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https://www.readbyqxmd.com/read/28905252/human-and-equipment-resources-for-difficult-airway-management-airway-education-programs-and-capnometry-use-in-japanese-emergency-departments-a-nationwide-cross-sectional-study
#1
Yuko Ono, Koichi Tanigawa, Kazuaki Shinohara, Tetsuhiro Yano, Kotaro Sorimachi, Ryota Inokuchi, Jiro Shimada
BACKGROUND: Although human and equipment resources, proper training, and the verification of endotracheal intubation are vital elements of difficult airway management (DAM), their availability in Japanese emergency departments (EDs) has not been determined. How ED type and patient volume affect DAM preparation is also unclear. We conducted the present survey to address this knowledge gaps. METHODS: This nationwide cross-sectional study was conducted from April to September 2016...
September 13, 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28893016/comparison-of-intubating-conditions-using-fentanyl-plus-propofol-versus-fentanyl-plus-midazolam-during-fiberoptic-laryngoscopy
#2
Parmod Kumar, Tripat Kaur, Gurpreet Kaur Atwal, Jatinderpaul Singh Bhupal, Ajay Kumar Basra
INTRODUCTION: Awake nasal or oral flexible fiberoptic intubation is the airway management technique of choice in known or anticipated difficult airway, unstable cervical fracture, limited mouth opening (as in temporomandibular joint disease), mandibular-maxillary fixation and severe facial burns. Both optimal intubating condition and patient comfort are important for fiberoptic intubation. Optimal intubating conditions provided by an ideal sedation regimen would ensure haemodynamic stability, patient comfort, attenuation of airway reflexes and amnesia...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28890557/are-cardiac-surgical-patients-at-increased-risk-of-difficult-intubation
#3
Deepak Prakash Borde, Savani Sameer Futane, Vijay Daunde, Sujata Zine, Nayana Joshi, Sumit Jaiswal, Sadhana Chinchole, Prasannakumar Kulkarni, Amit Hiwarkar, Priti Bhagyawant, Dilip Deshmukh, Manisha Takalkar
BACKGROUND AND AIMS: Safe airway management is the cornerstone of contemporary anaesthesia practice, and difficult intubation (DI) remains a major cause of anaesthetic morbidity and mortality. The surgical category, particularly cardiac surgery as a risk factor for DI has not been studied extensively. The aim of this study was to test the hypothesis whether cardiac surgical patients are at increased risk of DI. METHODS: During the study, 627 patients (329 cardiac and 298 non-cardiac surgical) were enrolled...
August 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28890532/diffuse-idiopathic-pulmonary-neuroendocrine-cell-hyperplasia-a-case-report-and-review-of-the-literature
#4
Evangelos Koliakos, Theodoros Thomopoulos, Ziad Abbassi, Christophe Duc, Michel Christodoulou
BACKGROUND Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) is a rare pulmonary disorder that is characterized by diffuse hyperplasia of bronchiolar and bronchial pulmonary neuroendocrine cells. In this condition, when no other pathological pulmonary condition is detected, DIPNECH is considered to be an idiopathic lung disease. DIPNECH is a rare condition that can be difficult to distinguish from other forms of reactive pulmonary neuroendocrine cell hyperplasia (NECH). We present a case of DIPNECH and describe the approach to diagnosis of this rare condition...
September 11, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28885520/caring-for-trauma-patients-with-coexisting-heart-failure
#5
Karen Bergman Schieman, Kelley Pattison, Conor Early
The coexisting conditions of traumatic injury coupled with a comorbid condition such as heart failure create a complex scenario for the trauma nurse to manage. Initial care of the trauma patient includes following the Advanced Trauma Life Support guidelines and managing the airway, breathing, and circulation (ABC) of the patient. Once the airway is secure and breathing is managed, the team addresses circulation. At this point in the patient's care, the team typically does not know which, if any, comorbid conditions exist...
September 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28879330/flexible-laryngeal-mask-airway-management-for-dental-treatment-cases-associated-with-difficult-intubation
#6
Masanori Tsukamoto, Takashi Hitosugi, Takeshi Yokoyama
Nasotracheal intubation is generally a useful maxillofacial surgery that provides good surgical access for intraoral procedures. When nasotracheal intubation is difficult, laryngeal mask airway (LMA) insertion can be performed, and the flexible LMA™ (FLMA) is also useful for anesthetic management. However, the FLMA provides limited access to the mouth, which restricts the insertion of instrumentation and confines the surgical field available. Here, we present our experience using the FLMA airway management for dental treatment cases involving difficulty with intubation...
