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Emergency airway management

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https://www.readbyqxmd.com/read/29147912/tracheal-agenesis-optimization-of-computed-tomography-diagnosis-by-airway-ventilation
#1
REVIEW
Marirosa Cristallo Lacalamita, Sebastien Fau, Aurelie Bornand, Isabelle Vidal, Antonella Martino, Isabelle Eperon, Seema Toso, Anne-Laure Rougemont, Sylviane Hanquinet
Tracheal agenesis is a rare and often lethal congenital defect that leads to airway emergency at birth. Computed tomography (CT) is the modality of choice to evaluate anomalous tracheal anatomy. The absence of spontaneous aeration of the tracheobronchial tree in children with tracheal agenesis makes CT interpretation difficult. We describe a procedure of airway management applied in two newborns with suspected tracheal agenesis. Correct airway management was performed immediately prior to CT examination by airway ventilation, with bag-valve mask alone in one case, and attached to an endotracheal tube placed into the esophagus in the other case...
November 17, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/29145705/review-article-critical-care-airway-management-elearning-modules
#2
REVIEW
Deepak Doshi, Sally McCarthy, Elizabeth Mowatt, Angela Cahill, Bronwyn Peirce, Geoff Hawking, Ruth Osborne, Belinda Hibble, Katharine Ebbs
The Australasian College for Emergency Medicine (ACEM) has recently launched the Critical Care Airway Management eLearning modules to support emergency medicine trainees in developing their airway management skills in the ED. A team of emergency physicians and trainees worked collaboratively to develop the eLearning resources ensuring extensive stakeholder consultation. A comprehensive resource manual was written to provide learners with knowledge that underpins the modules. ACEM provided project coordination as well as administrative and technical team support to the production...
November 16, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29143074/-additional-emergency-medical-measures-in-trauma-associated-cardiac-arrest
#3
B Ondruschka, C Baier, J Dreßler, A Höch, M Bernhard, C Kleber, C Buschmann
INTRODUCTION: More than half of all traumatic deaths happen in prehospital settings. Until now, there have been no long-term studies examining the actual additive treatment during trauma-associated cardiopulmonary resuscitation (tCPR), including pleural decompression, pericardiocentesis, tourniquets and external stabilization of the pelvis. The present cohort study evaluated forensic autopsy reports of trauma deaths occurring at the scene with respect to additive actions in preclinical tCPR as well as the potentially preventable nature of the individual death cases...
November 15, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29123910/management-of-pediatric-cannot-intubate-cannot-oxygenate
#4
Yohei Okada, Wataru Ishii, Norio Sato, Hirokazu Kotani, Ryoji Iiduka
Case: "Cannot intubate, cannot oxygenate" (CICO) is a rare, life-threatening situation. We describe a pediatric case of CICO and highlight some educational points.A 3-year-old boy who collapsed in the bathtub came to our emergency department. On admission, he went into cardiac arrest probably because of an airway obstruction. We judged his condition as CICO and carried out an emergent tracheostomy after several attempts to perform a cricothyroidotomy failed. We continued resuscitation; however, circulation did not return spontaneously...
October 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29121299/gender-power-and-leadership-the-effect-of-a-superior-s-gender-on-respiratory-therapists-ability-to-challenge-leadership-during-a-life-threatening-emergency
#5
N Pattni, M D Bould, M A Hayter, D McLuckie, L M K Noble, A Malavade, Z Friedman
Background: Effective communication within teams is crucial, especially in crisis situations. Hierarchy gradients between team members can contribute to communication failures and are influenced by many factors. The effect of gender on team performance has not been well studied. The objective of this study was to examine the effect of the physician's gender on respiratory therapists' ability to effectively challenge clearly incorrect clinical decisions during a life-threatening crisis...
October 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29114419/unanticipated-difficult-airway-in-a-neonate-are-we-prepared-for-this-chaos
#6
Priyanka Pradeep Karnik, Nandini Malay Dave, Madhu Garasia
Unanticipated difficult airway in a neonate is a challenging situation with many difficulties because of inherent anatomical variations. To complicate the situation there is a lack of appropriate equipment, expertise and established guidelines on the management of difficult airway in neonates and infants. There are few published reports regarding the use of available devices for emergency front-of-neck access. We report the case of airway management of a neonate with an unanticipated finding of subglottic stenosis...
