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"Rapid Sequence Induction"

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https://www.readbyqxmd.com/read/28289767/-update-on-muscle-relaxation-what-comes-after-succinylcholine-rocuronium-and-sugammadex
#1
N Zoremba, G Schälte, C Bruells, F K Pühringer
Due to the great advantages, it is not possible to imagine current practice in anesthesia without the adminstration of muscle relaxants. For a long time the administration of succinylcholine for rapid sequence induction (RSI) was considered to be the state of the art for patients at risk for aspiration. The favorable characteristics are, however, accompanied by many, sometimes severe side effects. Due to the development of non-depolarizing muscle relaxants, in particular rocuronium in combination with sugammadex, there is the possibility to achieve a profile of action similar to succinylcholine with low side effects...
March 13, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28237950/emergency-cricothyroidotomy-following-tracheobronchial-stenting
#2
Simon Robert Cavinato, Mike Denning, Brendan P Madden
A man aged 51 years was referred for tracheobronchial stenting after a poorly differentiated oesophageal carcinoma had progressed to cause stridor. Bronchoscopy revealed a left vocal cord palsy and tumour infiltration into the trachea. A tracheobronchial stent was placed, and after distal migration was endoscopically resited. Returning from theatre, the patient developed severe upper airway obstruction that progressed to cause CO2 narcosis and loss of consciousness. A rapid sequence induction was initiated, and a Glidescope revealed bilateral vocal cord palsy with severe oedema causing an inability to pass a tube or stylet...
February 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28230439/developing-an-e-learning-resource-for-nurse-airway-assistants-in-the-emergency-department
#3
Peter Hersey, Sean McAleer
The aims of this project were to determine the required competencies for a nurse in the emergency department assisting with a rapid sequence induction of anaesthesia (RSI), and to produce a relevant e-learning resource. A three-round multidisciplinary Delphi process produced the following competencies: ability to describe the steps and sequence of events of an RSI, familiarity with the equipment used during an RSI, ability to recognise and help manage problems occurring during an RSI, ability to prepare for an RSI, ability to apply cricoid pressure, and understanding the modification of an RSI in special circumstances...
February 23, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28141734/anaesthesia-and-orphan-disease-rapid-sequence-induction-in-systemic-mastocytosis
#4
Christoph Unterbuchner, Marina Hierl, Timo Seyfried, Thomas Metterlein
No abstract text is available yet for this article.
March 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28070654/anesthesia-management-of-cesarean-section-in-parturient-with-anti-n-methyl-d-aspartate-receptor-encephalitis-a-case-report
#5
Zhimin Liao, Xiaoqin Jiang, Juan Ni
A 24-year-old woman at 29 weeks' gestation, and with psychiatric symptoms, was admitted to hospital and diagnosed as having anti-N-methyl-D-aspartate receptor encephalitis. After 4 weeks of immunotherapy with little effect, an emergency cesarean section was performed at 33(+4) weeks gestation under general anesthesia. The parturient was intubated after rapid sequence induction with etomidate, remifentanil and succinylcholine. Anesthesia was maintained with sevoflurane and remifentanil. Except for low weight, the infant was normal at birth...
January 9, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28035669/a-randomised-controlled-trial-comparing-transnasal-humidified-rapid-insufflation-ventilatory-exchange-thrive-pre-oxygenation-with-facemask-pre-oxygenation-in-patients-undergoing-rapid-sequence-induction-of-anaesthesia
#6
F Mir, A Patel, R Iqbal, M Cecconi, S A R Nouraei
Pre-oxygenation is an essential part of rapid sequence induction of general anaesthesia for emergency surgery, in order to increase the oxygen reservoir in the lungs. We performed a randomised controlled trial of transnasal humidified rapid insufflation ventilatory exchange (THRIVE) pre-oxygenation or facemask pre-oxygenation in patients undergoing emergency surgery. Twenty patients were allocated to each group. No patient developed arterial oxygen saturation < 90% during attempted tracheal intubation. Arterial blood gases were sampled from an arterial catheter immediately after intubation...
April 2017: Anaesthesia
https://www.readbyqxmd.com/read/28003694/the-all-india-difficult-airway-association-2016-guidelines-for-tracheal-intubation-in-the-intensive-care-unit
#7
Sheila Nainan Myatra, Syed Moied Ahmed, Pankaj Kundra, Rakesh Garg, Venkateswaran Ramkumar, Apeksh Patwa, Amit Shah, Ubaradka S Raveendra, Sumalatha Radhakrishna Shetty, Jeson Rajan Doctor, Dilip K Pawar, Singaravelu Ramesh, Sabyasachi Das, Jigeeshu Vasishtha Divatia
Tracheal intubation (TI) is a routine procedure in the Intensive Care Unit (ICU) and is often life-saving. In contrast to the controlled conditions in the operating room, critically ill patients with respiratory failure and shock are physiologically unstable. These factors, along with a suboptimal evaluation of the airway and limited oxygen reserves despite adequate pre-oxygenation, are responsible for a high incidence of life-threatening complications such as severe hypoxaemia and cardiovascular collapse during TI in the ICU...
