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Cricothyrotomy

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https://www.readbyqxmd.com/read/27785883/systematic-review-and-meta-analysis-of-first-pass-success-rates-in-emergency-department-intubation-creating-a-benchmark-for-emergency-airway-care
#1
Louise Park, Irene Zeng, Andrew Brainard
OBJECTIVE: Many EDs have begun to evaluate their airway performance. The first-pass success (FPS) rate is a commonly used marker of proficiency, and has been associated with rates of adverse events. The aim of this systematic review and meta-analysis is to quantify the ED FPS rates and summarise the rates of adverse events associated with endotracheal intubation. METHODS: A structured literature search was performed through MEDLINE and EMBASE. Research published since 2000 was included if it prospectively collected data on all patients intubated in the ED and reported the FPS rates...
October 27, 2016: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/27769777/improvised-cricothyrotomy-on-a-mountain-using-hiking-gear
#2
Clare A Johnson, Diana S Goodwine, Ingrid Passier
We present a case of a 57-year-old man who fell while climbing a mountain in California and sustained severe facial trauma. Three firefighters and 2 emergency physicians witnessed the fall and resuscitated the patient. The patient ultimately required a surgical cricothyrotomy performed with a pocket knife and Platypus hydration pack. The physicians made a makeshift positive pressure airway device using the Platypus hydration pack. We believe this is the first case report describing an improvised cricothyrotomy performed in the wilderness using only hiking gear...
December 2016: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/27669029/anesthetic-management-for-pediatric-awake-tracheostomy
#3
Ian Yuan, Benjamin B Bruins, Eleanor P Kiell, Luv R Javia, Jorge A Galvez
Awake tracheostomy is indicated for acute upper airway obstruction, when other methods of securing the airway, such as intubation and cricothyrotomy, have failed or are inappropriate. This option is rarely considered in pediatrics because of the concerns of patient cooperation and safety and has not been described in the literature. We describe the anesthetic management of an awake tracheostomy performed on a 7-year-old girl, with a large supraglottic mass obstructing the laryngeal introitus.
December 1, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27607408/impaired-ventilation-and-oxygenation-after-emergency-cricothyrotomy-recommendations-for-the-management-of-suboptimal-invasive-airway-access
#4
Matthew A Warner, Hugh M Smith, Martin D Zielinski
Invasive airway access by emergent cricothyrotomy remains an essential treatment modality in "can't intubate/can't ventilate" scenarios. Although numerous commercial devices are available, limited comparative data exist with regard to the ventilation and oxygenation parameters of these devices. We report a case of severely compromised respiratory function while using the Quicktrach II, a commercially available emergency cricothyrotomy device. Because of oxygenation and ventilatory insufficiency, our patient required emergent removal of the device and surgical tracheostomy to improve respiratory function...
September 7, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27555619/compensating-artificial-airway-resistance-via-active-expiration-assistance
#5
Steffen Wirth, Luc Seywert, Johannes Spaeth, Stefan Schumann
BACKGROUND: Artificial airway resistance as provided by small-lumen tracheal tubes or catheters increases the risk of intrinsic PEEP (PEEPi). We hypothesized that by active expiration assistance, larger minute volumes could be generated without causing PEEPi compared with conventional mechanical ventilation when using small-lumen tracheal tubes or a cricothyrotomy catheter. METHODS: We investigated the active expiration assistance in a physical model of the respiratory system and estimated its hypothetical performance in terms of maximal flow generated with endotracheal tubes ranging from 3...
December 2016: Respiratory Care
https://www.readbyqxmd.com/read/27450602/literature-evidence-on-live-animal-versus-synthetic-models-for-training-and-assessing-trauma-resuscitation-procedures
#6
Danielle Hart, Mary Ann McNeil, Cullen Hegarty, Robert Rush, Jeffery Chipman, Joseph Clinton, Troy Reihsen, Robert Sweet
There are many models currently used for teaching and assessing performance of trauma-related airway, breathing, and hemorrhage procedures. Although many programs use live animal (live tissue [LT]) models, there is a congressional effort to transition to the use of nonanimal- based methods (i.e., simulators, cadavers) for military trainees. We examined the existing literature and compared the efficacy, acceptability, and validity of available models with a focus on comparing LT models with synthetic systems...
December 0: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/27437121/situational-analysis-of-essential-surgical-care-management-in-iran-using-the-who-tool
#7
Rohollah Kalhor, Nastaran Keshavarz Mohamadi, Nader Khalesi, Mehdi Jafari
BACKGROUND: Surgery is an essential component of health care, yet it has usually been overlooked in public health across the world. OBJECTIVES: This study aimed to perform a situational analysis of essential surgical care management at district hospitals in Iran. MATERIALS AND METHODS: This research was a descriptive and cross-sectional study performed at 42 first-referral district hospitals of Iran in 2013. The World Health Organization (WHO) Tool for the situational analysis of emergency and essential care was used for data collection in four domains of facilities and equipment, human resources, surgical interventions, and infrastructure...
