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https://www.readbyqxmd.com/read/29651626/current-topics-in-the-management-of-acute-traumatic-spinal-cord-injury
#1
Christopher D Shank, Beverly C Walters, Mark N Hadley
Acute traumatic spinal cord injury (SCI) affects more than 250,000 people in the USA, with approximately 17,000 new cases each year. It continues to be one of the most significant causes of trauma-related morbidity and mortality. Despite the introduction of primary injury prevention education and vehicle safety devices, such as airbags and passive restraint systems, traumatic SCI continues to have a substantial impact on the healthcare system. Over the last three decades, there have been considerable advancements in the management of patients with traumatic SCI...
April 12, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29644401/-skill-retention-using-extraglottic-airways-in-out-of-hospital-emergencies-efficacy-and-long-term-results-of-simulator-based-medical-education-a-prospective-follow-up-study
#2
V Mann, F Limberg, S T W Mann, S Little, M Müller, M Sander, R Röhrig
OBJECTIVE: For emergency medicine personnel (EMP), there is little evidence concerning the adequate timing for refresher courses to maintain routine in the application of extraglottic airways. The aim of this study was to evaluate the efficacy and long-term results of a simulator-based education concept teaching the basic airway management skills with extraglottic airways for EMP and also to draw conclusions concerning the adequate time interval for refresher courses. METHODS: By use of an explorative, prospective simulator-study with nonphysician EMP, airway management skills using the Larynxmaske Supreme® (LMA‑S) after an introduction lecture were examined...
April 11, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29643624/effectiveness-of-proseal-laryngeal-mask-airway-and-laryngeal-tube-suction-in-elective-non-laparoscopic-surgeries-of-up-to-ninety-minutes-duration-a-prospective-randomized-study
#3
Swapnil Verma, S P Sharma
Background and Aims: Proseal laryngeal mask airway (LMA) and laryngeal tube suction (LTS) are both supraglottic devices with an esophageal suction port. In the present prospective, randomized study, the effectiveness of airway seal, hemodynamic variables, ability to pass orogastric tube, and postoperative complications with the two devices were evaluated. Material and Methods: This was a prospective, randomized, single-blind study conducted in a hospital-based setting...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29628601/i-gel%C3%A2-may-be-the-device-of-choice-for-controlled-ventilation-in-patients-with-hemophilia-undergoing-abdominal-laparoscopic-surgery
#4
Sreyashi Sen, Koel Mitra, Shanta Ganguli, Sudakshina Mukherji
Haemophilia is an inherited bleeding disorder with variable deficiency of Factor VIII in the plasma and is characterised by bleeding into joints, muscles and tissues either spontaneously or in response to trivial trauma. Perioperative care requires multidisciplinary involvement. Perioperative management involves the risk of excessive bleeding from surgical site as well as spontaneous bleeding into the brain in response to surgical stress in patients with previous history of intracerebral haemorrhage. Airway management of such patients during anaesthetic intervention is a challenge and entails the risk of life threatening haemorrhage into the airway...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628566/comparison-of-the-laryngeal-mask-airways-laryngeal-mask-airway-classic-and-laryngeal-mask-airway-proseal-in-children
#5
Chetan B Bhat, Kiran A Honnannavar, Mallanna B Police Patil, Mahantesh S Mudakanagoudar
Introduction: In the past 25 years with the development of various supraglottic airway devices, the armamentarium for airway management has increased. In our study, the laryngeal mask airway (LMA)-ProSeal is compared with the LMA-Classic with respect to as follows: (a) Ease of insertion and number of insertion attempts, (b) Device positional stability and possible oropharyngeal leak, (c) Airway trauma, and (d) Hemodynamic changes; in children aged 3-15 years undergoing elective surgery under general anesthesia, hypothesizing that these would be different...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29623556/anesthesia-for-interventional-pulmonology-procedures-a-review-of-advanced-diagnostic-and-therapeutic-bronchoscopy
#6
Andres de Lima, Fayez Kheir, Adnan Majid, John Pawlowski
PURPOSE: Interventional pulmonology is a growing subspecialty of pulmonary medicine with flexible and rigid bronchoscopies increasingly used by interventional pulmonologists for advanced diagnostic and therapeutic purposes. This review discusses different technical aspects of anesthesia for interventional pulmonary procedures with an emphasis placed on pharmacologic combinations, airway management, ventilation techniques, and common complications. SOURCE: Relevant medical literature was identified by searching the PubMed and Google Scholar databases for publications on different anesthesia topics applicable to interventional pulmonary procedures...
April 5, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29622314/airway-management-for-the-oral-surgery-patient
#7
REVIEW
Allan Schwartz
This article discusses anesthesia assessment concepts related to airway evaluation and airway maintenance for safe and reliable selection of either open system (entrainment of room air) or closed system (no entrainment of room air) airway devices, which can be used during office-based oral surgical procedures, depending on the needs of a patient. Dental facial and oral structures are integral to an anesthetist's preoperative patient evaluation prior to surgery. The preoperative medical history and physical examination as well as the nature of the oral surgical procedure affect the selection of a proper and safe airway device...
