/sleep-disorders-in-patients-with-post-traumatic-stress-disorder
#10
REVIEW
Ali A El-Solh, Usman Riaz, Jasmine Roberts
A growing body of evidence supports a bidirectional relationship between post-traumatic stress disorder (PTSD) and sleep disturbances. Fragmented sleep induced by sleep-related breathing disorders, insomnia, and nightmares impacts recovery and treatment outcomes and worsens PTSD symptoms. Despite recent attention, management of these disorders has been unrewarding in the setting of PTSD. This review summarizes the evidence for empirically supported treatments of these sleep ailments as it relates to PTSD including psychotherapeutic and pharmacologic interventions...
April 20, 2018: Chest
https://www.readbyqxmd.com/read/29683730/biologic-drugs-a-new-target-therapy-in-copd
#11
Ahmed Yousuf, Christopher E Brightling
Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease associated with significant morbidity and mortality. Current diagnostic criteria based on the presence of fixed airflow obstruction and symptoms do not integrate the complex pathological changes occurring within the lung and they do not define different airway inflammatory patterns. The current management of COPD is based on 'one size fits all' approach and does not take the importance of heterogeneity in COPD population into account. The available treatments aim to alleviate symptoms and reduce exacerbation frequency but do not alter the course of the disease...
April 23, 2018: COPD
https://www.readbyqxmd.com/read/29661387/pre-hospital-advanced-airway-management-by-anaesthetist-and-nurse-anaesthetist-critical-care-teams-a-prospective-observational-study-of-2028-pre-hospital-tracheal-intubations
#12
M Gellerfors, E Fevang, A Bäckman, A Krüger, S Mikkelsen, J Nurmi, L Rognås, E Sandström, G Skallsjö, C Svensén, D Gryth, H M Lossius
BACKGROUND: Pre-hospital tracheal intubation success and complication rates vary considerably among provider categories. The purpose of this study was to estimate the success and complication rates of pre-hospital tracheal intubation performed by physician anaesthetist or nurse anaesthetist pre-hospital critical care teams. METHODS: Data were prospectively collected from critical care teams staffed with a physician anaesthetist or a nurse anaesthetist according to the Utstein template for pre-hospital advanced airway management...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29651626/current-topics-in-the-management-of-acute-traumatic-spinal-cord-injury
#13
Christopher D Shank, Beverly C Walters, Mark N Hadley
Acute traumatic spinal cord injury (SCI) affects more than 250,000 people in the USA, with approximately 17,000 new cases each year. It continues to be one of the most significant causes of trauma-related morbidity and mortality. Despite the introduction of primary injury prevention education and vehicle safety devices, such as airbags and passive restraint systems, traumatic SCI continues to have a substantial impact on the healthcare system. Over the last three decades, there have been considerable advancements in the management of patients with traumatic SCI...
April 12, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29643170/treatment-options-in-idiopathic-subglottic-stenosis-protocol-for-a-prospective-international-multicentre-pragmatic-trial
#14
Alexander Gelbard, Yu Shyr, Lynne Berry, Alexander T Hillel, Dale C Ekbom, Eric S Edell, Jan L Kasperbauer, David G Lott, Donald T Donovan, C Gaelyn Garrett, Guri Sandhu, James J Daniero, James L Netterville, Josh S Schindler, Marshall E Smith, Paul C Bryson, Robert R Lorenz, David O Francis
INTRODUCTION: Idiopathic subglottic stenosis (iSGS) is an unexplained progressive obstruction of the upper airway that occurs almost exclusively in adult, Caucasian women. The disease is characterised by mucosal inflammation and localised fibrosis resulting in life-threatening blockage of the upper airway. Because of high recurrence rates, patients with iSGS will frequently require multiple procedures following their initial diagnosis. Both the disease and its therapies profoundly affect patients' ability to breathe, communicate and swallow...