May 2016: Iranian Red Crescent Medical Journal
https://www.readbyqxmd.com/read/27432055/ultrasonographic-identification-of-the-cricothyroid-membrane-best-evidence-techniques-and-clinical-impact
#8
M S Kristensen, W H Teoh, S S Rudolph
Inability to identify the cricothyroid membrane by inspection and palpation contributes substantially to the high failure rate of cricothyrotomy. This narrative review summarizes the current evidence for application of airway ultrasonography for identification of the cricothyroid membrane compared with the clinical techniques. We identified the best-documented techniques for bedside use, their success rates, and the necessary training for airway-ultrasound-naïve clinicians. After a short but structured training, the cricothyroid membrane can be identified using ultrasound in difficult patients by previously airway-ultrasound naïve anaesthetists with double the success rate of palpation...
September 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27425433/teaching-advanced-trauma-life-support-atls-a-nationwide-retrospective-analysis-of-8202-lessons-taught-in-germany
#9
Markus M Luedi, Christoph C Wölfl, Katharina Wieferich, Agron Dogjani, Peter Kauf, Dietrich Doll
OBJECTIVE: To examine whether faculty who teach the Advanced Trauma Life Support (ATLS) course would improve with experience and, correspondingly, ratings from course evaluations would increase. DESIGN: Retrospective analysis of student evaluations of 262 ATLS courses held between 2008 and 2012. SETTING: All ATLS courses held between 2008 and 2012 nationwide in Germany. PARTICIPANTS: All ATLS student course evaluations covering 8202 lessons, 81 instructors, 36 course directors, and 5 coordinators...
July 11, 2016: Journal of Surgical Education
https://www.readbyqxmd.com/read/27330674/out-of-hospital-surgical-airway-management-does-scope-of-practice-equal-actual-practice
#10
Molly Furin, Melissa Kohn, Ryan Overberger, David Jaslow
INTRODUCTION: Pennsylvania, among other states, includes surgical airway management, or cricothyrotomy, within the paramedic scope of practice. However, there is scant literature that evaluates paramedic perception of clinical competency in cricothyrotomy. The goal of this project is to assess clinical exposure, education and self-perceived competency of ground paramedics in cricothyrotomy. METHODS: Eighty-six paramedics employed by four ground emergency medical services agencies completed a 22-question written survey that assessed surgical airway attempts, training, skills verification, and perceptions about procedural competency...
May 2016: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27315316/expanding-hematoma-s-life-threatening-neck-and-face-emergency-management-of-ballistic-injuries
#11
Sabri T Shuker
This article aims to bring attention to the morbidity and fatality of hemorrhage, how expanding hematoma and air compromise neck/face N/F injuries and present challenges. Large neck vessel ballistic injuries may lead to hemorrhage and expanding hematoma, resulting in airway compromise, due to injuries to the internal and/or external carotid arteries, internal jugular veins "internal carotid artery, external carotid artery, internal jugular vein," and the external carotid artery deep branches. This also leads to injuries to the cervical fascial layers (barriers of deep spaces) that facilitate pooling blood and hematoma into compartmental and large potential space which effects the pharynx, larynx, esophagus, and trachea...
July 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27281093/safairway-an-airway-training-for-pulmonologists-performing-a-flexible-bronchoscopy-with-nonanesthesiologist-administered-propofol-sedation-a-prospective-evaluation
#12
Melanie Schulze, Bastian Grande, Michaela Kolbe, Sarah Kriech, Christoph B Nöthiger, Malcolm Kohler, Donat R Spahn, Daniel Franzen
Nonanesthesiologist administered propofol (NAAP) sedation for flexible bronchoscopy is controversial, because there is no established airway management (AM) training for pulmonologists. The aim was to investigate the performance and acceptance of a proposed AM algorithm and training for pulmonologists performing NAAP sedation. The algorithm includes using 3 maneuvers including bag mask ventilation (BMV), laryngeal tube (LT), and needle cricothyrotomy (NCT). During training (consisting of 2 sessions with a break of 9 weeks in between), these maneuvers were demonstrated and exercised, followed by 4 consecutive attempts to succeed with each of these devices...
June 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27275670/surgical-cricothyrotomy-rather-than-percutaneous-cricothyrotomy-in-cannot-intubate-cannot-oxygenate-situation
#13
Takashi Asai
No abstract text is available yet for this article.
