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Airways management

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https://www.readbyqxmd.com/read/29470574/changes-in-scope-of-procedures-performed-by-pediatric-otolaryngologists-in-the-past-decade
#1
Alexandria L Irace, Catherine Shank, Eelam A Adil, Michael J Cunningham, Kosuke Kawai, Georgios Sideridis, Reza Rahbar
Importance: Monitoring current trends in pediatric otolaryngology will help adjust our training and practice paradigms in a way that ensures the long-term viability of the specialty. Objectives: To gauge the current scope of pediatric otolaryngology (ORL) practice within and outside of the United States and to identify changes in caseload over the past decade. Design, Setting, and Participants: An online survey was sent to pediatric ORL chairs and/or fellowship directors at 42 institutions in the United States and abroad...
February 22, 2018: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29470378/preanesthesia-concerns-in-a-patient-with-a-thyroid-mass
#2
Gayle B Bodner, Ashley L Talbott
Preoperative evaluation helps identify patient comorbidities and surgical characteristics that increase perioperative risk, and also can help identify patients with potentially difficult airways. Identifying patients with difficult airways before surgery lets clinicians plan appropriate perioperative management and prepare for potential complications. This article focuses on management of a difficult airway in a patient undergoing surgery for a thyroid mass.
March 2018: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/29468685/a-rapid-cycle-method-for-local-adaptation-of-an-obstetric-emergencies-training-program
#3
Kiren Ghag, Cathy Winter, Rachna Bahl, Mary Lynch, Nayda Bautista, Rogelio Ilagan, Timothy J Draycott
OBJECTIVE: To describe the adaptation of an obstetric emergencies training program to align with local clinical practice. METHODS: A feasibility study was conducted to investigate the potential implementation of the PRactical Obstetric Multi-Professional Training (PROMPT) program at eight urban tertiary hospitals in the Philippines. Multi-professional teams attended a 2-day course on September 23 and 24, 2015, that comprised a demonstration PROMPT course (day 1) and a Train-the-Trainers session (day 2)...
February 22, 2018: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/29467082/national-survey-on-airway-and-difficult-airway-management-in-intensive-care-units
#4
M G Gómez-Prieto, M R Míguez-Crespo, J R Jiménez-Del-Valle, M D González-Caro, I Marmesat-Ríos, J Garnacho-Montero
OBJECTIVE: To know organization, management and training in airway (AW) in Spanish Intensive Care Units (ICUs), with special interest in difficult airway (DAW). DESIGN: Descriptive cross-sectional study and χ2 subanalysis, conducted through a national survey from november 1th to december 15th, 2016. With the SEMICYUC's support, an online questionnaire of 27 items was sent to 179 ICUs. SETTING: ICUs of public, private centers, and consortia...
February 18, 2018: Medicina Intensiva
https://www.readbyqxmd.com/read/29466477/mysinusitiscoach-patient-empowerment-in-chronic-rhinosinusitis-using-mobile-technology
#5
S F Seys, J Bousquet, C Bachert, W J Fokkens, I Agache, M Bernal-Sprekelsen, I Callebaut, L O Cardel, S Carrie, P Castelnuovo, R Cathcart, J Constantinidis, L Cools, M Cornet, G Clement, J C de Sousa, T Cox, M Doulaptsi, P Gevaert, C Hopkins, V Hox, T Hummel, W Hosemann, R Jacobs, M Jorissen, B N Landis, A Leunig, V J Lund, J Mullol, M Onerci, S Palkonen, I Proano, E Prokopakis, D Ryan, H Riechelmann, J Saevels, C Segboer, K Speleman, E A Steinsvik, P Surda, P V Tomasiz, O Vanderveken, L Van Gerven, T Van Zele, B Verhaeghe, K Vierstraete, S Vlaminck, J Wilkinson, S Williams, B Pugin, P W Hellings
Mobile health technology is emerging to take a prominent position in the management of chronic diseases. These technologies aim at enhancing patient empowerment via education and self-management. To date, of all the different apps available for patients with sinus disease, none were developed by medical experts dealing with chronic rhinosinusitis (CRS). The European Forum for Research and Education in Allergy and Airway diseases (EUFOREA) has undertaken a multi-stakeholder approach for designing, developing and implementing a tool to support CRS patients in monitoring their symptoms and to provide patients with a digital support platform containing reliable medical information about their disease and treatment options...