May 2018: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/29619557/performance-and-skill-retention-of-five-supraglottic-airway-devices-for-the-pediatric-difficult-airway-in-a-manikin
#8
Johannes Kulnig, Lisa Füreder, Nicole Harrison, Michael Frass, Oliver Robak
Supraglottic airway devices (SADs) have been introduced to assist medical professionals in emergency situations with limited experience in securing airways via conventional endotracheal intubation (ETI). Literature on the use of SADs for securing an airway during pediatric critical settings is scarce, and there is a lack of studies comparing different SADs to each other and to conventional ETI. We conducted a study comparing five different SADs to ETI with regard to success rate, time to first ventilation, and personal rating in a pediatric manikin under simulated physiologic and pathologic airway conditions in 41 pediatricians of varying clinical experience and training...
April 5, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29618190/pre-hospital-i-gel-blind-intubation-for-trauma-a-simulation-study
#9
Jae Guk Kim, Wonhee Kim, Gu Hyun Kang, Yong Soo Jang, Hyun Young Choi, Hyeongtae Kim, Minji Kim
OBJECTIVE: This study aimed to evaluate the efficacy of i-gel blind intubation (IGI) as a rescue device for definitive airway management in ground intubation for pre-hospital trauma patients. METHODS: A prospective randomized crossover study was conducted with 18 paramedics to examine intubation performance of two blind intubation techniques through a supraglottic airway devices (IGI and laryngeal mask airway Fastrach), compared with use of a Macintosh laryngoscope (MCL)...
March 2018: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29605236/youtube-as-a-source-of-information-for-obstructive-sleep-apnea
#10
Sameer K Singh, Stanley Liu, Robson Capasso, Robert C Kern, Christopher J Gouveia
PURPOSE: Assess the quality of information on obstructive sleep apnea (OSA) presented on YouTube for patients. MATERIALS AND METHODS: "Obstructive sleep apnea" was entered into the YouTube search. Two independent reviewers categorized and analyzed videos utilizing a customized scoring-system along with search position, likes, and views. RESULTS: Forty-eight videos were analyzed. Most were educational (52.1%). Educational and news videos had significantly higher scores, but had no significant differences in search position, likes/day, or views/day...
March 19, 2018: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/29561288/to-intubate-or-not-to-intubate
#11
Christopher J R Gough, Jerry P Nolan
PURPOSE OF REVIEW: Cardiac arrest mortality remains high, and the impact on outcome of most advanced life support interventions is unclear. The optimal method for managing the airway during cardiac arrest remains unknown. This review will summarize and critique recently published evidence comparing basic airway management with the use of more advanced airway interventions [insertion of supraglottic airway (SGA) devices and tracheal intubation]. RECENT FINDINGS: Systematic reviews generally document an association between advanced airway management and worse neurological outcome but they are subject to considerable bias...
March 20, 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29554712/-use-of-bronchial-blockers-for-lung-isolation
#12
Tom Kreft, Thomas Hachenberg
Traditionally the double-lumen-tube (DLT) is considered the gold standard for lung separation. Despite being equally feasible for standard situations, there are special populations and circumstances requiring the use of a bronchial blocker (BB) to establish one-lung ventilation. Children under 8 years of age and patients without a patent orotracheal airway necessitate the use of a bronchial blocker in most cases, as well as those requiring selective lobar blockade or a rapid sequence induction. Surgery with predicted postoperative mechanical ventilation or in tracheotomized patients at least favors their use by avoiding the complications of a tube exchange...
March 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29554711/-difficult-airway-management-in-thoracic-anaesthesia
#13
Sarah-Hélène Müller, Jérôme M Defosse, Mark U Gerbershagen, Torsten Loop
Difficult airway management in thoracic anesthesia has rarely been addressed in current guidelines. However, difficult airway management may be a challenge in thoracic anaesthesia: Achieving lung separation and collapse in combination of potentially distorted upper airway anatomy (difficult upper airway), the presence of subglottic pathologies (difficult lower airway) and the need for one-lung ventilation (difficult lung separation). This review will focus on identification of patients at risk, recommendations and algorithms for the airway management in the anticipated and unexpected difficult in-/extubation, and choice of devices for lung separation in this context...
March 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29549460/success-rates-of-pre-hospital-difficult-airway-management-a-quality-control-study-evaluating-an-in-hospital-training-program
#14
Helmut Trimmel, Christoph Beywinkler, Sonja Hornung, Janett Kreutziger, Wolfgang G Voelckel
BACKGROUND: Competence in emergency airway management is key in order to improve patient safety and outcome. The scope of compulsory training for emergency physicians or paramedics is quite limited, especially in Austria. The purpose of this study was to review the difficult airway management performance of an emergency medical service (EMS) in a region that has implemented a more thorough training program than current regulations require, comprising 3 months of initial training and supervised emergency practice and 3 days/month of on-going in-hospital training as previously reported...
