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"Difficult airway"

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https://www.readbyqxmd.com/read/28630743/comparison-of-five-video-assisted-intubation-devices-by-novice-and-expert-laryngoscopists-for-use-in-the-aeromedical-evacuation-environment
#1
Matthew C Wallace, SSgt Tyler Britton, Robbie Meek, Sharon Walsh-Hart, Col Todd E Carter, Steven J Lisco
BACKGROUND: The critically ill or injured patient undergoing military medical evacuation may require emergent intubation. Intubation may be life-saving, but it carries risks. The novice or infrequent laryngoscopist has a distinct disadvantage because experience is critical for the rapid and safe establishment of a secured airway. This challenge is compounded by the austere environment of the back of an aircraft under blackout conditions. This study determined which of five different video-assisted intubation devices (VAIDs) was best suited for in-flight use by U...
2017: Military Medical Research
https://www.readbyqxmd.com/read/28619016/clinical-application-of-a-novel-endoscopic-mask-a-randomized-controlled-multi-center-trial-in-patients-undergoing-awake-fiberoptic-bronchoscopic-intubation
#2
Tianxiao Zou, Zhenling Huang, Xiaoxue Hu, Guangyu Cai, Miao He, Shanjuan Wang, Ping Huang, Bin Yu
BACKGROUND: Awake fiberoptic bronchoscopic tracheal intubation is usually regarded as an effective method in the management of predicted difficult airway. Hypoxia during awake nasal fiberoptic bronchoscopic intubation leads to discontinuation of the procedure, prolonged manipulation time and increased risk of severe complications. The main aim of the study was to test whether the novel endoscopic mask is helpful for hypoxia during the intubation. METHODS: This was a randomized, controlled, multi-center study...
June 15, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28614863/-anesthetic-management-in-thoracic-trauma-patients
#3
Alf Kozian, Astrid Bergmann, Thomas Hachenberg, Thomas Schilling
In daily practice, management of patients with blunt thoracic trauma is challenging for the anesthetist. Injuries of airways, lungs, diaphragm, heart and large vessels are the main difficulties.Respiratory and circulatory physiology in general is affected by general anesthesia, which may result in an increased number of perioperative complications. Therefore, anesthetic management of patients with thoracic trauma needs to address different clinical topics: management of difficult airways, intrinsic effects of anesthetics and mechanical ventilation on respiratory and cardiac function, the adequate replacement of blood loss as well as type and extent of the surgical intervention...
June 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28611887/derivation-and-validation-of-the-prehospital-difficult-airway-identificationtool-predait-a-predictive-model-for-difficult-intubation
#4
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/28607343/failed-epidural-for-labour-what-now
#5
Emilia Guasch, Fabrizio Iannuccelli, Nicolas Brogly, Fernando Gilsanz
Labour epidural failure is a challenging situation for the obstetric anaesthetist, especially when associated to high risk of caesarean delivery, obesity, and difficult airway predictors. Labour epidural failure is still not standardly defined, consequently its incidence is uncertain: improving the knowledge of risk factors related to failure will increase epidural block success rate. Prolonged labours, previous history of epidural failure, and repeated topups needed during labour are recognized risk factors for failure...
June 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28606617/management-of-patients-with-predicted-difficult-airways-in-an-academic-emergency-department
#6
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/28604467/transnasal-humidified-rapid-insufflation-ventilatory-exchange-for-preoxygenation-before-cesarean-delivery-under-general-anesthesia-a-case-report
#7
Maryse Hengen, Rosalie Willemain, Alain Meyer, Bruno Langer, Girish P Joshi, Pierre Diemunsch
Transnasal humidified rapid-insufflation ventilatory exchange has been shown to improve oxygenation and increase apnea time in difficult airway cases. It may also be beneficial in patients vulnerable to rapid desaturation due to limited pulmonary reserve. We report the use of transnasal humidified rapid-insufflation ventilatory exchange for preoxygenation before a cesarean delivery under general anesthesia in a patient with respiratory distress because of pneumonia and heart failure from severe mitral stenosis...
June 8, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28577552/determining-the-amount-of-training-needed-for-competency-of-anesthesia-trainees-in-ultrasonographic-identification-of-the-cricothyroid-membrane
#8
Katia F Oliveira, Cristian Arzola, Xiang Y Ye, Jefferson Clivatti, Naveed Siddiqui, Kong E You-Ten
BACKGROUND: Airway guidelines recommend the use of ultrasound to localize the cricothyroid membrane prior to airway manipulation in difficult airways. In this study, we aimed to determine the amount of training anesthesia trainees would need to achieve competence in bedside ultrasound to identify the cricothyroid membrane. METHODS: This is a prospective non-randomized cohort study in the Department of Anesthesia at Mount Sinai Hospital (Toronto, Ontario, Canada)...
