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Cervical spine injury intubation

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https://www.readbyqxmd.com/read/28217398/comparison-of-intubation-success-and-glottic-visualization-using-king-vision-and-c-mac-videolaryngoscopes-in-patients-with-cervical-spine-injuries-with-cervical-immobilization-a-randomized-clinical-trial
#1
Dhanyasi Shravanalakshmi, Prasanna U Bidkar, K Narmadalakshmi, Suman Lata, Sandeep K Mishra, S Adinarayanan
BACKGROUND: Glottic visualization can be difficult with cervical immobilization in patients with cervical spine injury. Indirect laryngoscopes may provide better glottic visualization in these groups of patients. Hence, we compared King Vision videolaryngoscope, C-MAC videolaryngoscope for endotracheal intubation in patients with proven/suspected cervical spine injury. METHODS: After standard induction of anesthesia, 135 patients were randomized into three groups: group C (conventional C-MAC videolaryngoscope), group K (King Vision videolaryngoscope), and group D (D blade C-MAC videolaryngoscope)...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28187797/airway-management-and-mechanical-ventilation-in-acute-brain-injury
#2
REVIEW
D B Seder, J Bösel
Patients with acute neurologic disease often develop respiratory failure, the management of which profoundly affects brain physiology and long-term functional outcomes. This chapter reviews airway management and mechanical ventilation of patients with acute brain injury, offering practical strategies to optimize treatment of respiratory failure and minimize secondary brain injury. Specific concerns that are addressed include physiologic changes during intubation and ventilation such as the effects on intracranial pressure and brain perfusion; cervical spine management during endotracheal intubation; the role of tracheostomy; and how ventilation and oxygenation are utilized to minimize ischemia-reperfusion injury and cerebral metabolic distress...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28106355/comparative-study-of-fiberoptic-guided-versus-intubating-laryngeal-mask-airway-assisted-awake-orotracheal-intubation-in-patients-with-unstable-cervical-spine-a-randomized-controlled-trial
#3
Tanmay Jadhav, Kamath Sriganesh, Madhusudan K Reddy, Dhritiman Chakrabarti
BACKGROUND: A safe airway technique minimizes intubation-associated cervical-spine movement and consequent neurological injury in patients with unstable cervical spine (UCS). Awake fiberoptic-guided intubation (FGI) is preferred in patients with UCS. Alternatively, intubating laryngeal mask airway assisted intubation (ILMA-AI) can be performed both during elective and emergency, requires less expertise and is cost-effective. This study evaluated cervical-spine movement during FGI and ILMA-AI in patients with UCS...
January 20, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28045856/a-multiparametric-alarm-criterion-for-motor-evoked-potential-monitoring-during-spine-deformity-surgery
#4
Martín J Segura, María E Talarico, Mariano A Noel
PURPOSE: This is a pilot study to compare changes in the amplitude, area below the curve, number of phases, duration, and latency of the intraoperative transcranial motor evoked potentials (TcMEP) for early detection of impending spinal cord injury. An empirical ratio calculated by a combination of the above-mentioned parameters was also assessed. METHODS: Intraoperative TcMEP recordings from five patients presenting with neuromuscular kyphoscoliosis, idiopathic scoliosis, achondroplasia and lumbar kyphosis, congenital kyphosis, and achondroplasia with cervical instability were reviewed...
January 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28041757/comparison-of-the-macintosh-laryngoscope-and-blind-intubation-via-the-igel-for-intubation-with-cervical-spine-immobilization-a-randomized-crossover-manikin-trial
#5
Pawel Gawlowski, Jacek Smereka, Marcin Madziala, Lukasz Szarpak, Michael Frass, Oliver Robak
INTRODUCTION: Endotracheal intubation (ETI) using a Macintosh laryngoscope (MAC) requires the head to be positioned in a modified Jackson position, slightly reclined and elevated. Intubation of trauma patients with an injured neck or spine is therefore difficult, since the neck usually cannot be turned or is already immobilized in order to prevent further injury. The iGEL supraglottic airway seems optimal for such conditions due to its blind insertion without the need of a modified Jackson position...
