Comparative Study of Airway Management Techniques with Restricted Access to Patient Airway

2007 ◽  
Vol 11 (3) ◽  
pp. 330-336 ◽  
Author(s):  
John D. Hoyle ◽  
Jeffrey S. Jones ◽  
Matthew Deibel ◽  
David T. Lock ◽  
Diann Reischman
2016 ◽  
Vol 23 (4) ◽  
pp. 286-291 ◽  
Author(s):  
Christoph Jänig ◽  
Julia Wenzel ◽  
Jochem König ◽  
Tim Piepho

2008 ◽  
Vol 36 (4) ◽  
pp. 513-515
Author(s):  
R. C. Clarke ◽  
A. I. Gardner

The purpose of this study was to estimate the exposure of trainees to airway management techniques in an Australian tertiary adult teaching hospital. Anaesthesia records for all patients over a 20-week period were reviewed and the following data were obtained: the presence of a trainee, the type of airway used, the grade of the laryngoscopic view and the use of non-standard laryngoscopy for intubation. Data was recorded contemporaneously and analysed retrospectively. The data was then extrapolated to give a yearly estimate of airway procedures per trainee. There were 28 full-time trainees in the department over the study period. The estimated mean number of standard intubations performed per trainee per year was 157.4, with 2.9% being grade 3 or 4 laryngoscopies. The estimated mean annual numbers for other airway techniques were: 1.2 fibreoptic intubations, 0.5 mask-only anaesthetics and 3.7 endobronchial double-lumen tubes. Our results suggest that trainees’ exposure to airway management techniques is not extensive. As there is no previous study to determine experience gained by trainees, we are unable to establish whether there has been a decrease in experience, however we believe this is likely. Although competency is difficult to assess, it may be that this data has implications for training, unsupervised practice and rostering. Experience in certain airway skills may need to be supplemented using techniques such as simulation.


2013 ◽  
pp. 143-154
Author(s):  
Jay R. Pinsky ◽  
Carin A. Hagberg

2005 ◽  
Vol 15 (9) ◽  
pp. 396-399
Author(s):  
Emma Durmaz

Airway obstruction is the most common cause of death in the prehospital environment. It is estimated that 85% of these patients had otherwise survivable injuries. The aim of the project was to increase firefighters' skills in airway management techniques, to include the laryngeal mask airway (LMA), by providing theatre-based hospital placements under the supervision of a consultant anaesthetist. The training in the use of the LMA by firefighters is currently a pilot project to assess the potential for its use operationally, based on ease of training to a competent level and retention of skills after one year.


2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Georgios Tziatzios ◽  
Dimitrios N. Samonakis ◽  
Theocharis Tsionis ◽  
Spyridon Goulas ◽  
Dimitrios Christodoulou ◽  
...  

Objectives. To examine the impact of endoscopy setting (hospital-based vs. office-based) on sedation/analgesia administration and to provide nationwide data on monitoring practices among Greek gastroenterologists in real-world settings. Material and Methods. A web-based survey regarding sedation/analgesia rates and monitoring practices during endoscopy either in a hospital-based or in an office-based setting was disseminated to the members of the Hellenic Society of Gastroenterology and Professional Association of Gastroenterologists. Participants were asked to complete a questionnaire, which consisted of 35 items, stratified into 4 sections: demographics, preprocedure (informed consent, initial patient evaluation), intraprocedure (monitoring practices, sedative agents’ administration rate), and postprocedure practices (recovery). Results. 211 individuals responded (response rate: 40.3%). Propofol use was significantly higher in the private hospital compared to the public hospital and the office-based setting for esophagogastroduodenoscopy (EGD) (85.8% vs. 19.5% vs. 10.5%, p<0.0001) and colonoscopy (88.2% vs. 20.1% vs. 9.4%, p<0.0001). This effect was not detected for midazolam, pethidine, and fentanyl use. Endoscopists themselves administered the medications in most cases. However, a significant contribution of anesthesiology sedation/analgesia provision was detected in private hospitals (14.7% vs. 2.8% vs. 2.4%, p<0.001) compared to the other settings. Only 35.2% of the private offices have a separate recovery room, compared to 80.4% and 58.7% of the private hospital- and public hospital-based facilities, respectively, while the nursing personnel monitored patients’ recovery in most of the cases. Participants were familiar with airway management techniques (83.9% with bag valve mask and 23.2% with endotracheal intubation), while 49.7% and 21.8% had received Basic Life Support (BLS) and Advanced Life Support (ALS) training, respectively. Conclusion. The private hospital-based setting is associated with higher propofol sedation administration both for EGD and for colonoscopy. Greek endoscopists are adequately trained in airway management techniques.


2020 ◽  
pp. 194338752095009
Author(s):  
Akshilkumar Patel ◽  
Robert Saadi ◽  
Jessyka G. Lighthall

Study Design: The present study is a systematic review of the literature. Objective: The goal of this study is to review our experience and the current literature on airway management techniques in maxillofacial trauma. Methods: Independent searches of the PubMed and MEDLINE databases were performed from January 1, 2019 to February 1, 2019. Articles from the period of 2008 to 2018 were collected. All studies which described both airway management and maxillofacial trauma using the Boolean method and relevant search term combinations, including “maxillofacial,” “trauma,” and “airway,” were considered. Results: A total of 452 relevant articles in total were identified. Articles meeting inclusion criteria by abstract review included 68 total articles, of which 16 articles were focused on airway management techniques for maxillofacial trauma in the general population and were deemed appropriate for inclusion in the literature review. Conclusions: Establishing an effective and stable airway in patients with maxillofacial trauma is of paramount concern. In both the acute setting and during delayed reconstruction, special considerations must be taken when securing a reliable airway in this patient population. The present article provides techniques for securing the airway and algorithms for utilization of these techniques, including both during the initial evaluation and the definitive operative management.


2002 ◽  
Vol 81 (4) ◽  
pp. 223-226 ◽  
Author(s):  
Rose Mary S. Stocks ◽  
Robert Egerman ◽  
Jerome W. Thompson ◽  
Michael Peery

Successful airway management of an infant or child with moderate to severe retrognathia first requires recognition of a potential problem. If the child cannot be intubated in a standard fashion, the use of a laryngeal mask airway (LMA) should be considered. We describe two cases wherein a toddler and an infant with severe retrognathia failed multiple attempts at traditional intubation. Both had an anterior larynx and hypoplasia of the mandible. In both cases, a subsequent LMA was successfully placed. The severely retrognathic newborn or child presents to the physician a unique challenge in airway management. Techniques to manage this difficult pediatric airway are different from those used in the adult. Otolaryngologists should be aware of this intubation technique and include it in their armamentarium of airway-management strategies. The LMA is not recommended as the technique of choice for securing a difficult airway, but it is an effective alternative when indicated, and it might be life-saving.


2019 ◽  
Vol 80 (8) ◽  
pp. 432-440 ◽  
Author(s):  
J Hews ◽  
K El-Boghdadly ◽  
I Ahmad

This article reviews the key considerations when managing a patient with a difficult airway. The difficult airway may be anticipated from preassessment allowing time for investigations and preparation. Alternatively, the unanticipated difficult airway can present in an emergency situation, or unexpectedly during a routine anaesthetic. The main airway management techniques are discussed with a description of their advantages and limitations. Current guidelines are included that demonstrate how the techniques are incorporated into an overall strategy with a plan A–D when failure occurs. It is critical to progress through such an algorithm in a timely manner to prevent the onset of hypoxia.


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