October 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/29114334/anesthesia-and-analgesia-in-the-patient-with-an-unstable-shoulder
#7
Ismael Acevedo Bambaren, Fernando Dominguez, Maria Elena Elias Martin, Silvia Domínguez
Introduction: The patient with an unstable shoulder represents a challenge for the anesthesiologist. Most patients will be young individuals in good health but both shoulder dislocation reduction, a procedure that is usually performed under specific analgesia in an urgent setting, and instability surgery anesthesia and postoperative management present certain peculiarities. Material and Methods: For the purpose of the article, 78 references including clinical trials and reviews were included...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/29109646/ludwig-s-angina-in-children-anesthesiologist-s-nightmare-case-series-and-review-of-literature
#8
Maitree Pandey, Manpreet Kaur, Manoj Sanwal, Aruna Jain, Sunil K Sinha
Ludwig's angina is potentially lethal, rapidly spreading cellulitis of the floor of mouth and neck. The anticipated difficult airway becomes even more challenging when it occurs in children. In children, the larynx is positioned relatively higher in the neck, and one does not have the option for blind nasal intubation or awake fiberoptic, which otherwise is the technique of choice in adult patients. We present the clinical course of 16 children and highlight various problems encountered during the anesthetic management of six children who required emergency surgical drainage under general anesthesia...
July 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29101956/anesthesia-for-routine-and-advanced-upper-gastrointestinal-endoscopic-procedures
#9
REVIEW
Christopher D Sharp, Ezekiel Tayler, Gregory G Ginsberg
This article aims to detail the breadth and depth of advanced upper gastrointestinal endoscopic procedures. It will focus on sedation and airway management concerns pertaining to this emerged and emerging class of minimally invasive interventions. The article will also cover endoscopic hemostasis, endoscopic resection, stenting and Barrett eradication therapy plus endoscopic ultrasound. It additionally will address the nuances of endoscopic retrograde cholangiopancreatography and new natural orifice transluminal endoscopic surgery procedures including endoscopic cystgastrostomy and the per-oral endoscopic myotomy procedure...
December 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/29081662/novel-strategy-of-stents-in-thyroid-mass-a-case-series-report-of-managing-severely-dyspneic-patients
#10
Adheesh Bhandari, Ying-Hao Wang, Shi-Xu Lv, Er-Jie Xia, Ou-Chen Wang
BACKGROUND: Tracheal and bronchial stenosis is a life-threatening condition causing difficulty in breathing and even severe respiratory distress. The silicone tracheobronchial stents were placed using the rigid bronchoscopy into the trachea of severe dyspneic patients and they exhibited symptomatic improvement as well as a rise in the saturation of oxygen. The bronchial stents were applicable to many extensive malignant airway stenosis patients, such as those with esophageal cancer, lung cancer, and laryngeal cancer...
2017: OncoTargets and Therapy
https://www.readbyqxmd.com/read/29079071/occult-spinal-cord-injury-after-blunt-force-trauma-in-a-patient-with-achondroplasia-a-case-report-and-review-of-trauma-management-strategy
#11
Martin Huecker, Zach Harris, Eric Yazel
BACKGROUND: Achondroplastic dwarfism is associated with anatomic abnormalities that can predispose to occult injury and challenges in trauma management. Airway anatomy is problematic due to macrocephaly, midface hypoplasia, and a narrow nasopharynx. Manipulation of the neck is very dangerous due to the high likelihood of preexisting cervicomedullary stenosis. Restrictive lung disease and obstructive sleep apnea may complicate respiratory status. Peripheral and central venous access can be difficult to obtain...
October 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29078649/prevention-and-management-of-intraoperative-crisis-in-vats-and-open-chest-surgery-how-to-avoid-emergency-conversion
#12
REVIEW
Fernando M Safdie, Manuel Villa Sanchez, Inderpal S Sarkaria
Video assisted thoracic surgery (VATS) has become a routinely utilized approach to complex procedures of the chest, such as pulmonary resection. It has been associated with decreased postoperative pain, shorter length of stay and lower incidence of complications such as pneumonia. Limitations to this modality may include limited exposure, lack of tactile feedback, and a two-dimensional view of the surgical field. Furthermore, the lack of an open incision may incur technical challenges in preventing and controlling operative misadventures leading to major hemorrhage or other intraoperative emergencies...
2017: J Vis Surg
https://www.readbyqxmd.com/read/29078615/catastrophes-and-complicated-intraoperative-events-during-robotic-lung-resection
#13
REVIEW
Brian E Louie
Intraoperative complications and catastrophes are an accepted and perhaps inevitable aspect of all surgeries. Anatomic pulmonary resection puts in close proximity the tracheal-bronchial tree, pulmonary vasculature, heart and great vessels within the small volume area of the chest. Fortunately, major complications and catastrophes are uncommon regardless of surgical approach. Pulmonary arterial injury is the most frequently reported. Most injuries necessitate a thoracotomy for definitive management though novel techniques are emerging for minimally invasive management...
2017: J Vis Surg
https://www.readbyqxmd.com/read/29076979/the-impact-of-intraoperative-magnetic-resonance-imaging-on-patient-safety-management-during-awake-craniotomy
#14
Kotoe Kamata, Takashi Maruyama, Hiroshi Iseki, Minoru Nomura, Yoshihiro Muragaki, Makoto Ozaki
BACKGROUND: Awake craniotomy paired with intraoperative magnetic resonance imaging (iMRI) is now the established technique for maximizing surgical resection, while preserving neurological function. However, leaving an unsecured airway patient in the iMRI gantry represents considerable risk. Our study aimed at identifying the incidence of critical adverse events in unsecured airway patients during iMRI as part of awake craniotomy. MATERIALS AND METHODS: We conducted a clinical chart review of consecutive awake craniotomies performed between November 1999 and December 2015...
