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https://www.readbyqxmd.com/read/29750692/trainability-of-cricoid-pressure-force-application-a-simulation-based-study
#1
Eric Noll, Shivam Shodhan, Arnavi Varshney, Christopher Gallagher, Pierre Diemunsch, F Barry Florence, Jamie Romeiser, Elliott Bennett-Guerrero
BACKGROUND: Aspiration of gastric contents is a leading cause of airway management-related mortality during anesthesia practice. Cricoid pressure (CP) is widely used during rapid sequence induction to prevent aspiration. National guidelines for CP suggest a target force of 10 N before and 30 N after loss of consciousness. However, few studies have rigorously assessed whether clinicians can be trained to consistently achieve these levels of force. We hypothesized that clinicians can be trained effectively to deliver 10-30 N during application of CP...
May 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29627046/tracheal-injuries-complicating-prolonged-intubation-and-tracheostomy
#2
REVIEW
Joel D Cooper
Respiratory care advances such as the introduction of ventilatory assistance have been associated with postintubation airway stenosis resulting from tracheal injury at the site of the inflatable cuff on endotracheal or tracheostomy tubes. Low-pressure cuffs have significantly reduced this occurrence. Loss of airway stability at the site of a tracheostomy stoma may result in tracheal stenosis. Subglottic stenosis may result from a high tracheostomy site at, or just inferior to, the cricoid arch, or to malposition of an endotracheal tube cuff...
May 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/29533256/use-of-survey-and-delphi-process-to-understand-trauma-anesthesia-care-practices
#3
Catherine M Kuza, Monica S Vavilala, Rebecca M Speck, Richard P Dutton, Maureen McCunn
BACKGROUND: Few trauma guidelines evaluate and recommend anesthesiology practices and there are no trauma anesthesia-specific guidelines. There is no information on how anesthesiologists perceive clinical practice patterns. Our objective was to understand the perceptions of anesthesiologists regarding trauma anesthesia practices. METHODS: A survey assessing anesthesia management of trauma patients was distributed to 21,491 anesthesiologists. A subset of 10 of these questions was subsequently reviewed by a trauma anesthesiology focus group through a 3-round web-based Delphi process...
May 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29508014/-certain-and-controversial-components-of-rapid-sequence-induction
#4
T Mencke, A Zitzmann, D A Reuter
Rapid sequence induction (RSI) is a specific technique for anesthesia induction, which is performed in patients with an increased risk for pulmonary aspiration (e.g. intestinal obstruction, severe injuries and cesarean section). The incidence of acute respiratory distress syndrome (ARDS) is very low but 10-30% of anesthesia-related deaths are caused by the consequences of ARDS. The classical RSI with its main components (i.e. head-up position, avoidance of positive pressure ventilation and administration of succinylcholine) was published nearly 50 years ago and has remained almost unchanged...
April 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29504951/videographic-assessment-of-pediatric-tracheal-intubation-technique-during-emergency-airway-management
#5
Yuko Shiima, Ting-Chang Hsieh, Andrew Long, Aaron Donoghue
OBJECTIVES: To examine technical aspects of pediatric tracheal intubation using video recording and to determine the association between tracheal intubation technique and procedural outcomes. DESIGN: Prospective observational study. SETTING: Emergency department resuscitation bay in single tertiary pediatric center. PATIENTS: Children undergoing emergent tracheal intubation under videorecorded conditions. INTERVENTIONS: None...
March 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29395827/pediatric-patients-with-high-pulmonary-arterial-pressure-in-congenital-heart-disease-have-increased-tracheal-diameters-measured-by-computed-tomography
#6
Nobuko Ohashi, Hidekazu Imai, Yutaka Seino, Hiroshi Baba
OBJECTIVES: Determination of the appropriate tracheal tube size using formulas based on age or height often is inaccurate in pediatric patients with congenital heart disease (CHD), particularly in those with high pulmonary arterial pressure (PAP). Here, the authors compared tracheal diameters between pediatric patients with CHD with high PAP and low PAP. DESIGN: Retrospective clinical study. SETTING: Hospital. PARTICIPANTS: Pediatric patients, from birth to 6 months of age, requiring general anesthesia and tracheal intubation who underwent computed tomography were included...
