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Emergency airway management

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https://www.readbyqxmd.com/read/28635202/palliative-treatment-of-life-threatening-hemoptysis-with-silicone-stent-insertion-in-advanced-lung-cancer
#1
Emanuela Barisione, Carlo Genova, Marco Grosso, Mercedes Pasquali, Alessandro Blanco, Raffaella Felletti, Mario Salio
Massive hemoptysis is a stressful and life-threatening event that can occur in lung cancer patients. The management of this event is usually challenging, and can involve surgery, embolization, and bronchoscopy. Unfortunately, while surgery can offer a definitive solution to hemoptysis, lung cancer patients are often excluded from this approach. On the other hand, bronchial arterial embolization rarely results in long-term control of bleeding. Endoscopy allows a skilled physician to perform mechanical tamponade or laser photocoagulation of bleeding lesions and preserve the main airways...
May 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28629917/personalized-management-approach-for-obstructive-sleep-apnea
#2
REVIEW
Jayne C Carberry, Jason Amatoury, Danny J Eckert
Obstructive sleep apnea (OSA) is a heterogeneous disorder. If left untreated, OSA has major health, safety and economic consequences. In addition to varying levels of impairment in pharyngeal anatomy (narrow/collapsible airway), non-anatomical 'phenotypic traits' are also important contributors to OSA for most patients. However, the majority of existing therapies only target the anatomical cause (e.g. continuous positive airway pressure [CPAP], oral appliances, weight loss, positional therapy, and upper airway surgery)...
June 16, 2017: Chest
https://www.readbyqxmd.com/read/28624182/oral-appliances-for-the-management-of-osa-an-updated-review-of-the-literature
#3
REVIEW
Mona M Hamoda, Yuuya Kohzuka, Fernanda R Almeida
Oral appliances (OAs) are becoming increasingly recognized not only as an alternative, but also possibly as an adjunct treatment modality for obstructive sleep apnea (OSA). Compared to Continuous Positive Airway Pressure (CPAP), the gold standard therapy, OAs are less efficacious but are more accepted and tolerated by the patients which may in turn lead to a comparable therapeutic effectiveness. Different oral appliance designs currently exist and even more are constantly emerging. Additionally, state of the art technologies are being utilized in the fabrication of many however, all the currently available OAs employ the same mechanism of action by targeting the anatomical component involved in the pathogenesis of the disease...
June 14, 2017: Chest
https://www.readbyqxmd.com/read/28623005/pre-oxygenation-implications-in-emergency-airway-management
#4
REVIEW
Ali Pourmand, Chelsea Robinson, Kelsey Dorwart, Francis O'Connell
Transient oxygen desaturation during emergency department intubation is an event with potentially devastating consequences. Pre-oxygenation is an important means of increasing a patient's oxygen reserve and duration of safe apnea prior to intubation. In the emergent setting, important modifications to pre-oxygenation techniques need to be considered to best manage critically ill patients. In this review, we discuss recent updates in pre-oxygenation techniques and evaluate the evidence supporting both commonly used and newly emerging techniques for pre-oxygenation, assessing nature and level of illness, the best delivery method of oxygen, using delayed sequence intubation in patients who cannot tolerate non-invasive pre-oxygenation and using apneic oxygenation via nasal cannula and non-rebreather mask during intubation...
June 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28616369/management-of-an-obstructed-tracheostomy-in-a-limited-resource-setting
#5
Julie Chiaravalli, Norman Lufesi, Elwin Shawa, Vitumbiko Nkhoma, Elaine Sigalet, Adam Dubrowski
Obstruction of a tracheostomy tube is a common cause of respiratory compromise in adults and pediatric patients, which can lead to a life-threatening emergency if it is not properly managed. Compromised airway patency has many potential etiologies; however, the scenario described in this technical report focuses specifically on the management of tracheostomy obstruction through the presence of a mucus plug, blood clot, or highly viscous secretions. The simulation described in this technical report was written to be conducted as an in-situ simulation within the intensive care unit (ICU) at Mzuzu Central Hospital, Malawi...
