Airway ultrasound: Point of care in children—The time is now

2020 ◽  
Vol 30 (3) ◽  
pp. 347-352 ◽  
Author(s):  
Sam J. Daniel ◽  
Gianluca Bertolizio ◽  
Tobial McHugh
Keyword(s):  
Point Of Care ◽  
Airway Ultrasound

scholarly journals Point of care airway ultrasound to select tracheal tube and determine insertion depth in cleft repair surgery

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jung Hwan Ahn ◽  
Jae Hyun Park ◽  
Min Soo Kim ◽  
Hyun Cheol Kang ◽  
Il Seok Kim
Keyword(s):  
Adverse Events ◽  
Tracheal Tube ◽  
Point Of Care ◽  
Conventional Group ◽  
Insertion Depth ◽  
Tube Size ◽  
Airway Complications ◽  
Ultrasound Application ◽  
Ultrasound Group ◽  
Airway Ultrasound

AbstractWe aimed to evaluate the efficacy of using airway ultrasonography to select the correct tracheal tube size and insertion depth in pediatric patients who underwent cleft repair surgery as a way to decrease airway complications and adverse events during perioperative periods. Fifty-one patients (age < 28 months) were consecutively divided into conventional (n = 28) and ultrasound (n = 23) groups. Tracheal tube size and insertion depth were determined using the age-based formula and auscultation in the conventional group, whereas using ultrasonographic measurement of subglottic diameter with auscultation and lung ultrasonography in the ultrasound group. We evaluated the initially selected tube size, insertion depth, ventilatory indices, and the incidence of airway complications and adverse events. Tube insertion depth (median [interquartile range]) was significantly greater in the ultrasound group than in the conventional group (13.5 cm [12.5–14.0] vs 13.0 cm [11.8–13.0], P = 0.045). The number of complications and adverse events was significantly higher in the conventional group than in the ultrasound group (32.1% vs 4.3%, P = 0.013). Airway ultrasound application could reduce airway-related complications and adverse events by determining the appropriate tracheal tube size and insertion depth.

scholarly journals Point-of-Care Airway Ultrasonography Prior to an Emergency Cricothyroidotomy: Case report

2018 ◽  
Vol 18 (2) ◽  
pp. 219 ◽  
Author(s):  
Mohamad Iqhbal ◽  
Julina M. Noor ◽  
Nur A. Karim ◽  
Izzat Ismail ◽  
Halim Sanib ◽  
...  
Keyword(s):  
Emergency Department ◽  
Emergency Medicine ◽  
Critical Care ◽  
Case Report ◽  
Imaging Technique ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Vocal Cords ◽  
Emergency Tracheostomy ◽  
Airway Ultrasound

The use of ultrasonography in acute and critical care medicine is becoming increasingly common. However, use of an airway ultrasound as an adjunct to determine the type of intervention needed and assess complications is not common practice. We report a 56-year-old male who presented to the Emergency Department of the Sungai Buloh Hospital, Selangor, Malaysia, in 2015 with hoarseness, stridor and impending respiratory failure. A point-of-care ultrasound performed to assess the neck and vocal cords indicated a heterogeneous echogenic mass in the larynx, thus ruling out a cricothyroidotomy. The patient was therefore referred for an emergency tracheostomy. This case highlights the importance of point-of-care airway ultrasonography in the assessment of patients with stridor. This imaging technique not only helps to detect the cause of the stridor, but also to determine the feasibility of a cricothyroidotomy in emergency cases.Keywords: Emergency Medicine; Stridor; Ultrasonography; Airway Management; Tracheostomy; Case Report; Malaysia.

“Aspirin - resistance”? A few critical considerations on definition, terminology, diagnosis, clinical value, natural course of atherosclerotic disease, and therapeutic consequences

VASA ◽  
2011 ◽  
Vol 40 (6) ◽  
pp. 429-438 ◽  
Author(s):  
Berent ◽  
Sinzinger
Keyword(s):  
Platelet Function ◽  
Point Of Care ◽  
Aspirin Resistance ◽  
Point Of View ◽  
Evidence Based ◽  
Platelet Function Tests ◽  
Clinical Value ◽  
Vascular Events ◽  
Therapeutic Consequences ◽  
Function Tests

Based upon various platelet function tests and the fact that patients experience vascular events despite taking acetylsalicylic acid (ASA or aspirin), it has been suggested that patients may become resistant to the action of this pharmacological compound. However, the term “aspirin resistance” was created almost two decades ago but is still not defined. Platelet function tests are not standardized, providing conflicting information and cut-off values are arbitrarily set. Intertest comparison reveals low agreement. Even point of care tests have been introduced before appropriate validation. Inflammation may activate platelets, co-medication(s) may interfere significantly with aspirin action on platelets. Platelet function and Cox-inhibition are only some of the effects of aspirin on haemostatic regulation. One single test is not reliable to identify an altered response. Therefore, it may be more appropriate to speak about “treatment failure” to aspirin therapy than using the term “aspirin resistance”. There is no evidence based justification from either the laboratory or the clinical point of view for platelet function testing in patients taking aspirin as well as from an economic standpoint. Until evidence based data from controlled studies will be available the term “aspirin resistance” should not be further used. A more robust monitoring of factors resulting in cardiovascular events such as inflammation is recommended.