December 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28003691/all-india-difficult-airway-association-2016-guidelines-for-the-management-of-unanticipated-difficult-tracheal-intubation-in-obstetrics
#8
Venkateswaran Ramkumar, Ekambaram Dinesh, Sumalatha Radhakrishna Shetty, Amit Shah, Pankaj Kundra, Sabyasachi Das, Sheila Nainan Myatra, Syed Moied Ahmed, Jigeeshu Vasishtha Divatia, Apeksh Patwa, Rakesh Garg, Ubaradka S Raveendra, Jeson Rajan Doctor, Dilip K Pawar, Singaravelu Ramesh
The various physiological changes in pregnancy make the parturient vulnerable for early and rapid desaturation. Severe hypoxaemia during intubation can potentially compromise two lives (mother and foetus). Thus tracheal intubation in the pregnant patient poses unique challenges, and necessitates meticulous planning, ready availability of equipment and expertise to ensure maternal and foetal safety. The All India Difficult Airway Association (AIDAA) proposes a stepwise plan for the safe management of the airway in obstetric patients...
December 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/27984372/intubation-success-rates-of-prehospital-rapid-sequence-induction
#9
Joost Peters, Bas Van Wageningen, Ilze Hendriks, Ruud Eijk, Michael Edwards, Nico Hoogerwerf, Jan Biert
No abstract text is available yet for this article.
February 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/27984371/intubation-success-rates-of-prehospital-rapid-sequence-induction-of-anaesthesia-by-physicians-versus-paramedics
#10
Scot Phelps
No abstract text is available yet for this article.
February 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/27979641/awake-laryngoscopy-in-the-emergency-department
#11
Joseph E Tonna, Peter M C DeBlieux
BACKGROUND: Many emergency physicians gain familiarity with the laryngeal anatomy only during the brief view achieved during rapid sequence induction and intubation. Awake laryngoscopy in the emergency department (ED) is an important and clinically underutilized procedure. DISCUSSION: Providing benefit to the emergency physician through a slow, controlled, and deliberate examination of the airway, awake laryngoscopy facilitates confidence in the high-risk airway and eases the evolution to intubation, should it be required...
March 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27900760/choice-of-anaesthesia-for-category-1-caesarean-section-in-women-with-anticipated-difficult-tracheal-intubation-the-use-of-decision-analysis
#12
A J Krom, Y Cohen, J P Miller, T Ezri, S H Halpern, Y Ginosar
A predicted difficult airway is sometimes considered a contra-indication to rapid sequence induction of general anaesthesia, even in an urgent case such as a category-1 caesarean section for fetal distress. However, formally assessing the risk is difficult because of the rarity and urgency of such cases. We have used decision analysis to quantify the time taken to establish anaesthesia, and probability of failure, of three possible anaesthetic methods, based on a systematic review of the literature. We considered rapid sequence induction of general anaesthesia with videolaryngoscopy, awake fibreoptic intubation and rapid spinal anaesthesia...
February 2017: Anaesthesia
https://www.readbyqxmd.com/read/27871575/dose-requirements-of-alfentanil-to-eliminate-autonomic-responses-during-rapid-sequence-induction-with-thiopental-4-mg-kg-and-rocuronium-0-6-mg-kg
#13
Mohammad H Abou-Arab, Morten Rostrup, Tom Heier
STUDY OBJECTIVE: Opioids are integral part of anesthesia induction, but information on optimal dosing is limited. We aimed to determine doses of alfentanil needed to eliminate increases in 5 autonomic response variables (plasma concentrations of epinephrine, norepinephrine and vasopressin, arterial blood pressure [ABP], and heart rate) during rapid-sequence induction of anesthesia with thiopental 4 mg/kg and rocuronium 0.6 mg/kg. DESIGN: Prospective, randomized, observer-blinded, interventional clinical study...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27833478/comparison-of-rocuronium-at-two-different-doses-and-succinylcholine-for-endotracheal-intubation-in-adult-patients-for-elective-surgeries
#14
S G Chavan, S Gangadharan, A K Gopakumar
BACKGROUND: The effects of rocuronium at two different doses, that is, 0.6 mg/kg (2 × ED95) and 0.9 mg/kg (3 × ED95), were compared with succinylcholine (2 mg/kg) when used for endotracheal intubation in adult patients for elective surgeries under general anesthesia. MATERIALS AND METHODS: Ninety patients were divided into three groups of 30 each. Groups A, B received injection rocuronium at 0.6 mg/kg, 0.9 mg/kg respectively and Group C received succinylcholine at 2 mg/kg...