December 6, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29359076/effect-of-cricoid-pressure-on-laryngeal-view-during-macintosh-mcgrath-mac-x-blade-and-glidescope-video-laryngoscopies
#7
Zehra İpek Arslan, Mine Solak
Objective: Cricoid pressure is useful in fasted patients requiring emergency intubation. We compared the effect of cricoid pressure on laryngeal view during Macintosh, McGrath MAC X-Blade and GlideScope video laryngoscopy. Methods: After obtaining approval from the Human Research Ethics Committee and written informed consent from patients, we enrolled 120 patients (American Society of Anesthesiologists I-II, age 18-65 years) undergoing elective surgery that required endotracheal intubation in this prospective randomised study...
December 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/29349045/advantages-disadvantages-indications-contraindications-and-surgical-technique-of-laryngeal-airway-mask
#8
REVIEW
Anubhav Jannu, Ashim Shekar, Ramdas Balakrishna, H Sudarshan, G C Veena, S Bhuvaneshwari
The beauty of the laryngeal mask is that it forms an air tight seal enclosing the larynx rather than plugging the pharynx, and avoid airway obstruction in the oropharynx. The goal of its development was to create an intermediate form of airway management face mask and endotracheal tube. Indication for its use includes any procedure that would normally involve the use of a face mask. The laryngeal mask airway was designed as a new concept in airway management and has been gaining a firm position in anesthetic practice...
December 2017: Archives of Craniofacial Surgery
https://www.readbyqxmd.com/read/29328751/a-comparative-prospective-cohort-study-comparing-physical-exam-to-ultrasound-for-identifying-the-cricoid-cartilage
#9
Peter Williams, Abhay Umranikar
Applying cricoid pressure is a common practice when intubating patients thought to be at risk of pulmonary aspiration. Recently, the perceived benefits of applying cricoid pressure have been questioned. Prior research has shown that cricoid pressure is applied incorrectly and that palpation of adjacent anatomy of the cricothyroid membrane is also inaccurate. We compared physical palpation to ultrasound for identifying the location of the cricoid cartilage using a total of 50 assessments. The median distance to target was 10 mm...
September 2017: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/29232240/cricoid-pressure-effective-measure-or-ritual
#10
LETTER
Hans-Joachim Priebe
No abstract text is available yet for this article.
January 2018: Anesthesiology
https://www.readbyqxmd.com/read/29232239/should-the-dominant-or-nondominant-hand-be-used-for-applying-cricoid-pressure
#11
LETTER
Jonathan V Roth
No abstract text is available yet for this article.
January 2018: Anesthesiology
https://www.readbyqxmd.com/read/29161401/the-evolution-of-airway-management-new-concepts-and-conflicts-with-traditional-practice
#12
A F McNarry, A Patel
In the last 25 yr, there have been several advances in the safe management of the airway. Videolaryngoscopes and supraglottic airways, now in routine use by new trainees in anaesthesia, have had their genesis in the recent past. The 4th National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society published in 2011 a seminal report that has influenced airway management worldwide . Understanding how the report's recommendations were constructed and how clinical guidelines compliment rather than contradict them is important in understanding the tenets of safe airway management...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29063711/role-of-ultrasound-measuring-position-and-ventilation-pressure-in-determining-correct-tube-size-in-children
#13
Christoph Schramm, Luzie S Eisleben, Jens Kessler, Katrin Jensen, Konstanze Plaschke
BACKGROUND: Ultrasound measurements of the airway are useful for determining correctly sized, uncuffed endotracheal tubes in children. AIMS: The primary objective of this study was to evaluate the influence of ventilation pressure on the sonographically measured tracheal diameter at different levels. METHODS: A total of 100 patients (under 7 years) were enrolled in this study. Six sonographic measurements of minimal transverse diameters at 3 locations (vocal chords, cricoid cartilage, and proximal trachea) and at 2 different ventilation pressures (0 and 15 mbar) were performed before the intubation procedure...
October 24, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28988443/effects-of-supramaximal-balloon-dilatation-pressures-on-adult-cricoid-and-tracheal-cartilage-a-cadaveric-study
#14
Venkata S P B Durvasula, Sara C Shalin, Ozlem E Tulunay-Ugur, James Y Suen, Gresham T Richter
OBJECTIVES/HYPOTHESIS: Cricoid fracture is a serious concern for balloon dilatation in airway stenosis. Furthermore, there are no studies examining tracheal rupture in balloon dilatation of stenotic segments. The aim of this study was to evaluate the effect of supramaximal pressures of balloons on the cricoid and tracheal rings. STUDY DESIGN: Prospective cadaveric study. METHODS: Seven cadaveric laryngotracheal complexes of normal adults with intact cricothyroid membranes were acquired...