June 2, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28574957/-attention-everyone-time-out-safety-attitudes-and-checklist-practices-in-anesthesiology-in-germany-a-cross-sectional-study
#9
Christopher Neuhaus, Aline Spies, Henryk Wilk, Markus A Weigand, Christoph Lichtenstern
BACKGROUND: The use of perioperative checklists has generated a growing body of evidence pointing toward reduction of mortality and morbidity, improved compliance with guidelines, reduction of adverse events, and improvements in human factor-related areas. Usual quality management metrics generally fall short in assessing compliance with their perioperative application. Our study assessed application attitudes and compliance with safety measures centered around the World Health Organization (WHO) "Safe Surgery Saves Lives" campaign as perceived by anesthesia professionals in Germany...
June 1, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28549421/comparison-of-vividtrac%C3%A2-airtraq%C3%A2-king-vision%C3%A2-macintosh-laryngoscope-and-a-custom-made-videolaryngoscope-for-difficult-and-normal-airways-in-mannequins-by-novices
#10
Szilárd Rendeki, Dóra Keresztes, Gábor Woth, Ákos Mérei, Martin Rozanovic, Mátyás Rendeki, József Farkas, Diána Mühl, Bálint Nagy
BACKGROUND: Direct laryngoscopy remains the gold standard for endotracheal intubation and is preferred by experienced operators. However, an increasing number of reports currently support videolaryngoscopy, particularly for novice users. The widespread use of videolaryngoscopy may be limited due to financial limitations, especially in low-income countries. Therefore, affordable single-use scopes are now becoming increasingly popular. We sought to compare these new scopes with direct laryngoscopes and the previously tested videolaryngoscopes in mannequins by novices...
May 26, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28527873/comparison-of-xenon-with-led-illuminant-in-difficult-and-inhalation-injury-airway-scenario-a-randomized-crossover-manikin-study
#11
Andreas Moritz, Johannes Prottengeier, Joachim Schmidt
PURPOSE: The purpose of this study was to compare the effectiveness of a Xenon halogen with a light-emitting diode (LED) laryngoscope light handle in a difficult airway scenario, as well as in an inhalation injury airway scenario that combines a difficult airway and a limited view. METHODS: We recruited forty-two anesthetists into a randomized crossover trial. Each performed tracheal intubation (TI) with a Xenon halogen and a LED light handle in the two manikin scenarios...
May 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28526471/-comparison-of-different-stylets-used-for-intubation-with-the-c-mac-d-blade-%C3%A2-videolaryngoscope-a-randomized-controlled-study
#12
Dilek Ömür, Başak Bayram, Şule Özbilgin, Volkan Hancı, Bahar Kuvaki
OBJECTIVE: The angle of the C-MAC D-Blade(®) videolaryngoscope, which is used for difficult airway interventions, is not compatible with routinely used endotracheal tubes. METHODS: A prospective randomized crossover study was performed comparing five intubation methods for use with standardized airways, including using different stylets or no stylet: Group HS, hockey-stick stylet; Group DS, D-blade type stylet; Group CS, CoPilot(®) videolaryngoscope rigid stylet(®); Group GEB, gum elastic bougie; and Group NS, no stylet...
May 17, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28525401/glidescope-versus-airtraq-dl-for-double-lumen-tracheal-tube-insertion-in-patients-with-a-predicted-or-known-difficult-airway-a-randomised-study
#13
Olivier Belze, Evan Lepage, Yvan Bazin, Pierre Kerourin, Jacques Fusciardi, Francis Remérand, Fabien Espitalier
BACKGROUND: Double-lumen tracheal tube (DLT) insertion can be managed with videolaryngoscopes such as the Glidescope or indirect laryngoscopes like the Airtraq DL. No study has compared both devices when a difficult intubation is predicted. OBJECTIVE: Our hypothesis was that the Glidescope is superior to the Airtraq for double-lumen tube insertion in patients with a predicted or known difficult airway. DESIGN: Randomised study. PATIENTS: Adults scheduled for thoracic elective surgery, requiring one-lung ventilation with a predicted difficult intubation score of at least 7 (Arné risk index)...