May 13, 2017: Curēus
https://www.readbyqxmd.com/read/28615900/predictors-of-outcome-in-children-with-status-epilepticus-during-resuscitation-in-pediatric-emergency-department-a-retrospective-observational-study
#6
Indumathy Santhanam, Sangeetha Yoganathan, V Akila Sivakumar, Rubini Ramakrishnamurugan, Sharada Sathish, Murali Thandavarayan
OBJECTIVES: To study the clinical profile and predictors of outcome in children with status epilepticus (SE) during resuscitation in pediatric emergency department. MATERIALS AND METHODS: This retrospective study was carried out in a tertiary care teaching hospital. Admission and resuscitation data of children, aged between 1 month and 12 years, treated for SE, between September 2013 and August 2014, were extracted using a standard data collection form. Our SE management protocol had employed a modified pediatric assessment triangle to recognize and treat acute respiratory failure, cardiovascular dysfunction (CD), and subtle SE until all parameters resolved...
April 2017: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/28611887/derivation-and-validation-of-the-prehospital-difficult-airway-identificationtool-predait-a-predictive-model-for-difficult-intubation
#7
Jestin N Carlson, David Hostler, Francis X Guyette, Mark Pinchalk, Christian Martin-Gill
INTRODUCTION: Endotracheal intubation (ETI) in the prehospital setting poses unique challenges where multiple ETI attempts are associated with adverse patient outcomes. Early identification of difficult ETI cases will allow providers to tailor airway-management efforts to minimize complications associated with ETI. We sought to derive and validate a prehospital difficult airway identification tool based on predictors of difficult ETI in other settings. METHODS: We prospectively collected patient and airway data on all airway attempts from 16 Advanced Life Support (ALS) ground emergency medical services (EMS) agencies from January 2011 to October 2014...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28606617/management-of-patients-with-predicted-difficult-airways-in-an-academic-emergency-department
#8
John C Sakles, Matthew J K Douglas, Cameron D Hypes, Asad E Patanwala, Jarrod M Mosier
BACKGROUND: Patients with difficult airways are sometimes encountered in the emergency department (ED), however, there is a little data available regarding their management. OBJECTIVES: To determine the incidence, management, and outcomes of patients with predicted difficult airways in the ED. METHODS: Over the 1-year period from July 1, 2015 to June 30, 2016, data were prospectively collected on all patients intubated in an academic ED. After each intubation, the operator completed an airway management data form...
June 9, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28601212/awake-cricothyrotomy-a-novel-approach-to-the-surgical-airway-in-the-tactical-setting
#9
REVIEW
Robert L Mabry, Chetan U Kharod, Brad L Bennett
Airway obstruction on the battlefield is most often due to maxillofacial trauma, which may include bleeding and disrupted airway anatomy. In many of these cases, surgical cricothyrotomy (SC) is the preferred airway management procedure. SC is an emergency airway procedure performed when attempts to open an airway using nasal devices, oral devices, or tracheal intubation have failed, or when the risks from intubation are unacceptably high. The aim of this overview is to describe a novel approach to the inevitably surgical airway in which SC is the first and best procedure to manage the difficult or failed airway...
June 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28601203/the-care-of-thermally-injured-patients-in-operational-austere-and-mass-casualty-situations
#10
REVIEW
Booker T King, Wylan C Peterson
Burn injury affects a half million people in the United States annually. The severe thermal injury can have long-term debilitating effects. The management of burn patients in austere and operational environments is more complex. Mass casualty incidents can result in a large number of patients with multiple traumatic injuries, which often include burn injury. Appropriate triage of casualties is essential. Severely burned patients should be evacuated to a burn center if possible. Airway management and fluid resuscitation of burn patients present unique challenges...
