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https://www.readbyqxmd.com/read/28719483/difficult-intubation-and-ventilation-in-an-infant-with-retropharyngeal-abscess-with-mediastinal-extension
#1
Michael A Bruno, Tomas Drabek, Mioara D Manole
A previously healthy 7-month-old male infant presented for evaluation of fever, deceased oral intake, and intermittent noisy breathing. Physical examination revealed neck tenderness. Soft tissue neck radiographs and computed tomography (CT) scan supported a diagnosis of retropharyngeal swelling with extension to the superior mediastinum. Surgical exploration was planned, and endotracheal intubation was performed in the operating room. Significant cardiorespiratory derangements developed immediately after the tracheal tube was inserted, including hypotension, hypoxia, and bradycardia with signs of cardiac ischemia...
July 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28709415/assessing-anesthesiology-residents-out-of-the-operating-room-ooor-emergent-airway-management
#2
Lauryn R Rochlen, Michelle Housey, Ian Gannon, Shannon Mitchell, Deborah M Rooney, Alan R Tait, Milo Engoren
BACKGROUND: At many academic institutions, anesthesiology residents are responsible for managing emergent intubations outside of the operating room (OOOR), with complications estimated to be as high as 39%. In order to create an OOOR training curriculum, we evaluated residents' familiarity with the content and correct adherence to the American Society of Anesthesiologists' Difficult Airway Algorithm (ASA DAA). METHODS: Residents completed a pre-simulation multiple-choice survey measuring their understanding and use of the DAA...
July 15, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28701849/blunt-trauma-neck-with-complete-tracheal-transection-a-diagnostic-and-therapeutic-challenge-to-the-trauma-team
#3
K N J Prakash Raju, D Anandhi, R Surendar, Ashwith Shetty, Vinay R Pandit
Survival following trachea-esophageal transection is uncommon. Establishing a secure airway has the highest priority in trauma management. Airway management is a unique and a defining element to the specialty of emergency medicine. There is no doubt regarding the significance of establishing a patent airway in the critically ill patient in the emergency department. Cannot intubate and cannot ventilate situation is a nightmare to all emergency physicians. The most important take-home message from this case report is that every Emergency physician should have the ability to predict "difficult airway" and recognize "failed airway" very early and be skilled in performing rescue techniques when routine oral-tracheal intubation fails...
June 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28682951/preoperatively-screened-obstructive-sleep-apnea-is-associated-with-worse-postoperative-outcomes-than-previously-diagnosed-obstructive-sleep-apnea
#4
Ana Fernandez-Bustamante, Karsten Bartels, Claudia Clavijo, Benjamin K Scott, Rachel Kacmar, Kenneth Bullard, Angela F D Moss, William Henderson, Elizabeth Juarez-Colunga, Leslie Jameson
BACKGROUND: Obstructive sleep apnea (OSA) affects up to 26% of US adults, is often undiagnosed, and increases perioperative morbidity. We hypothesized that patients screened on the day of surgery as moderate/high risk for OSA (S-OSA) present similar perioperative respiratory complications, hospital use, and mortality than patients with previously diagnosed OSA (D-OSA). Second, we hypothesized that both OSA groups have more respiratory complications than No-OSA patients. METHODS: The electronic medical database from 1 academic and 2 community hospitals was retrospectively queried to identify adults undergoing nonemergent inpatient surgery (January 1, 2012, to December 31, 2014)...
July 4, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28658881/cross-sectional-observational-study-performed-to-see-for-relation-of-mallampati-score-and-extended-mallampati-score-with-body-mass-index
#5
Sasha Maria Menon, Shailaja Sampangiramaiah, Megha Mathew
INTRODUCTION: There is increasing incidence of obesity worldwide. Since obese patients have an increased fatty tissue distributed in a truncal fashion, they may have an important and negative impact on the airway patency and respiratory function. Various scoring systems have been used to predict difficult airway, the most commonly used universal bedside tool is the Modified Mallampati Scoring (MMS). It was shown that the Extended Mallampati Score (EMS) predicted difficult laryngoscopy better than the MMS in the obese populations...