February 21, 2018: Rhinology
https://www.readbyqxmd.com/read/29465600/a-novel-endobronchial-approach-to-massive-hemoptysis-complicating-silicone-y-stent-placement-for-tracheobronchomalacia-a-case-report
#6
Changwan Ryu, Daniel Boffa, Kyle Bramley, Margaret Pisani, Jonathan Puchalski
RATIONALE: Airway stabilization for severe, symptomatic tracheobronchomalacia (TBM) may be accomplished by silicone Y-stent placement. Common complications of the Y-stent include mucus plugging and granulation tissue formation. PATIENT CONCERNS: We describe a rare case of massive hemoptysis originating from a silicone Y-stent placed for TBM. DIAGNOSES: An emergent bronchoscopy showed an actively bleeding, pulsatile vessel at the distal end of the left bronchial limb of the Y-stent...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29465279/a-continuous-quality-improvement-airway-program-results-in-sustained-increases-in-intubation-success
#7
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/29465199/-injury-prevention-while-ensuring-the-airway-during-surgery-in-the-nose-and-sinuses
#8
E V Ivlev, E A Ruben
THE AIM: A comparative analysis of the injuries of upper airways flexible reinforced laryngeal mask and endotracheal intubation by examining the stress response reaction of the cardiovascular system, as well as the frequency and variety of complications. Blood pressure, heart rate, glucose and cortisol, and complications of airway management in children were analyzed. METHODS: The influence of the method of airway management with surgery in nose and sinuses in children in the stress response, hemodynamics, injuries of the airway were studied...
September 2017: Anesteziologiia i Reanimatologiia
https://www.readbyqxmd.com/read/29461292/inhalation-injury-in-the-burned-patient
#9
Guillermo Foncerrada, Derek M Culnan, Karel D Capek, Sagrario González-Trejo, Janos Cambiaso-Daniel, Lee C Woodson, David N Herndon, Celeste C Finnerty, Jong O Lee
Inhalation injury causes a heterogeneous cascade of insults that increase morbidity and mortality among the burn population. Despite major advancements in burn care for the past several decades, there remains a significant burden of disease attributable to inhalation injury. For this reason, effort has been devoted to finding new therapeutic approaches to improve outcomes for patients who sustain inhalation injuries.The three major injury classes are the following: supraglottic, subglottic, and systemic. Treatment options for these three subtypes differ based on the pathophysiologic changes that each one elicits...
February 15, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29459095/the-pharmacist-s-role-in-supporting-people-living-with-cystic-fibrosis
#10
Olufunmilola Abraham, Jenny S Li, Kathy E Monangai, Alison M Feathers, Daniel Weiner
OBJECTIVES: To describe the critical need for pharmacists' involvement in outpatient care for people living with cystic fibrosis (CF). DATA SOURCES: Not applicable. SUMMARY: CF is a pulmonary condition that affects more than 30,000 children and adults in the United States and 70,000 people worldwide. Various complex medication regimens are given to patients with CF, some depending on the type of mutation they have in their CF transmembrane conductance regulator protein...
February 16, 2018: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/29458746/stridor-combined-with-other-sleep-breathing-disorders-in-multiple-system-atrophy-a-tailored-treatment
#11
Saleheddine Rekik, Francis Martin, Pauline Dodet, Stefania Redolfi, Smaranda Leu-Semenescu, Jean-Christophe Corvol, David Grabli, Isabelle Arnulf
OBJECTIVES: To determine the frequency of sleep breathing disorders in multiple systemic atrophy (MSA, combining Parkinsonism, cerebellar syndrome, and dysautonomia) and evaluate the benefit/tolerance of various modes of ventilation. METHODS: We retrospectively analyzed 45 patients with MSA having undergone a videopolysomnography. Their sleep characteristics were compared to those of 45 patients with Parkinson's disease and 45 healthy controls, matched for age and sex...
February 2018: Sleep Medicine
https://www.readbyqxmd.com/read/29458294/the-impact-of-implementing-an-intensivist-model-with-nighttime-in-hospital-nocturnist-and-effect-on-icu-outcomes
#12
Maged A Tanios, Daniel Teres, Hyunsoon Park, Antonio Beltran, Arunpal Sehgal, James D Leo
BACKGROUND: Various intensivist staffing models have been suggested, but the long-term sustainability and outcomes vary and may not be sustained. We examined the impact of implementing a high-intensity intensivist coverage model with a nighttime in-house nocturnist (non-intensivist) and its effect on intensive care unit (ICU) outcomes. METHODS: We obtained historical control baseline data from 2007 to 2011 and compared the same data from 2011 to 2015. The Acute Physiological and Chronic Health Evaluation outcomes system was utilized to collect clinical, physiological, and outcome data on all adult patients in the medical ICU and to provide severity-adjusted outcome predictions...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29457112/anesthetic-management-during-a-cesarean-section-in-a-patient-with-cleidocranial-dysplasia-a-case-report
#13
Yumiko Nishio, Teruyuki Hiraki, Hiroko Taniguchi, Kazuo Ushijima
Background: Cleidocranial dysplasia is a type of skeletal dysplasia, which is primarily characterized by delayed ossification of skeletal structures. It causes facial and oral abnormalities, resulting in difficult airway management and neuraxial anesthesia. Case presentation: The patient was a 24-year-old primipara (height 138 cm, weight 42 kg) with a hypoplastic right clavicle, patent fontanelles, dental malalignment, and a high palate. She was diagnosed with cleidocranial dysplasia at birth, although gene examination has not been performed...