June 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28599052/tccc-updates-two-decades-of-saving-lives-on-the-battlefield-tactical-combat-casualty-care-turns-20
#11
Frank K Butler
BACKGROUND: Twenty years ago, the original Tactical Combat Casualty Care (TCCC) article was published in this journal. Since TCCC is essentially a set of bestpractice prehospital trauma care guidelines customized for use on the battlefield, the presence of a journal with a specific focus on military medicine was a profound benefit to the initial presentation of TCCC to the US Military. METHODS: In the two ensuing decades, which included the longest continuous period of armed conflict in our nation's history, TCCC steadily evolved as the prehospital trauma care evidence base was augmented and as feedback from user medics, corpsmen, and pararescuemen was obtained...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28593019/rural-physicians-scope-of-practice-on-remote-islands-a-case-report-of-severe-pneumonia-that-required-overnight-artificial-airway-management
#12
Ryuichi Ohta, Akira Shimabukuro
Objective: To clarify the scope of practice on rural islands of Okinawa. Patient: A 59-year-old man presented to our clinic with shortness of breath. He was intubated due to acute respiratory failure caused by severe pneumonia. We could not transfer him owing to bad weather, and had to continue patient care in the clinic for more than 24 hours. Discussion: In remote regions, rural physicians may require a broad scope of practice from primary to tertiary care, in addition to preventive and end-of-life care. Conclusion: This case illustrates the current state of emergency care and unique scope of practice on rural islands of Okinawa...
May 2017: Journal of Rural Medicine: JRM
https://www.readbyqxmd.com/read/28591509/-double-pneumotorax-secondary-to-single-proyectile-weapon-one-case-report-and-review-of-literature
#13
Mario Quintero-Amaya, Francisco Flores-Orozco, José Herrera-Maldonado, Jorge Miño-Bernal, Edna López-Morales, Abigail Juárez-Ugalde, Marisol Flores-Gonzaga, Débora Aguilar-Sánchez
BACKGROUND: The 25% of traumatic deaths are due to chest trauma with a mortality of 28%, and closed trauma is the most common mechanism of injury. The use of firearms increases the relative risk of death. The five more frequent specific chest injuries are lung contusion (31.8%), hemothorax/pneumothorax (19.4%), rib fractures (13.2%), and diaphragmatic injury (7.5%). CLINICAL CASE: Patient of 25 years with a single firearm projectile wound in the chest who assisted to the emergency room (ER) with significant respiratory distress and meriting surgical emergency airway, documenting double pneumothorax, aortic laceration and rupture of the trachea, which required management in the ER with bilateral chest tube placement and subsequent surgical repair...
July 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/28589109/laryngo-tracheo-bronchial-foreign-bodies-in-children-clinical-presentations-and-complications
#14
Hazem-Saeed Amer, Mohammad-Waheed El-Anwar, Ashraf Raafat, Mohamed AlShawadfy, Ehab Sobhy, Samir-Attia Ahmed, Ahmed-Ma Maaty
INTRODUCTION: Foreign-body (FB) aspiration in the airway of children is a life-threatening clinical situation responsible for many deaths each year. The aim of this study was to evaluate the different clinical presentations, methods of diagnosis, types and complications of FB inhalation in the pediatric age group. MATERIALS AND METHODS: The study included patients who presented with a definitive or suspicious history of FB aspiration. Detailed data for each patient were recorded concerning the age, sex, nature and site of the FB, presenting symptoms and signs, and radiological findings...
May 2017: Iranian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/28584070/the-natural-history-of-prenatally-diagnosed-congenital-cystic-lung-lesions-long-term-follow-up-of-119-cases
#15
James Cook, Lyn S Chitty, Paolo De Coppi, Michael Ashworth, Colin Wallis
BACKGROUND: A paucity of evidence regarding the natural history of congenital pulmonary airway malformations (CPAMs) and pulmonary sequestration (PS) has resulted in a divergence in management strategy of asymptomatic cases. METHODS: We describe the long-term clinical course of 119 children diagnosed with these lesions treated at Great Ormond Street Hospital (GOSH). Cases were identified via the GOSH patient database. Study entry required the identification of a cystic lung lesion on prenatal ultrasound and confirmation of CPAM/PS on postnatal CT imaging...