August 2016: Anesthesiology
https://www.readbyqxmd.com/read/27275669/emergency-cricothyrotomy-performed-by-surgical-airway-naive-medical-personnel-a-randomized-crossover-study-in-cadavers-comparing-three-commonly-used-techniques
#14
Frédéric Heymans, Georg Feigl, Stephan Graber, Delphine S Courvoisier, Kerstin M Weber, Pavel Dulguerov
BACKGROUND: When conventional approaches to obtain effective ventilation and return of effective spontaneous breathing fail, surgical airway is the last rescue option. Most physicians have a limited lifetime experience with cricothyrotomy, and it is unclear what method should be taught for this lifesaving procedure. The aim of this study is to compare the performance of medical personnel, naive to surgical airway techniques, in establishing an emergency surgical airway in cadavers using three commonly used cricothyrotomy techniques...
August 2016: Anesthesiology
https://www.readbyqxmd.com/read/27114241/anterograde-catheterization-of-severe-tracheal-stenosis-as-a-difficult-airway-management-option-followed-by-emergent-tracheostomy-a-case-report
#15
Behrad Ziapour
BACKGROUND: To describe the successful management of a patient with severe dyspnea and hypoxia due to tracheal stenosis by the application of a novel bridging technique-anterograde tracheal catheterization-prior to tracheostomy. CASE PRESENTATION: A 55-year-old woman entered the Emergency Department with severe dyspnea, tachypnea, and stridor and a pulse oximetry reading of 60 %. An attempt at intubation failed because of tracheal stenosis discovered 3-4 cm distal to the vocal cords, which had been formed as a complication of intubation the previous month...
2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27095773/bystander-cricothyrotomy-with-ballpoint-pen-a-fresh-cadaveric-feasibility-study
#16
Ulrich Kisser, Christian Braun, Astrid Huber, Klaus Stelter
OBJECTIVE: In motion pictures and anecdotal reports, ballpoint pens have been used for life-saving cricothyroidotomies. The objective of this study was to examine the widespread belief that ballpoint pens can perforate the skin and cricothyroid ligament and could be used as substitute tracheostomy sets in an emergency setting. METHODS: Three different ballpoint pens were examined regarding their inner diameter, their demountability to form a cannula and their airflow properties...
August 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27082606/difficult-airway-due-to-an-undiagnosed-subglottic-tumor-a-case-report
#17
Kohji Uzawa, Joho Tokumine, Alan Kawarai Lefor, Toshiyuki Takagi, Kunitaro Watanabe, Tomoko Yorozu
The "cannot ventilate, cannot intubate" scenario during anesthesia induction can be lethal. We present a patient with an undiagnosed subglottic tumor who developed the "cannot ventilate, cannot intubate" situation after induction of general anesthesia, due to the presence of an undiagnosed subglottic tumor. A 93-year-old woman was brought to the operating room for repair of a femoral neck fracture. Both ventilation and intubation could not be accomplished, and the patient was awakened without complications after trials of maintaining the airway...
April 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27046605/a-new-design-for-airway-management-training-with-mixed-reality-and-high-fidelity-modeling
#18
Yunhe Shen, David Hananel, Zichen Zhao, Daniel Burke, Crist Ballas, Jack Norfleet, Troy Reihsen, Robert Sweet
Restoring airway function is a vital task in many medical scenarios. Although various simulation tools have been available for learning such skills, recent research indicated that fidelity in simulating airway management deserves further improvements. In this study, we designed and implemented a new prototype for practicing relevant tasks including laryngoscopy, intubation and cricothyrotomy. A large amount of anatomical details or landmarks were meticulously selected and reconstructed from medical scans, and 3D-printed or molded to the airway intervention model...
2016: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/27021389/cadaver-based-training-is-superior-to-simulation-training-for-cricothyrotomy-and-tube-thoracostomy
#19
James Kimo Takayesu, David Peak, Dana Stearns
Emergency medicine (EM) training mandates that residents be able to competently perform low-frequency critical procedures upon graduation. Simulation is the main method of training in addition to clinical patient care. Access to cadaver-based training is limited due to cost and availability. The relative fidelity and perceived value of cadaver-based simulation training is unknown. This pilot study sought to describe the relative value of cadaver training compared to simulation for cricothyrotomy and tube thoracostomy...
March 28, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/26970139/tracheal-exposure-anticipatory-management-of-the-difficult-airway
#20
Christopher J Britt, Marc R Rohrbach, Timothy M McCulloch
BACKGROUND: When a patient cannot be intubated or ventilated, cricothyrotomy is indicated. Risks associated with emergent cricothyrotomy are significant, and this procedure typically requires revision. Additional options for establishing an emergent airway are limited. Thus, elective tracheotomy to ensure a safe airway after procedures involving the upper aerodigestive tract is common. Although safe and effective overall, this procedure is not without additional risks, added resources, complex cares, and extended hospitalizations...
June 2016: Head & Neck
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