November 30, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27988252/airway-and-circulatory-collapse-due-to-retropharyngeal-hematoma-after-blunt-vertebral-artery-injury
#6
Shunsuke Kudo, Kazuyuki Fukushima, Motonori Hashimoto, Masayuki Furutake, Keiji Tanaka, Kunihiko Okada
Retropharyngeal hematoma following blunt cervical spine injury is a known cause of airway obstruction, but it is not known to cause hemorrhagic shock. We report the case of a massive retropharyngeal hematoma caused by a blunt vertebral artery transection leading simultaneously to airway obstruction and hemorrhagic shock. An 83-year-old woman was injured in a motorcycle accident. In the field, the patient exhibited paradoxical breathing with no breath sounds, and her blood pressure could not be measured. Therefore, emergency intubation and fluid resuscitation were initiated and the patient was transferred to the emergency department...
December 9, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27828781/tracheal-extubation-of-patients-with-cervical-spine-injury-a-case-report-and-review-of-literature
#7
REVIEW
Aleksandra Nowicka, Narcis Ungureanu, Shyam Balasubramanian, Cyprian Mendonca
In patients with cervical spine injuries, emergence from anesthesia and tracheal extubation can prove as challenging to the anesthesiologist as the tracheal intubation. We report a case of a patient with a potentially unstable cervical spine injury who presented for a nonspinal surgery and experienced agitation on emergence from anesthesia. The use of an intravenous sedative was necessary to ensure cervical spine immobilization but was complicated by severe respiratory depression and the need for reintubation and admission to intensive care...
January 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/27752604/comparison-of-intubation-times-using-a-manikin-with-an-immobilized-cervical-spine-macintosh-laryngoscope-vs-glidescope-vs-fiberoptic-bronchoscope
#8
Jung-In Ko, Sang Ook Ha, Min Seok Koo, Miyoung Kwon, Jieun Kim, Jin Jeon, So Hee Park, Sangwoo Shim, Youjin Chang, Taejin Park
OBJECTIVE: Airway management in patients with suspected cervical spine injury is classified as a "difficult airway." The best device for managing difficult airways is not known. Therefore, we conducted an intubation study simulating patients with cervical spine injury using three devices: a conventional Macintosh laryngoscope, a video laryngoscope (GlideScope), and a fiberoptic bronchoscope (MAF-TM). Success rates, intubation time, and complication rates were compared. METHODS: Nine physician experts in airway management participated in this study...
December 2015: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/27650719/tracheal-malplacement-of-the-king-lt-airway-may-be-an-important-cause-of-prehospital-device-failure
#9
Brian E Driver, David Plummer, William Heegaard, Robert F Reardon
BACKGROUND: The King LT airway (King Systems, Noblesville, IN) is a popular extraglottic device that is widely used in the prehospital setting. We report a case of tracheal malplacement of the King airway with a severe kink in the distal tube. CASE REPORT: A 51-year-old unhelmeted motorcyclist collided with a freeway median and was obtunded when paramedics arrived. After bag mask ventilation, a King airway was placed uneventfully and the patient was transported to the emergency department...
December 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27533711/c-mac-videolaryngoscope-compared-with-direct-laryngoscopy-for-rapid-sequence-intubation-in-an-emergency-department-a-randomised-clinical-trial
#10
Simon Sulser, Dirk Ubmann, Martin Schlaepfer, Martin Brueesch, Georg Goliasch, Burkhardt Seifert, Donat R Spahn, Kurt Ruetzler
BACKGROUND: Airway management in the emergency room can be challenging when patients suffer from life-threatening conditions. Mental stress, ignorance of the patient's medical history, potential cervical injury or immobilisation and the presence of vomit and/or blood may also contribute to a difficult airway. Videolaryngoscopes have been introduced into clinical practice to visualise the airway and ultimately increase the success rate of airway management. OBJECTIVE: The aim of this study was to test the hypothesis that the C-MAC videolaryngoscope improves first-attempt intubation success rate compared with direct laryngoscopy in patients undergoing emergency rapid sequence intubation in the emergency room setting...