July 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28515525/management-of-an-intraoperatively-damaged-endotracheal-tube-in-a-case-of-difficult-airway-using-fibre-optic-bronchoscope-with-minimal-apnoea-period
#14
Jayachandran Himarani, S Mary Nancy, V B Krishna Kumar Raja, S Shanmuga Sundaram
Damage to the endotracheal tube (ETT) is common in head and neck surgeries, especially in maxillary osteotomy. Airway management in such a crisis is crucial as there is risk of aspiration of blood into lungs, hypoxia and apnoea. This case illustrates a patient with an anticipated difficult airway who had an intraoperative damage to the ETT and was successfully managed by re-intubation with fiberoptic bronchoscope in a minimal apnoea period of <15 s using a new technique.
April 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28509804/video-laryngoscopes-and-best-rescue-strategy-for-unexpected-difficult-airways-do-not-forget-a-combined-approach-with-flexible-bronchoscopy
#15
Filippo Sanfilippo, Giuseppe Chiaramonte, Francesco Sgalambro
No abstract text is available yet for this article.
June 2017: Anesthesiology
https://www.readbyqxmd.com/read/28492404/trend-and-outcomes-of-video-laryngoscope-use-across-picus
#16
Jocelyn R Grunwell, Pradip P Kamat, Michael Miksa, Ashwin Krishna, Karen Walson, Dennis Simon, Conrad Krawiec, Ryan Breuer, Jan Hau Lee, Eleanor Gradidge, Keiko Tarquinio, Asha Shenoi, Justine Shults, Vinay Nadkarni, Akira Nishisaki
OBJECTIVE: Video (indirect) laryngoscopy is used as a primary tracheal intubation device for difficult airways in emergency departments and in adult ICUs. The use and outcomes of video laryngoscopy compared with direct laryngoscopy has not been quantified in PICUs or cardiac ICUs. DESIGN: Retrospective review of prospectively collected observational data from a multicenter tracheal intubation database (National Emergency Airway Registry for Children) from July 2010 to June 2015...
May 10, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28487824/significance-of-a-clean-tip-catheter-closed-suctioning-system-in-a-high-setting-ventilated-super-morbidly-obese-patient-with-profuse-respiratory-secretions
#17
Mohd Zulfakar Mazlan, Rhendra Hardy Mohd Zaini, Shamsul Kamalrujan Hassan, Saedah Ali, Sanihah Che Omar, Wan Mohd Nazaruddin Wan Hassan
INTRODUCTION: Closed suctioning is commonly used in the context of high-setting mechanical ventilation (MV), given its ability to prevent lung volume loss that otherwise accompanies open suctioning. However, closed suctioning systems (CSS) are not equivalent regarding components and capabilities, and thus this technique may be differentially effective to adequately clear patient secretions from an endotracheal tube (ETT), which is of paramount importance when the tube size makes the ETT particularly vulnerable to block by patient secretions...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28463474/the-height-of-the-cricothyroid-membrane-on-computed-tomography-scans-in-trauma-patients
#18
T Nutbeam, R Clarke, T Luff, D Enki, D Gay
Emergency cricothyrotomy is a common feature in all difficult airway algorithms. It is the final step following a 'can't intubate, can't oxygenate' scenario. It is rarely performed and has a significant failure rate. There is variation in the reported size of the cricothyroid membrane, especially across population groups. Procedural failure may result from attempting to pass a device with too large an external diameter through the cricothyroid membrane. We aimed to determine the maximum height of the cricothyroid membrane in a UK trauma population...
May 2, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28460858/analysis-of-out-of-hospital-pediatric-intubation-by%C3%A2-an-australian-helicopter-emergency-medical%C3%A2-service
#19
Brian J Burns, Joanna B Watterson, Sandra Ware, Luke Regan, Cliff Reid
STUDY OBJECTIVE: We examine first-look success in emergency pediatric intubation by a physician-staffed helicopter emergency medical service (EMS). METHODS: A database analysis of all pediatric (<16 years) intubations during a 64-month period was undertaken, using data from a prospectively enrolled electronic airway registry form. Recorded findings included patient demographics, operator background, airway intervention including intubation attempts, complications, and critical timings...
April 28, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28460647/-cannot-ventilate-cannot-intubate-situation-after-penetration-of-the-tongue-root-through-to-the-epipharynx-by-a-surfboard-a-case-report
#20
Yuko Ono, Miha Kunii, Tomohiro Miura, Kazuaki Shinohara
BACKGROUND: Surfing is an increasingly popular activity and surfing-related injuries have increased accordingly. However, to the best of our knowledge, there are no reports of penetrating upper airway injuries in surfers. We present a "cannot ventilate, cannot intubate" situation following penetrating neck injury by a surfboard fin. CASE PRESENTATION: A previously healthy 29-year-old Japanese man was swept off his board by a large wave and his left mandible, tongue root, and right epipharynx were penetrated by the surfboard fin...
May 1, 2017: Journal of Medical Case Reports
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