An unusual cause of intraoperative wheeze and difficult ventilation – saved by the fibreoptic scope

2020 ◽  
Vol 30 ◽  
pp. e124-e125
Author(s):  
Rosie May ◽  
Chima Oti
2021 ◽  
Author(s):  
Kubra Evren Sahin ◽  
◽  
Canan Salman Onemli ◽  

2011 ◽  
Vol 46 (2) ◽  
pp. 117-125 ◽  
Author(s):  
J. Scott Delaney ◽  
Ammar Al-Kashmiri ◽  
Penny-Jane Baylis ◽  
Tracy Troutman ◽  
Mahmood Aljufaili ◽  
...  

Abstract Context: Managing an airway in an unconscious athlete is a lifesaving skill that may be made more difficult by the recent changes in protective equipment. Different airway maneuvers and techniques may be required to help ventilate an unconscious athlete who is wearing full protective equipment. Objective: To assess the effectiveness of different airway maneuvers with football, ice hockey, and soccer players wearing full protective equipment. Design: Crossover study. Setting: University sports medicine clinic. Patients or Other Participants: A total of 146 university varsity athletes, consisting of 62 football, 45 ice hockey, and 39 soccer players. Intervention(s): Athletes were assessed for different airway and physical characteristics. Three investigators then evaluated the effectiveness of different bag-valve-mask (BVM) ventilation techniques in supine athletes who were wearing protective equipment while inline cervical spine immobilization was maintained. Main Outcome Measure(s): The effectiveness of 1-person BVM ventilation (1-BVM), 2-person BVM ventilation (2-BVM), and inline immobilization and ventilation (IIV) was judged by each investigator for each athlete using a 4-point rating scale. Results: All forms of ventilation were least difficult in soccer players and most difficult in football players. When compared with 1-BVM, both 2-BVM and IIV were deemed more effective by all investigators for all athletes. Interference from the helmet and stabilizer were common reasons for difficult ventilation in football and ice hockey players. Conclusions: Sports medicine professionals should practice and be comfortable with different ventilation techniques for athletes wearing full equipment. The use of a new ventilation technique, termed inline immobilization and ventilation, may be beneficial, especially when the number of responders is limited.


2007 ◽  
Vol 104 (4) ◽  
pp. 1004 ◽  
Author(s):  
Xuebing Xu ◽  
Shouzhang She ◽  
Shanglong Yao ◽  
Martin Mok ◽  
Zhiyi Zuo

2004 ◽  
Vol 100 (5) ◽  
pp. 1146-1150 ◽  
Author(s):  
Xavier Combes ◽  
Bertrand Le Roux ◽  
Powen Suen ◽  
Marc Dumerat ◽  
Cyrus Motamed ◽  
...  

Background Management strategies conceived to improve patient safety in anesthesia have rarely been assessed prospectively. The authors undertook a prospective evaluation of a predefined algorithm for unanticipated difficult airway management. Methods After a 2-month period of training in airway management, 41 anesthesiologists were asked to follow a predefined algorithm for management in the case of an unanticipated difficult airway. Two different scenarios were distinguished: "cannot intubate" and "cannot ventilate." The gum elastic bougie and the Intubating Laryngeal Mask Airway (ILMA) were proposed as the first and second steps in the case of impossible laryngoscope-assisted tracheal intubation, respectively. In the case of impossible ventilation or difficult ventilation, the IMLA was recommended, followed by percutaneous transtracheal jet ventilation. The patient's details, adherence rate to the algorithm, efficacy, and complications of airway management processes were recorded. Results Impossible ventilation never occurred during the 18-month study. One hundred cases of unexpected difficult airway were recorded (0.9%) among 11,257 intubations. Deviation from the algorithm was recorded in three cases, and two patients were wakened before any alternative intubation technique attempt. All remaining patients were successfully ventilated with either the facemask (89 of 95) or the ILMA (6 of 95). Six difficult-ventilation patients required the ILMA before completion of the first intubation step. Eighty patients were intubated with the gum elastic bougie, and 13 required a blind intubation through the ILMA. Two patients ventilated with the ILMA were never intubated. Conclusion When applied in accordance with a predefined algorithm, the gum elastic bougie and the ILMA are effective to solve most problems occurring during unexpected difficult airway management.


Author(s):  
Maria M. Zestos ◽  
Dima Daaboul ◽  
Zulfiqar Ahmed ◽  
Nasser Durgham ◽  
Roland Kaddoum

Author(s):  
Dalamagka Maria ◽  

Obesity as a disease causes a restrictive lung disease and is a sufficient predisposing factor for difficult ventilation of the patient in the ventilator. In addition to covid-19, the phenomenon of hard lung is observed as the ventilation of intubated patients is very difficult and recruitment is quite difficult to achieve. The combination is quite difficult as these patients oppose the ventilator. This paper aims to explore the link between obesity and mechanical ventilation in COVID-19 patients.


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