October 2016: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/27793243/anesthesia-in-pregnant-women-with-hellp-syndrome-case-report
#15
Eduardo Barbin Zuccolotto, Eugenio Pagnussatt Neto, Glínia Cavalcante Nogueira, José Roberto Nociti
BACKGROUND AND OBJECTIVES: HELLP syndrome, characterized by hemolysis, high levels of liver enzyme, and low platelet count, is an advanced clinical stage of pre-eclampsia, progressing to high maternal (24%) and perinatal (up 40%) mortality, despite childbirth care in a timely manner. The goal is to describe the anesthetic management of a case with indication to emergency cesarean. CASE REPORT: Female patient, 36 years old, gestational age of 24 weeks, with hypertensive crisis (BP 180/100mmHg) and severe headache, was admitted to the operating room for a cesarean section after diagnosis of HELLP syndrome...
November 2016: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/27718129/the-readiness-of-emergency-and-trauma-care-in-low-and-middle-income-countries-a-cross-sectional-descriptive-study-of-42-public-hospitals-in-albania
#16
Rifat Latifi, Jayleen K L Gunn, John A Stroster, Edmond Zaimi, Fatos Olldashi, Agron Dogjani, Mihal Kerci, Xheladin Draçini, Julian Kuçani, Zhaneta Shatri, Agim Kociraj, Arian Boci, Ross I Donaldson
BACKGROUND: Traumatic injuries have become a substantial but neglected epidemic in low- and middle-income countries (LMICs), but emergency rooms (ERs) in these countries are often staffed with healthcare providers who have minimal emergency training and experience. The aim of this paper was to describe the specialized training, available interventions, and the patient management strategies in the ERs in Albanian public hospitals. METHODS: A cross-sectional descriptive study of 42 ERs in the Republic of Albania between September 5, 2014, and December 29, 2014 was performed...
December 2016: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27692621/use-of-king-vision-%C3%A2-videolaryngoscope-in-an-unanticipated-difficult-airway-in-an-adult-patient-with-giant-vallecular-cyst-a-case-report
#17
L España Fuente, P de la Rica Fernández, J L González González
Laryngeal cysts are largely asymptomatic and typically described in the context of incidental discovery on routine laryngoscopy. These cysts, in adults are even rarer and can have catastrophic consequences in an anaesthetized patient if airway management is inappropriate. We describe a case of difficult endotracheal intubation and the treatment of an adult patient with an asymptomatic, giant vallecular cyst that was discovered during rapid-sequence induction of general anesthesia in urgent surgery. In conclusion, vallecular cysts can cause extreme problems in securing the airway...
February 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/27678137/-simulation-based-training-and-or-apprenticeship-for-medical-students-a%C3%A2-prospective-randomized-single-blind-study-of-clinical-skills
#18
RANDOMIZED CONTROLLED TRIAL
T Ott, I Schmidtmann, T Limbach, P F Gottschling, H Buggenhagen, S Kurz, G Pestel
BACKGROUND: Simulation-based training (SBT) has developed into an established method of medical training. Studies focusing on the education of medical students have used simulation as an evaluation tool for defined skills. A small number of studies provide evidence that SBT improves medical students' skills in the clinical setting. Moreover, they were strictly limited to a few areas, such as the diagnosis of heart murmurs or the correct application of cricoid pressure. Other studies could not prove adequate transferability from the skills gained in SBT to the patient site...
November 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27640666/rapid-sequence-induction-in-patients-with-acute-appendicitis-is-it-always-justified
#19
Peter Keogh, Tara Keogh
No abstract text is available yet for this article.
September 2, 2016: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/27631579/simulation-fails-to-replicate-stress-in-trainees-performing-a-technical-procedure-in-the-clinical-environment
#20
B G Baker, A Bhalla, B Doleman, E Yarnold, S Simons, J N Lund, J P Williams
INTRODUCTION: Simulation-based training (SBT) has become an increasingly important method by which doctors learn. Stress has an impact upon learning, performance, technical, and non-technical skills. However, there are currently no studies that compare stress in the clinical and simulated environment. We aimed to compare objective (heart rate variability, HRV) and subjective (state trait anxiety inventory, STAI) measures of stress theatre with a simulated environment. METHODS: HRV recordings were obtained from eight anesthetic trainees performing an uncomplicated rapid sequence induction at pre-determined procedural steps using a wireless Polar RS800CX monitor © in an emergency theatre setting...
September 15, 2016: Medical Teacher
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