March 16, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29544752/management-of-an-internal-carotid-artery-injury-caused-by-a-displaced-titanium-plate-with-a-combination-of-interventional-vascular-radiology-and-surgery
#15
Yoshitaka Shimizu, Takahito Okazaki, Tomoaki Hamana, Masahiro Irifune
Treatment of pseudoaneurysms in the internal carotid artery (ICA) is associated with a high risk of cerebral infarction; therefore, vessel ligation for hemostasis must be avoided. A 66-year-old man had intraoral hemorrhaging. At the time of the initial examination, computed tomography angiography showed jaw plate displacement near the ICA. A more detailed image was obtained using digital-subtraction angiography. After evaluation of the image, a pseudoaneurysm was diagnosed. Six days later, there were concerns about aspiration and airway obstruction; therefore, tracheostomy was performed...
February 20, 2018: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29521802/prehospital-airway-procedures-performed-in-trauma-patients-by-ground-forces-in-afghanistan
#16
Megan B Blackburn, Maj Michael D April, Cpt Derek J Brown, Robert A DeLorenzo, Kathy L Ryan, August N Blackburn, Maj Steven G Schauer
BACKGROUND: Airway management is of critical importance in combat trauma patients. Airway compromise is the second leading cause of potentially survivable death on the battlefield and accounts for approximately 1 in 10 preventable deaths. Reports from the Iraq and Afghanistan wars indicate 4-7% incidence of airway interventions on casualties transported to combat hospitals. The goal of this study was to describe airway management in the prehospital combat setting and document airway devices used on the battlefield...
March 8, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29505333/video-laryngoscopy-assisted-tracheal-intubation-in-airway-management
#17
Chia-Chih Liao, Fu-Chao Liu, Allen H Li, Huang-Ping Yu
Video laryngoscopy-assisted tracheal intubation devices have become alternatives to traditional laryngoscopes in recent years. This review will provide information on commonly used video laryngoscopes and their clinical applications in airway management. Areas covered: In this review, the differences between video laryngoscopy and direct laryngoscopy, and the utilization of video laryngoscopes in specific clinical settings are discussed. Expert commentary: Video laryngoscopy should be embraced as an initial approach to intubation in patients with suspected difficult airway...
April 2018: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/29491514/comparison-of-the-proseal-laryngeal-mask-airway-with-the-i-gel%C3%A2-in-the-different-head-and-neck-positions-in-anaesthetised-paralysed-children-a-randomised-controlled-trial
#18
Gargi Banerjee, Divya Jain, Indu Bala, Komal Gandhi, Ram Samujh
Background and Aims: Head and neck movements alter the shape of the pharynx, resulting in changes in the oropharyngeal leaking pressures and ventilation with supragottic airway devices. We compared the effect of the different head-and-neck positions on the oropharyngeal leak pressures and ventilation with the I-Gel™ and ProSeal™ laryngeal mask airway (PLMA) in anaesthetised paralysed children. Methods: A total of 70 children were randomly assigned to receive PLMA ( n = 35) or I-Gel™ ( n = 35) for airway management...
February 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29465279/a-continuous-quality-improvement-airway-program-results-in-sustained-increases-in-intubation-success
#19
David J Olvera, David F E Stuhlmiller, Allen Wolfe, Charles F Swearingen, Troy Pennington, Daniel P Davis
INTRODUCTION: Airway management is a critical skill for air medical providers, including the use of rapid sequence intubation (RSI) medications. Mediocre success rates and a high incidence of complications has challenged air medical providers to improve training and performance improvement efforts to improve clinical performance. OBJECTIVES: The aim of this research was to describe the experience with a novel, integrated advanced airway management program across a large air medical company and explore the impact of the program on improvement in RSI success...
February 21, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29452333/male-requires-a-higher-median-target-effect-site-concentration-of-propofol-for-i-gel-placement-when-combined-with-dexmedetomidine
#20
M-M Han, F-S Xue, F Kang, X Huang, J Li
OBJECTIVE: The supraglottic airway device (SAD) can be used for airway management of spontaneous breathing patients, and propofol is commonly applied for the SAD placement. This study was designed to assess the effect of gender on median target effect-site concentration (Ce50 ) of propofol for I-gel placement when combined with dexmedetomidine. MATERIAL AND METHOD: 19 males and 18 females, aged 18 to 59 and undergoing elective surgery, were enrolled. After intravenous infusion of dexmedetomidine 1...
February 13, 2018: Anaesthesia, Critical Care & Pain Medicine
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