December 2016: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/27499408/pan-computed-tomography-for-blunt-polytrauma-are-we-doing-too-many
#11
G V Oosthuizen, J L Bruce, W Bekker, N Shangase, G L Laing, D L Clarke
BACKGROUND: Pan computed tomography (CT) is widely used in the evaluation of patients with blunt polytrauma, but there is growing concern about the radiation risks imposed. OBJECTIVE: To ascertain whether we were possibly overutilising pan CT in our trauma service, and whether we could safely cut down on scans without missing significant injuries. METHODS: We audited all pan scans performed in the Metropolitan Trauma Service, Pietermaritzburg, South Africa, during the 12-month period 1 January - 31 December 2012...
August 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/27292101/airway-management-in-a-patient-with-nuchal-interspinous-and-flavum-ligament-rupture-by-a-sickle-a-case-report
#12
Kotaro Sorimachi, Yuko Ono, Hideo Kobayashi, Kazuyuki Watanabe, Kazuaki Shinohara, Koji Otani
BACKGROUND: Penetrating neck injury is an important trauma subset but is relatively rare, especially when involving the posterior cervical column. Rupture of the neck restraints, including the interspinous and flavum ligaments, can create serious cervical instability that requires special consideration when managing the airway. However, no detailed information regarding airway management in patients with profound posterior neck muscle laceration and direct cervical ligament disruption by an edged weapon is yet available in the literature...
June 13, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27231810/intubation-biomechanics-laryngoscope-force-and-cervical-spine-motion-during-intubation-in-cadavers-effect-of-severe-distractive-flexion-injury-on-c3-4-motion
#13
Bradley J Hindman, Ricardo B Fontes, Robert P From, Vincent C Traynelis, Michael M Todd, Christian M Puttlitz, Brandon G Santoni
OBJECTIVE With application of the forces of intubation, injured (unstable) cervical segments may move more than they normally do, which can result in spinal cord injury. The authors tested whether, during endotracheal intubation, intervertebral motion of an injured C3-4 cervical segment 1) is greater than that in the intact (stable) state and 2) differs when a high- or low-force laryngoscope is used. METHODS Fourteen cadavers underwent 3 intubations using force-sensing laryngoscopes while simultaneous cervical spine motion was recorded with lateral fluoroscopy...
November 2016: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/27036600/airway-management-for-cervical-spine-surgery
#14
REVIEW
Ehab Farag
Cervical spine surgery is one of the most commonly performed spine surgeries in the United States, and 90% of the cases are related to degenerative cervical spine disease (the rest to cervical spine trauma and/or instability). The airway management for cervical spine surgery represents a crucial step in the anesthetic management to avoid injury to the cervical cord. The crux for upper airway management for cervical spine surgery is maintaining the neck in a neutral position with minimal neck movement during endotracheal intubation...
March 2016: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/27034926/airway-management-with-cervical-spine-immobilisation-a-comparison-between-the-macintosh-laryngoscope-truview-evo2-and-totaltrack-vlm-used-by-novices-a-manikin-study
#15
Dawid Aleksandrowicz, Tomasz Gaszyński
Airway management in patients with suspected cervical spine injury plays an important role in the pathway of care of trauma patients. The aim of this study was to evaluate three different airway devices during intubation of a patient with reduced cervical spine mobility. Forty students of the third year of emergency medicine studies participated in the study (F = 26, M = 14). The time required to obtain a view of the entry to the larynx and successful ventilation time were recorded. Cormack-Lehane laryngoscopic view and damage to the incisors were also assessed...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27006543/comparative-effectiveness-of-mccoy-laryngoscope-and-cmac-%C3%A2-videolaryngoscope-in-simulated-cervical-spine-injuries
#16
Divya Jain, Indu Bala, Komal Gandhi
BACKGROUND: Videolaryngoscopes are increasingly being used in potentially difficult airway. McCoy laryngoscope provides definitive advantage over conventional laryngoscopes in cervical spine patients. The aim of this study was to compare the performance of the CMAC(®) videolaryngoscope with the McCoy Laryngoscope in patients with a cervical collar. MATERIAL AND METHODS: Sample size of at least 22 patients in each group was calculated using Intubation Difficulty Scale (IDS) score as the primary outcome...