Sicher und effizient - Point-of-Care-Messung kardialer Biomarker

2008 ◽  
Vol 37 (10) ◽  
pp. 499-499
Keyword(s):  
Point Of Care

Hämatokrit-induzierte Interferenz bei Point-of-Care Geräten zur Blutzuckermessung

2014 ◽  
Vol 9 (S 01) ◽  
Author(s):  
C Hasslacher ◽  
F Kulozik
Keyword(s):  
Point Of Care

Cloud-Computing: eHealth aus der Wolke

2018 ◽  
Vol 23 (11) ◽  
pp. 38-41
Author(s):  
Sebastian Krolop ◽  
Florian Benthin ◽  
Constanze Knahl
Keyword(s):  
Cloud Computing ◽  
Point Of Care

Cloud-Computing gewinnt auch in Kliniken zunehmend an Bedeutung. Über das Internet bereitgestellte Lösungen verändern nicht nur Verwaltung und Logistik – im klinischen Bereich geht es zum Beispiel um die Nutzung elektronischer Patientenakten am Point-of-Care.

Thrombozytenaggregationshemmer

2003 ◽  
Vol 23 (04) ◽  
pp. 181-185 ◽  
Author(s):  
H. Patscheke
Keyword(s):  
Point Of Care ◽  
Von Willebrand

ZusammenfassungUnabhängig von ihrem Wirkungsmechanismus greifen Antikoagulanzien stets unmittelbar in die Bildung und Wirkung von Thrombin und damit die Endstrecke der Gerinnung ein. Von den Aggregationshemmern hemmen nur die GPIIb/IIIa-Antagonisten die gemeinsame Endstrecke der Plättchenaggregation, indem sie die Bildung von Fibrinogen/von-Willebrand-Faktor-vermittelten Plättchen-Plättchen-Brücken hemmen.Azetylsalizylsäure (ASS), NSARs, Clopidogrel oder Ticlopidin begrenzen die Plättchenaktivierung dagegen, indem sie die Bildung bzw. Wirkung der sekundären Plättchenagonisten Thromboxan A2 bzw. ADP ausschalten, aber z. B. die durch Thrombin direkt induzierbare Plättchenaggregation nicht. Deshalb rufen ASS, Clopidogrel oder Ticlopidin allein kein wesentliches Blutungsrisiko hevor, wenn nicht weitere, die Hämostase beeinträchtigende Faktoren (z.B. ausgeprägte Thrombozytopenie, Antikoagulation) vorliegen. Deshalb entfällt für diese Hemmstoffe auch die Notwendigkeit der Therapiekontrolle. Beim therapeutischen Einsatz von ASS als Aggregationshemmer ist vielmehr die Dosierung darauf abzustellen, eine vollständige Blockade (mind. 90%) der Thromboxanbiosynthese in den Plättchen zu erreichen, um überhaupt einen therapeutischen bzw. prophylaktischen Effekt zu erzielen.Von den GPIIb/IIIa-Antagonisten sind nur die parenteral eingesetzten (Abciximab, Eptifibatid, Tirofiban) zugelassen. Orale GPIIb/IIIa-Antagonisten zeigten bisher in klinischen Studien ein erhöhtes Blutungsrisiko bei nicht ausreichendem therapeutischen Nutzen. Die meisten GPIIb/IIIa-Antagonisten verursachen eine leichte Thrombozytopenie, als deren Auslöser die Inhibitor-Rezeptor-Wechselwirkung bzw. immunologische Mechanismen diskutiert werden. Für das spezifische Monitoring dieser potenten Aggregationshemmer ist ein »Point-of-Care«-Testsystem verfügbar. Für die Einschätzung des Blutungsrisikos müssen jedoch stets alle, die Hämostase beeinflussende Faktoren berücksichtigt werden. Das gilt insbesondere, wenn neben GPIIb/IIIa-Antagonisten Heparin u.a. Wirkstoffe eingesetzt werden.

Handheld-Ultraschall (HHUS) im Point-of-Care-Einsatz – ein probates Mittel zur Verbesserung der ambulanten Versorgung in unterversorgten Regionen. Eine POCUS-Studie aus Brandenburg

2019 ◽  
Author(s):  
H Lo ◽  
C Grulich ◽  
V Walther ◽  
B Seckinger ◽  
D Nürnberg
Keyword(s):  
Point Of Care

Zukunftsfähige Pflege

2017 ◽  
Vol 04 (05) ◽  
pp. 22-22
Keyword(s):  
Point Of Care

ZusammenfassungDurch die Etablierung „exzellent ausgebildeter Pflegeperson am point of care“ verbessert sich die Versorgung nachweislich. Die Fachgesellschaft fordert daher pro Fachstation eine Pflegeperson mit mindestens Bachelorabschluss.

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