Surgical airway management

Abstract Klippel-Feil syndrome (KFS) is a rare disease characterized by a classic triad comprising a short neck, a low posterior hairline, and restricted motion of the neck due to fused cervical vertebrae. We report repeated anesthetic management for orthognathic surgeries for a KFS patient with micrognathia. Because KFS can be associated with a number of other anomalies, we therefore performed a careful preoperative evaluation to exclude them. The patient had an extremely small mandible, significant retrognathia, and severe limitation of cervical mobility due to cervical vertebral fusion. As difficult intubation was predicted, awake nasal endotracheal intubation with a fiberoptic bronchoscope was our first choice for gaining control of the patient's airway. Moreover, the possibility of respiratory distress due to postoperative laryngeal edema was considered because of the surgeries on the mandible. In the operating room, tracheotomy equipment was always kept ready if a perioperative surgical airway control was required. Three orthognathic surgeries and their associated anesthetics were completed without a fatal outcome, although once the patient was transferred to the intensive care unit for precautionary postoperative airway management and observation. Careful preoperative examination and preparation for difficult airway management are important for KFS patients with micrognathia.

Download Full-text

A retrospective study of surgical airway management in prehospital settings

Journal of the Japanese Society of Intensive Care Medicine ◽

10.3918/jsicm.22.105 ◽

2015 ◽

Vol 22 (2) ◽

pp. 105-111

Author(s):

Kazuaki Shigemitsu ◽

Hirotaka Sawano ◽

Tomoaki Natsukawa ◽

Yasuyuki Hayashi ◽

Tatsuro Kai

Keyword(s):

Retrospective Study ◽

Airway Management ◽

Surgical Airway

Download Full-text

Airway Management in Accident and Emergency

10.5772/intechopen.96477 ◽

2021 ◽

Author(s):

Kemal Tolga Saracoglu ◽

Gul Cakmak ◽

Ayten Saracoglu

Keyword(s):

Airway Management ◽

Rapid Sequence Intubation ◽

Training Materials ◽

Accident And Emergency ◽

Rapid Sequence ◽

Surgical Airway ◽

Tracheobronchial Injury ◽

Airway Devices ◽

Stabilization Technique ◽

Extraglottic Airway Devices

Accidents are associated with airway complications. Tracheobronchial injury, pneumothorax, pneumomediastinum, atelectasis, and subcutaneous emphysema can be observed. Therefore airway management in emergency medicine requires skills and equipment. Rapid-sequence intubation, effective preoxygenation, apneic oxygenation, manual inline stabilization technique should be used properly. Rapid-sequence intubation consists of sedation, analgesia, and muscle paralysis components. Videolaryngoscopes, supraglottic and extraglottic airway devices, bougie and surgical airway tools are among training materials. A range of training materials have been described to improve providers’ understanding and knowledge of patient safety. In conclusion providing oxygenation, minimizing the risk of complications and choosing the appropriate devices constitute the airway management’s pearls.

Download Full-text

Prehospital Surgical Airway Management: An NAEMSP Position Statement and Resource Document

Prehospital Emergency Care ◽

10.1080/10903127.2021.1995552 ◽

2022 ◽

Vol 26 (sup1) ◽

pp. 96-101

Author(s):

Robert F. Reardon ◽

Aaron E. Robinson ◽

Rebecca Kornas ◽

Jeffrey D. Ho ◽

Brendan Anzalone ◽

...

Keyword(s):

Airway Management ◽

Position Statement ◽

Surgical Airway

Download Full-text

Autonomous Cricothyroid Membrane Detection Using Neural Networks for First-Aid Surgical Airway Management

Volume 10: 44th Mechanisms and Robotics Conference (MR) ◽

10.1115/detc2020-22190 ◽

2020 ◽

Author(s):

Xiaoxue Han ◽

Hailin Ren ◽

Pinhas Ben-Tzvi

Keyword(s):

Airway Management ◽

Spatial Information ◽

Region Of Interest ◽

First Aid ◽

Cricothyroid Membrane ◽

Global Features ◽

Severe Injuries ◽

Anatomy And Physiology ◽

Surgical Airway ◽

Improved Performance

Abstract Airway management is one of the most important priorities when dealing with patients with severe injuries, but knowledge of the important anatomy and physiology is needed for providers to perform a successful surgery. This paper provides a solution for the precise cricothyroid membrane detection problem for real-time surgical airway management applications. With a commercial compact and portable cricothyrotomy kit, the proposed method will enable providers with general knowledge to perform successful first-aid airway management. In this paper, we propose a Hybrid Neural Network (HNNet), consisting of two parallel computing ensembles. The first ensemble takes as an input a low-resolution global image and outputs the Region-of-Interest (ROI) from the predefined grids. The high-resolution image is then cropped according to the ROI, and fed into the second ensemble to achieve precise keypoint detection. Global features and their spatial information from the first ensemble are also fed into the second ensemble to improve the precision. A dataset that consists of over 16,000 images from 13 subjects is built, and the location of the cricothyroid membrane in each image is precisely labeled by medical experts. The training results are presented to show both the efficiency and improved performance of our proposed method compared to existing ones.

Download Full-text