October 25, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/29072869/research-protocol-intravenous-access-during-resuscitation-the-ivar-trial
#15
Pwb Nanayakkara, Y M Smulder
OBJECTIVE: To compare the effects of central versus peripheral drug administration on the rate of return of organised electrical activity and/or spontaneous circulation during CPR. STUDY DESIGN: Randomized clinical trial. STUDY POPULATION: Hospitalized patients and patients presenting at the emergency department, older than 18 years, requiring CPR. INTERVENTION: Central venous access Main study parameters/endpoints: Combined primary endpoint: rate of appearance of organised electrical activity or return of spontaneous circulation...
2017: Acute Medicine
https://www.readbyqxmd.com/read/29068802/emergency-ventilation-of-infant-subglottic-stenosis-through-small-gauge-lumen-using-the-ventrain-a-case-report
#16
Francisco J Escribá Alepuz, Javier Alonso García, J Vicente Cuchillo Sastriques, Emilio Alcalá, Pilar Argente Navarro
Postintubation subglottic stenosis is one of the most common causes of stridor in newborns and babies after prolonged mechanical ventilation. Management of this pathology is complex and requires highly trained personnel because it is associated with a high rate of airway-related mortality. This article presents the rescue of a difficult airway in a pediatric patient with subglottic stenosis with a new device available on the market, the Ventrain, offering certain advantages over those available until now.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4...
October 24, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29063722/a-quality-improvement-initiative-to-increase-the-safety-of-pediatric-emergency-airway-management
#17
Elliot Long, Domenic R Cincotta, Joanne Grindlay, Stefano Sabato, Emmanuelle Fauteux-Lamarre, David Beckerman, Terry Carroll, Nuala Quinn
BACKGROUND: Emergency airway management is commonly associated with life-threatening hypoxia and hypotension which may be preventable. AIMS: The aim of this quality improvement study was to reduce the frequency of intubation-related hypoxia and hypotension. METHODS: This prospective quality improvement study was conducted over 4 years in the Emergency Department of The Royal Children's Hospital, Melbourne, Australia. A preintervention cohort highlighted safety gaps and was used to design study interventions, including an emergency airway algorithm, standardized airway equipment, a preintubation checklist and equipment template, endtidal carbon dioxide monitoring, postintubation team debriefing, and multidisciplinary team training...
October 24, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29063583/infrared-red-intubation-system-irris-guided-flexile-videoscope-assisted-difficult-airway-management
#18
M S Kristensen, E Fried, P Biro
BACKGROUND: Tracheal intubation with a flexible scope is a cornerstone technique in patients with severely difficult airways, but may fail. We report on a technique, Infrared Red Intubation System (IRRIS), that seems to facilitate the identification of the glottis. METHODS: The IRRIS is placed over the patient's cricothyroid membrane and emits blinking infrared light through the patient's skin into the subglottic space. When a flexible videoscope (one that does not filter infrared light) is introduced into the airway, it will display this as a blinking white light emerging from the glottis, retrograde transillumination, showing the pathway to the trachea...
October 24, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29059667/-life-saving-cricothyroidotomy-in-throat-and-laryngeal-injuries-case-study
#19
Maja Chrzanowska-Wąsik, Leszek Sobiech, Vadim Matsibora, Tomasz Stankiewicz, Mariusz Goniewicz, Kamil Bednarz, Patryk Rzońca
The percentage of laryngeal injuries managed by hospital emergency departments is low. Currently, with the Emergency Medical Services working more efficiently, diagnostic imaging tools being more available and more precise surgical procedures after the injury, the mortality and disability rate among trauma victims is systematically decreasing. The given paper presents a case of a multiple organ trauma, including trauma to the larynx and throat, experienced during agricultural works. Life-saving surgical cricothyroidotomy using a tracheal tube was performed after preliminary diagnosis of the patient...
2017: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29055963/a-fatal-case-of-acute-bentazone-overdose-despite-cricothyroidotomy-during-cardiopulmonary-resuscitation
#20
Kyungwon Lee
Bentazone is classified as a moderately hazardous (class II) herbicide by the World Health Organization. A 53-year-old Korean woman was transferred to the emergency department after a suicide attempt using approximately 500 mL of bentazone one hour prior to admission. Upon admission, she was alert and tachycardia of 125/min was observed. She was treated with gastric lavage and activated charcoal, during which she experienced diarrhea. Two hours after bentazone ingestion, cardiac arrest and muscle rigidity throughout the body occurred...
October 20, 2017: Clinical and Experimental Emergency Medicine
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