March 2017: J Dent Anesth Pain Med
https://www.readbyqxmd.com/read/28879322/difficult-airway-management-in-a-patient-with-a-thin-mandible
#7
Hong-Seok Choi, Jong-Shik Oh, Eun-Jung Kim, Ji-Young Yoon, Ji-Uk Yoon, Cheul-Hong Kim
A 47-year-old woman was referred for surgical treatment of osteomyelitis of the mandible. She had already undergone three previous surgeries. Pre-anesthetic airway evaluation predicted a difficult airway, due to the thin, retro-positioned mandible, tongue, and atrophic changes in the lips and soft tissue. We inserted packing gauzes in the buccal mucosa for easier mask fitting and ventilation. During direct laryngoscopic intubation with a nasotracheal tube (NTT), fracture of a thin mandible can easily occur...
December 2016: J Dent Anesth Pain Med
https://www.readbyqxmd.com/read/28879321/perioperative-airway-management-of-a-patient-with-beckwith-wiedemann-syndrome
#8
Masanori Tsukamoto, Takashi Hitosugi, Takeshi Yokoyama
Airway obstruction in pediatric patients always poses a challenge for anesthesiologists. Beckwith-Wiedemann syndrome causes various abnormalities such as macroglossia and omphalocele. Patients with these abnormalities often need corrective surgeries. Management of difficult airway caused by conditions such as macroglossia in patients with this syndrome could be challenging. We encountered a case of difficult airway in an infant with Beckwith-Wiedemann syndrome. It was predicted that macroglossia might cause difficult ventilation, intubation, and extubation...
December 2016: J Dent Anesth Pain Med
https://www.readbyqxmd.com/read/28868170/clinical-experiences-with-the-front-formula-for-pre-operative-airway-assessment-and-documentation-a-multi-centre-study
#9
Calin Mitre, Ileana Mitre, Zoltán Gyöngyösi, Béla Fülesdi, Claudiu Zdrehus, Caius Breazu, Peter Biro
OBJECTIVE: The prediction of difficult airway is one of the most important challenges before general anaesthesia. This study aimed to assess the clinical usefulness of the FRONT score, a recently developed scoring system to predict and document airway difficulties. METHODS: This multi-centre, inter-observer, prospective and double-blinded study included 976 patients from two university centres. The pre-operative evaluation of the patients was performed by a pre-operative team of anaesthesiologists (team A) who evaluated and scored the expected difficulty of airway management...
August 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28865448/pediatric-supraglottic-airway-devices-in-clinical-practice-a-prospective-observational-study
#10
Maren Kleine-Brueggeney, Anne Gottfried, Sabine Nabecker, Robert Greif, Malte Book, Lorenz Theiler
BACKGROUND: Supraglottic airway devices (SGA) are commonly used in pediatric anesthesia and serve as primary or back-up devices for difficult airway management. Most SGA are marketed without proper clinical evaluation. The purpose of this study was to evaluate the performance of the pediatric LMA Supreme™, Air-Q® and Ambu® Aura-i™. METHODS: This prospective observational study was performed at Bern University Hospital, Switzerland. With ethics committee approval and a waiver for written informed consent 240 children undergoing elective surgery with an ASA class I-III and a weight of 5-30 kg were included...
September 2, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28860875/extraglottic-airway-devices-technology-update
#11
REVIEW
Bimla Sharma, Chand Sahai, Jayashree Sood
Extraglottic airway devices (EADs) have revolutionized the field of airway management. The invention of the laryngeal mask airway was a game changer, and since then, there have been several innovations to improve the EADs in design, functionality, safety and construction material. These have ranged from changes in the shape of the mask, number of cuffs and material used, like rubber, polyvinylchloride and latex. Phthalates, which were added to the construction material in order to increase device flexibility, were later omitted when this chemical was found to have serious adverse reproductive outcomes...
2017: Medical Devices: Evidence and Research
https://www.readbyqxmd.com/read/28838826/dental-injury-associated-with-anaesthesia-an-8-year-database-analysis-of-592-claims-from-a-major-french-insurance-company
#12
Giraudon Antoine, Guillaume de Saint Maurice, Matthieu Biais, Dan Benhamou, Karine Nouette-Gaulain
Introduction Dental injury is the most common incident associated with anaesthesia. Regarding recent recommendations on informed consent and changes in airway management practices, a large series of claims related to dental injury has not been recently described. The aim of this study was to analyse a recent database in order to describe the characteristics of dental injury in France. Methods A database that prospectively collected claims reported to Le Sou Médical-MACSF between January 2003 and December 2010, was analysed...
August 21, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28822609/transient-vocal-cord-paralysis-following-central-venous-hemodialysis-catheter-insertion
#13
Gül Pamukçu Günaydın, Selahattin Gürü, Elif Aslan Taş, Fatih Tanrıverdi, Gülhan Kurtoğlu Çelik
In this article, we present a case of recurrent laryngeal nerve palsy not caused by nerve injury but due to local anesthetic infiltration that was applied prior to central venous catheterization. A 47-year-old female patient was admitted to emergency room with fatigue and nausea and was diagnosed with acute renal failure. Right jugular venous catheterization was performed for emergency hemodialysis with Seldinger technique using middle approach. Within minutes and immediately after the procedure the patient complained of hoarseness and shortness of breath, and she had stridor in her physical exam...