May 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28658109/exchange-of-supraglottic-airways-for-endotracheal-tube-using-the-eschmann-introducer-during-simulated-child-resuscitation-a-randomized-study-comparing-4-devices
#6
RANDOMIZED CONTROLLED TRIAL
Lukasz Szarpak, Zenon Truszewski, Joseph Vitale, Logan Glosser, Kurt Ruetzler, Antonio Rodríguez-Núñez
BACKGROUND: The aim of this study was to examine the application of the Eschmann tracheal tube introducer (ETTI) with 4 types of supraglottic airway devices (SADs) using a child-manikin. METHODS: A total of 79 paramedics were asked to exchange the 4 SADs for an endotracheal tube with the ETTI in 3 different scenarios using a randomized crossover study format: normal airway without chest compression; normal airway with uninterrupted chest compression; and difficult airway with uninterrupted chest compression...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28655959/management-of-predicted-difficult-airway-with-conventional-techniques-in-an-infant-with-rhabdomyosarcoma-of-the-upper-lip
#7
Kavya R Upadhya, Chandrika Y Ramavakoda, Madhavi Ravindra, Anuradha Ganigara
In paediatric patients, airway management can be challenging due to unique anatomical and physiological variations. Hence, a thorough history, examination and pre-operative planning are essential in securing difficult airway in paediatrics. We report a case of a 7-month-old infant with rhabdomyosarcoma of the upper lip with anticipated difficult airway. The airway was managed with three different conventional techniques (modified nasal trumpet, supraglottic airway and direct laryngoscopy) for three different procedures in the same infant...
June 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28655950/comparison-of-ultrasound-and-anatomical-landmark-guided-technique-for-superior-laryngeal-nerve-block-to-aid-awake-fibre-optic-intubation-a-prospective-randomised-clinical-study
#8
Uday S Ambi, B K Arjun, Shilpa Masur, Archana Endigeri, Vinod Hosalli, S Y Hulakund
BACKGROUND AND AIMS: Ultrasonography has emerged as a novel, portable, non-invasive tool encouraging airway assessment and procedural interventions. This study assesses the feasibility of ultrasound for block of internal branch of superior laryngeal nerve (ibSLN) block during upper airway anaesthesia to aid awake fibre-optic intubation. METHODS: Forty American Society of Anesthesiologists' physical status I-II patients, aged 18-60 years, deemed to have a difficult airway (modified Mallampati class III-IV or inter-incisor distance <2...
June 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28655086/-clinical-study-of-smt-%C3%A2-video-laryngoscope-with-difficult-airway-intubation-in-emergency-department
#9
J H Yu, Y Wang
Objective: To observe the clinical feasibility and security of SMT-Ⅱ video laryngoscope in difficult airway intubation in emergency department. Methods: This study took 90 adults with difficult airway who were admitted to the rescue room of Jingxi court of Beijing Chao-Yang Hospital, Capital Medical University from January 2015 to December 2016.The patients were randomly divided into 2 groups(SMT-Ⅱ video laryngoscope group: n=45, Macintosh direct laryngoscope group: n=45), which were treated with endotracheal intubation and ventilator assisted ventilation...
July 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28651520/surgical-anesthesia-with-a-combination-of-t12-paravertebral-block-and-lumbar-plexus-sacral-plexus-block-for-hip-replacement-in-ankylosing-spondylitis-care-compliant-4-case-reports
#10
Xijian Ke, Ji Li, Yong Liu, Xi Wu, Wei Mei
BACKGROUND: Anesthesia management for patients with severe ankylosing spondylitis scheduled for total hip arthroplasty is challenging due to a potential difficult airway and difficult neuraxial block. We report 4 cases with ankylosing spondylitis successfully managed with a combination of lumbar plexus, sacral plexus and T12 paravertebral block. CASE PRESENTATION: Four patients were scheduled for total hip arthroplasty. All of them were diagnosed as severe ankylosing spondylitis with rigidity and immobilization of cervical and lumbar spine and hip joints...
June 26, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28650415/videolaryngoscopy-versus-fiber-optic-intubation-through-a-supraglottic-airway-in-children-with-a-difficult-airway-an-analysis-from-the-multicenter-pediatric-difficult-intubation-registry
#11
Nicholas E Burjek, Akira Nishisaki, John E Fiadjoe, H Daniel Adams, Kenneth N Peeples, Vidya T Raman, Patrick N Olomu, Pete G Kovatsis, Narasimhan Jagannathan
BACKGROUND: The success rates and related complications of various techniques for intubation in children with difficult airways remain unknown. The primary aim of this study is to compare the success rates of fiber-optic intubation via supraglottic airway to videolaryngoscopy in children with difficult airways. Our secondary aim is to compare the complication rates of these techniques. METHODS: Observational data were collected from 14 sites after management of difficult pediatric airways...
June 23, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28648141/anesthetic-management-of-spontaneous-cervical-epidural-hematoma-during-pregnancy-a-case-report
#12
Mehdi Samali, Abdelghafour Elkoundi, Achraf Tahri, Mustapha Bensghir, Charki Haimeur
BACKGROUND: Spontaneous spinal epidural hematoma during pregnancy is a quite rare event requiring emergent decompressive surgery in the majority of cases to prevent permanent neurological damage. Therefore, there is little data in the literature regarding anesthetic management of cervical localization during pregnancy. The potential for difficult airway management with the patient under general anesthesia is one of the major concerns that needs to be addressed to prevent further cord compression...
June 26, 2017: Journal of Medical Case Reports
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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