April 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29628599/temporomandibular-joint-ankylosis-a-pediatric-difficult-airway-management
#15
Anoop Sharma, Deepak Dwivedi, Ram Murti Sharma
Intubating a pediatric patient with temporomandibular joint ankylosis is a daunting task, and it becomes more challenging with limited mouth opening. Fiberoptic nasotracheal intubation technique is considered a gold standard. We describe an improvised technique of securing airway in the absence of appropriate-sized fiberoptic scope. The endotracheal tube inserted in the left nostril for maintaining depth of anesthesia was advanced under vision by the fiberoptic scope inserted into the right nostril, and with external laryngeal manipulation, the airway was secured with no complications...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628333/multidisciplinary-difficult-airway-course-an-essential-educational-component-of-a-hospital-wide-difficult-airway-response-program
#16
W Robert Leeper, Elliott R Haut, Vinciya Pandian, Sajan Nakka, Jeffrey Dodd-O, Nasir Bhatti, Elizabeth A Hunt, Mustapha Saheed, Nicholas Dalesio, Adam Schiavi, Christina Miller, Thomas D Kirsch, Lauren Berkow
OBJECTIVE: A hospital-wide difficult airway response team was developed in 2008 at The Johns Hopkins Hospital with three central pillars: operations, safety monitoring, and education. The objective of this study was to assess the outcomes of the educational pillar of the difficult airway response team program, known as the multidisciplinary difficult airway course (MDAC). DESIGN: The comprehensive, full-day MDAC involves trainees and staff from all provider groups who participate in airway management...
April 5, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29627276/a-review-on-drug-induced-sedation-endoscopy-technique-grading-systems-and-controversies
#17
REVIEW
Matt Lechner, Dominic Wilkins, Bhik Kotecha
Sleep disordered breathing (SDB) comprises a spectrum of disorders, ranging from simple snoring to severe obstructive sleep apnoea (OSA), with a significant burden to health care systems in high income countries. If left untreated, OSA has significant cumulative, long-term health consequences. In the 1990s drug induced sedation endoscopy (DISE) has been developed to become a primary tool in the diagnosis and management of OSA. It allows meticulous endoscopic evaluation of the airway and identifies areas of collapse, thereby informing both on the selection of surgical techniques, where efficacy depends entirely on success at relieving obstruction at a certain level and on the usefulness of conservative measures, such as mandibular advancement splints...
February 24, 2018: Sleep Medicine Reviews
https://www.readbyqxmd.com/read/29627058/nonoperative-endoscopic-management-of-benign-tracheobronchial-disorders
#18
REVIEW
Cameron D Wright
Modern thoracic surgery requires knowledge and skill in advanced bronchoscopic techniques. Rigid bronchoscopy remains a workhorse for the management of central airway obstruction. Dilation of tracheal strictures is now much simpler with the advent of the balloon dilator, which can be passed through a therapeutic bronchoscope. Numerous adjuncts, such as laser, argon beam coagulation, electrocautery, and cryotherapy, can be used to improve airway patency. There are now numerous stenting options for strictures that require stenting to maintain airway patency...
May 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/29625664/challenges-in-the-treatment-of-asthma-in-children-and-adolescents
#19
REVIEW
Stanley J Szefler, Bradley Chipps
OBJECTIVE: Despite the availability of effective treatments, asthma control in children and adolescents remains inadequate and rates of health care use are high. This follow-up to a recent review (O'Byrne et al, Eur Respir J. 2017;50[3]) examines a number of challenges in current pediatric asthma management compared with that of an adult perspective and discusses possible alternative strategies that might improve pediatric asthma management and control. DATA SOURCES: The evidence base for this review is limited because, historically, much of the research has been performed in adults...
April 2018: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/29623556/anesthesia-for-interventional-pulmonology-procedures-a-review-of-advanced-diagnostic-and-therapeutic-bronchoscopy
#20
Andres de Lima, Fayez Kheir, Adnan Majid, John Pawlowski
PURPOSE: Interventional pulmonology is a growing subspecialty of pulmonary medicine with flexible and rigid bronchoscopies increasingly used by interventional pulmonologists for advanced diagnostic and therapeutic purposes. This review discusses different technical aspects of anesthesia for interventional pulmonary procedures with an emphasis placed on pharmacologic combinations, airway management, ventilation techniques, and common complications. SOURCE: Relevant medical literature was identified by searching the PubMed and Google Scholar databases for publications on different anesthesia topics applicable to interventional pulmonary procedures...
April 5, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
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