October 8, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28960597/ideal-cricoid-pressure-is-biomechanically-impossible-during-laryngoscopy
#15
Christopher E Trethewy, Steven R Doherty, Julie M Burrows, Don Clausen
OBJECTIVE: This study was a prospective, randomized controlled trial of rapid sequence intubation (RSI) with cricoid pressure (CP) within the emergency department (ED). The primary aim of the study was to examine the link between ideal CP and the incidence of aspiration. METHOD: Patients > 18 years of age undergoing RSI in the ED of two hospitals in New South Wales, Australia, were randomly assigned to receive measured CP using weighing scales to target the ideal CP range (3...
January 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28953309/measurement-of-cricoid-pressure-force-during-simulated-sellick-s-manoeuvre
#16
Paweł Andruszkiewicz, Mateusz Zawadka, Anna Kosińska, Paulina Walczak-Wieteska, Kalina Majerowicz
BACKGROUND: Cricoid pressure is a standard anaesthetic procedure used to reduce the risk of aspiration of gastric contents during the induction of general anaesthesia. However, for several years its validity has been questioned. There still remains the question of whether we perform it correctly. The aim of the study was an evaluation of the theoretical knowledge of Sellick's manoeuvre, as well an assessment of practical skill related with it when simulated on a model of the upper airway...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28874304/effect-of-cricoid-pressure-on-the-insertion-efficacy-of-six-supraglottic-devices-a-crossover-randomized-simulation-trial
#17
Fumihiro Ohchi, Nobuyasu Komasawa, Ryosuke Mihara, Kazuo Hattori, Toshiaki Minami
BACKGROUND: No study has ever compared the efficacy of various types of supraglottic devices (SGDs) for securing the airway under cricoid pressure. OBJECTIVE: This study aimed to evaluate the efficacy of six SGDs, LMA-ProSeal (ProSeal), LMA-Classic (Classic), Laryngeal Tube (LT), LMA-Supreme (Supreme), air-Q (air-Q), and i-gel (i-gel), in airway management under cricoid pressure using a manikin. METHODS: Fifteen novice doctors and 16 experienced doctors used the six SGDs under cricoid or sham pressure on an adult manikin...
November 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28837293/-%C3%A2-golden-hour-%C3%A2-and-the-sellick-manoeuvre-in-emergency-care-we-must-not-throw-out-the-baby-with-the-bathwater
#18
Lukas Bürki, Bertrand Yersin
This article evaluates 3 controversial subjects of pre-hospital emergency care : 1) The concept of the « Golden hour » predicates an increased morbidity and mortality for injured patients, if pre-hospital care exceeds 1 hour. In the subgroup of patients presenting with severe hemorrhagic injuries or penetrating trauma to the torso, a transport of 60 minutes or less decreases mortality ; 2) The Sellick manoeuvre is used to decrease the risk of bronchoaspiration in patients undergoing an emergency intubation...
August 9, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28602458/using-ultrasonography-to-assess-the-effectiveness-of-cricoid-pressure-on-esophageal-compression
#19
Jonathan Kei, Emily E Utschig, Reinier J van Tonder
BACKGROUND: Cricoid pressure during intubation has been used for decades as a way to potentially occlude the esophagus to avoid aspiration of gastric contents. However, recent evidence has questioned the effectiveness of this maneuver. OBJECTIVE: This study uses a noninvasive modality, ultrasonography, to determine the anatomic position of the cricoid cartilage and the esophagus and examines the effectiveness of cricoid pressure on esophageal compression. METHODS: Ultrasound imaging was used to describe the anatomic relationship of the esophagus to the trachea as either being directly behind the trachea, partially behind the trachea, or completely lateral to the trachea...
August 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28582364/cricoid-pressure-impedes-mask-ventilation-a-randomised-crossover-trial
#20
Nobuyasu Komasawa, Ryosuke Mihara, Kazuo Hattori, Toshiaki Minami
No abstract text is available yet for this article.
July 2017: European Journal of Anaesthesiology
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