January 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/27006542/dexmedetomidine-provides-optimum-conditions-during-awake-fiberoptic-intubation-in-simulated-cervical-spine-injury-patients
#17
Pooja Chopra, Madhu Bala Dixit, Aashish Dang, Vibhuti Gupta
BACKGROUND AND AIMS: We undertook this study to assess if a small-dose of dexmedetomidine (DEX) for conscious sedation during awake fiberoptic intubation (AFOI) in simulated cervical spine injury (CSI) patients provides optimum conditions and fulfills the need of postintubation neurological examination required in such patients. The aim was to assess the efficacy of DEX on arousability and patient's comfort during AFOI in simulated CSI patients. MATERIAL AND METHODS: In this prospective, randomized double-blind study, 100 American Society of Anesthesiologists Grade I-II patients aged between 18 and 65 years scheduled for elective surgery under general anesthesia underwent AFOI under conscious sedation with DEX...
January 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/26957691/diagnostic-accuracy-of-bedside-tests-for-predicting-difficult-intubation-in-indian-population-an-observational-study
#18
Sangeeta Dhanger, Suman Lata Gupta, Stalin Vinayagam, Prasanna Udupi Bidkar, Lenin Babu Elakkumanan, Ashok Shankar Badhe
BACKGROUND: Unanticipated difficult intubation can be challenging to anesthesiologists, and various bedside tests have been tried to predict difficult intubation. AIMS: The aim of this study was to determine the incidence of difficult intubation in the Indian population and also to determine the diagnostic accuracy of bedside tests in predicting difficult intubation. SETTINGS AND DESIGN: In this study, 200 patients belonging to age group 18-60 years of American Society of Anesthesiologists I and II, scheduled for surgery under general anesthesia requiring endotracheal intubation were enrolled...
January 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/26952653/safety-of-the-lateral-trauma-position-in-cervical-spine-injuries-a-cadaver-model-study
#19
COMMENT
P K Hyldmo, M B Horodyski, B P Conrad, D N Dubose, J Røislien, M Prasarn, G R Rechtine, E Søreide
BACKGROUND: Endotracheal intubation is not always an option for unconscious trauma patients. Prehospital personnel are then faced with the dilemma of maintaining an adequate airway without risking deleterious movement of a potentially unstable cervical spine. To address these two concerns various alternatives to the classical recovery position have been developed. This study aims to determine the amount of motion induced by the recovery position, two versions of the HAINES (High Arm IN Endangered Spine) position, and the novel lateral trauma position (LTP)...
August 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/26712970/comparison-of-hemodynamic-responses-to-intubation-flexible-fiberoptic-bronchoscope-versus-mccoy-laryngoscope-in-presence-of-rigid-cervical-collar-simulating-cervical-immobilization-for-traumatic-cervical-spine
#20
Nitesh Gill, Shobha Purohit, Poonam Kalra, Tarun Lall, Avneesh Khare
BACKGROUND: Intubation is known to cause an exaggerated hemodynamic response in the form of tachycardia, hypertension, and dysrhythmias. In cervical spine instability, intubation has to be performed using cervical immobilization to prevent exacerbation of spinal cord injuries. Application of rigid cervical collar may reduce cervical spine movements, but it hinders tracheal intubation with a standard laryngoscope. The aim of this study was to compare the hemodynamic responses to fiberoptic bronchoscope (FOB) and McCoy laryngoscope in patients undergoing elective surgery under general anesthesia with rigid cervical collar simulating cervical spine immobilization in the situation of cervical trauma...
September 2015: Anesthesia, Essays and Researches
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