2018: JA Clin Rep
https://www.readbyqxmd.com/read/29456603/successful-management-of-70-acetic-acid-ingestion-on-the-intensive-care-unit-a-case-report
#14
Andrew Ratcliffe, Andrew Baker, Daniel Smith
Acetic acid is an organic acid available in concentrations from 2 to 80%. Whilst lower concentrations of 2-6% are more commonly used as the table top condiment, vinegar, much stronger solutions are regularly used in Eastern Europe as food preservatives and cleaning solutions. Oral ingestion of greater than 12% has been reported to cause haemolysis, renal failure, shock and death. Most reported cases of deliberate or accidental poisoning are from Russia and Eastern Europe in the 1980s, with very little currently in western publications...
February 2018: Journal of the Intensive Care Society
https://www.readbyqxmd.com/read/29455359/eosinophilic-esophagitis-an-important-comorbid-condition-of-asthma
#15
REVIEW
Sandy R Durrani, Vincent A Mukkada, Theresa W Guilbert
Eosinophilic esophagitis and asthma are frequently found as comorbid conditions in children and adults along with other manifestations of atopic diathesis. These two conditions have similar T helper 2 responses-driven pathophysiology and share common management strategies such as using systemic corticosteroids and targeted anti-cytokine biologic therapies. Review of the literature finds that asthma is often a comorbid condition in eosinophilic esophagitis in both children and adults; however, the EoE-asthma relationship remains poorly characterized mechanistically and clinically...
February 18, 2018: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/29454826/diagnosis-follow-up-and-management-of-sleep-disordered-breathing-in-children-with-osteogenesis-imperfecta
#16
Antoine Léotard, Jessica Taytard, Marion Aouate, Michèle Boule, Veronique Forin, Pauline Lallemant-Dudek
OBJECTIVES: Osteogenesis imperfecta (OI) is the most common genetic skeletal disorder. Extraskeletal findings are common but an association with sleep disordered breathing (SDB) has never been described. The aim of this study was to investigate clinical features of children with OI and suspected SDB. METHODS: A retrospective study of clinical records, signs of SDB and polysomnographic recordings of children with OI was performed. We paid particular attention to symptoms that could be associated with SDB in this population - scoliosis, kyphosis, vertebral arthrodesis, chest wall deformities, basilar impression, autonomy - as well as data already known to be associated with obstructive sleep apnea such as body mass index and upper airway impairment...
February 15, 2018: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/29452732/efficacy-of-pre-hospital-rapid-sequence-intubation-in-paediatric-traumatic-brain-injury-a-9-year-observational-study
#17
Stefan Heschl, Ben Meadley, Emily Andrew, Warwick Butt, Stephen Bernard, Karen Smith
INTRODUCTION: Prehospital airway management of the paediatric patient with traumatic brain injury (TBI) is controversial. Endotracheal intubation of children in the field requires specific skills and has potential benefits but also carries potentially serious complications. We aimed to compare mortality and functional outcomes after six months between children with TBI who either underwent prehospital rapid sequence intubation (RSI) by trained Intensive Care paramedics (ICP) or received no intubation...
February 12, 2018: Injury
https://www.readbyqxmd.com/read/29452722/traumatic-lingual-hematoma-resulting-in-bilateral-temporal-mandibular-joint-dislocations
#18
Dhara P Amin, Michael N Cooper, Kim I Newton
BACKGROUND: Lingual hematoma (LH) is a relatively uncommon entity seen after both medical and traumatic etiologies. Regardless of the cause, the feared complication is acute airway obstruction. CASE REPORT: Our case involves a 39-year-old man who presented to the Emergency Department via emergency medical services with an enlarging LH after an unwitnessed fall, suspected to be an alcohol withdrawal seizure. The bleeding was likely exacerbated by previously undiagnosed thrombocytopenia...
February 13, 2018: Journal of Emergency Medicine
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
#19
Ming-Ming Han, Fu-Shan Xue, Fang Kang, Xiang Huang, Juan 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 (Ce 50 ) 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
https://www.readbyqxmd.com/read/29447888/pathogenesis-of-chronic-rhinosinusitis-in-patients-affected-by-%C3%AE-thalassemia-major-and-sickle-cell-anaemia-post-allogenic-bone-marrow-transplant
#20
F Martino, R Di Mauro, K Paciaroni, J Gaziev, C Alfieri, L Greco, R Floris, S Di Girolamo, M Di Girolamo
OBJECTIVES: Sickle cell anemia (SCA) and β -thalassemia major are well-recognized beta-globin gene disorders of red blood cells associated to mortality and morbidity included bone morbidities due to ineffective erythropoiesis and bone marrow expansion, which affect every part of the skeleton. While there are an abundance of described disease manifestations of the head and neck, the manner of paranasal sinuses involvement and its relations to β-thalassemia and SCA process was not studied yet...
March 2018: International Journal of Pediatric Otorhinolaryngology
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