June 5, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28582801/emergency-airway-management-in-australian-and-new-zealand-emergency-departments-a-multicentre-descriptive-study-of-3710-emergency-intubations
#16
Hatem Alkhouri, John Vassiliadis, Matthew Murray, John Mackenzie, Alex Tzannes, Sally McCarthy, Toby Fogg
OBJECTIVE: The aim of this study was to describe the practice of endotracheal intubation across a range of Australasian EDs. METHODS: We established a multicentre airway registry (The Australian and New Zealand Emergency Department Airway Registry [ANZEDAR]) prospectively capturing intubations from 43 Australian and New Zealand EDs over 24 months using the ANZEDAR form. Information recorded included patient demographics, intubation indications, predicted difficulty, rapid sequence induction and endotracheal intubation preparation technique, induction drugs, airway adjuncts and complications...
June 5, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28582298/flail-mandible-and-immediate-airway-management-traumatic-detachment-of-mandibular-lingual-cortex-results-in-obstructive-dyspnea-and-severe-odynophagia
#17
Ioannis Papadiochos, Lampros Goutzanis, Vasileios Petsinis
Isolated mandibular fractures usually represent themselves as non-life-threatening injuries and are not treated in emergency setting. However, some rare patterns of them may result in airway obstruction as a result of displacement of bony fragments. The authors report a patient of an open comminuted fracture of mandibular symphysis which exhibited an uncommon split pattern with retrogression of lingual cortical plate, and thereby induced glossoptosis, painful deglutition, and obstruction of the upper airway within a few hours...
June 2, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28567500/treatment-of-sleep-dysfunction-in-parkinson-s-disease
#18
REVIEW
Amy W Amara, Lana M Chahine, Aleksandar Videnovic
Impaired sleep and alertness affect the majority of Parkinson's disease (PD) patients, negatively impacting safety and quality of life. The etiology of impaired sleep-wake cycle in PD is multifactorial and encompasses medication side effects, nocturnal PD motor symptoms, and presence of co-existent sleep and neuropsychiatric disorders. The primary neurodegenerative process of PD involves brain regions that regulate the sleep-wake cycle, such as brainstem and hypothalamic nuclei. Sleep disorders in PD include insomnia, REM sleep behavior disorder (RBD), sleep disordered breathing (SDB), restless legs syndrome (RLS), and circadian disruption...
July 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28556897/claims-for-compensation-after-injuries-related-to-airway-management-a-nationwide-study-covering-15-years
#19
I Fornebo, K A Simonsen, I R K Bukholm, U E Kongsgaard
BACKGROUND: Securing the airway is one of the most important responsibilities in anaesthesia. Injuries related to airway management can occur. Analysis from closed claims can help to identify patterns of injury, risk factors and areas for improvement. METHODS: All claims to The Norwegian System of Compensation to Patients from 1 January 2001 to 31 December 2015 within the medical specialty of anaesthesiology were studied. Data were extracted from this database for patients and coded by airway management procedures...
May 30, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28551485/spontaneous-submental-hematoma-a-pseudo-ludwig-s-phenomenon-in-101-year-old-patient-case-report-and-literature-review
#20
Uthman Alamoudi, Yasser Alsallumi, Matthew H Rigby, S Mark Taylor, Jonathan R B Trites, Robert D Hart
OBJECTIVE: Submental hematoma or pseudo-Ludwig's phenomenon, is a rare entity seen in anticoagulated patients and can precipitate upper airway obstruction. Our objective is to present a rare case of spontaneous submental hematoma due to poorly controlled hypertension in elderly patient and to perform a literature review. CASE REPORT: 101-year-old female presented to emergency room with sudden painful swelling in the floor of mouth and slurred speech. Not on anticoagulation and no history of trauma or known allergies...
2017: International Journal of Surgery Case Reports
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