August 15, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28801782/common-pediatric-medical-emergencies-in-office-practice
#14
Bharat Mehra, Suresh Gupta
General Practitioners frequently see children with medical conditions that may evolve into an emergency if not promptly attended to. The most common emergencies encountered in pediatric office practice are respiratory distress, dehydration, anaphylaxis, seizures and trauma. Assessment of children is sometimes difficult as the signs and symptoms might be subtle and not markedly expressed. Also, normal value of vital signs vary with age, thus their interpretation requires discrete knowledge of age appropriate values...
August 12, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28797305/improved-success-rates-using-videolaryngoscopy-in-unexperienced-users-a-randomized-crossover-study-in-airway-manikins
#15
Hendrik Eismann, Lion Sieg, Nicola Etti, Lars Friedrich, Christian Schröter, Philipp Mommsen, Christian Krettek, Christian Zeckey
BACKGROUND: Videolaryngoscopy has been proven to be a safe procedure managing difficult airways in the hands of airway specialists. Information about the success rates in unexperienced users of videolaryngoscopy compared to conventional laryngoscopy is sparse. Therefore, we aimed to evaluate if there might be more success in securing an airway if the unexperienced provider is using a videolaryngoscope in simulated airways in a randomized manikin study. Differences between commonly used videolaryngoscopes were elucidated...
August 10, 2017: European Journal of Medical Research
https://www.readbyqxmd.com/read/28793002/laryngeal-tube-suction-for-airway-management-during-in-hospital-emergencies
#16
Haitham Mutlak, Christian Friedrich Weber, Dirk Meininger, Colleen Cuca, Kai Zacharowski, Christian Byhahn, Richard Schalk
OBJECTIVE: The role of supraglottic airway devices in emergency airway management is highlighted in international airway management guidelines. We evaluated the application of the new generation laryngeal tube suction (LTS-II/LTS-D) in the management of in-hospital unexpected difficult airway and cardiopulmonary resuscitation. METHODS: During a seven-year period, patients treated with a laryngeal tube who received routine anesthesia and had an unexpected difficult airway (Cormack Lehane Grade 3-4), who underwent cardiopulmonary resuscitation, or who underwent cardiopulmonary resuscitation outside the operating room and had a difficult airway were evaluated...
July 2017: Clinics
https://www.readbyqxmd.com/read/28781848/successful-difficult-airway-management-of-a-child-with-coffin-siris-syndrome
#17
Ahmet Selim Ozkan, Sedat Akbas, Mehmet Ridvan Yalin, Emine Ozdemir, Zeynep Koylu
Management of airway in patients who have Coffin-Siris syndrome (CSS) is often problematic because most of these patients have difficult airway. NTI via C-MAC VL is an useful alternative to direct laryngoscope for orotracheal intubation in airway and anesthetic management in a case of CSS. Alternative airway devices should be readily available.
August 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28781841/perioperative-airway-management-of-a-16-year-old-boy-with-progressive-airway-obstruction-due-to-juvenile-nasopharyngeal-angiofibroma
#18
Kei Kamiyama, Maiko Satomoto, Kotaro Minami, Yukiko Baba, Koshi Makita
Juvenile nasopharyngeal angiofibroma (JNA) involves difficult anesthetic management because of the risk of massive bleeding, while airway management is rarely a problem in JNA. This report presents an unusual case of JNA causing airway obstruction.
August 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28763154/best-practices-in-peri-operative-management-of-patients-with-skeletal-dysplasias
#19
Klane K White, Viviana Bompadre, Michael J Goldberg, Michael B Bober, Tae-Joon Cho, Julie E Hoover-Fong, Melita Irving, William G Mackenzie, Shawn E Kamps, Cathleen Raggio, Gregory J Redding, Samantha S Spencer, Ravi Savarirayan, Mary C Theroux
Patients with skeletal dysplasia frequently require surgery. This patient population has an increased risk for peri-operative complications related to the anatomy of their upper airway, abnormalities of tracheal-bronchial morphology and function; deformity of their chest wall; abnormal mobility of their upper cervical spine; and associated issues with general health and body habitus. Utilizing evidence analysis and expert opinion, this study aims to describe best practices regarding the peri-operative management of patients with skeletal dysplasia...
August 1, 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28753704/-sleep-apnea-and-mechanical-ventilation-impact-on-clinical-course-and-perioperative-management
#20
S Keymel, S Krüger, S Steiner
There is a high prevalence of sleep related breathing disorders in critical ill patients and in perioperative settings. Nevertheless, less is known about their impact on clinical course and therapeutic strategies in this context. Intensive care physicians should be aware of difficult airway, weaning- and post-extubation failure and negative impact of SRBD on hemodynamics. Sedatives and analgetics might worsen SRBD and their use should be restricted as far as possible, furthermore the use of NIV might be beneficial...
July 28, 2017: Pneumologie
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