scholarly journals Secrets to a successful awake fibreoptic intubation (AFOI) on a patient with odentogenous abscess

2021 ◽  
Vol 14 (2) ◽  
pp. e238600
Author(s):  
Ming Kai Teah ◽  
Esther Huey Ring Liew ◽  
Melvin Teck Fui Wong ◽  
Tat Boon Yeap
Keyword(s):  
Tracheal Intubation ◽  
Airway Management ◽  
Difficult Airway ◽  
Patient Outcomes ◽  
Fibreoptic Intubation

Awake fibreoptic intubation (AFOI) is an established modality in patients with anticipated difficulty with tracheal intubation. This case demonstrates that with careful and meticulous preparations, AFOI can lead to improved airway management and excellent patient outcomes. A 38-year-old woman presented with severe trismus secondary to odentogenous abscess was identified preoperatively as having a potential difficult airway. AFOI was performed successfully using combined Spray-As-You-Go and dexmedetomidine technique.

scholarly journals The retrograde tracheal intubation technique for difficult airway management

2019 ◽  
Vol 3 (2) ◽  
pp. e16 ◽  
Author(s):  
Vincenzo Marchello ◽  
Ruggero M. Corso ◽  
Emanuele Piraccini ◽  
Alfredo Del Gaudio ◽  
Giuseppe Mincolelli ◽  
...  
Keyword(s):  
Tracheal Intubation ◽  
Airway Management ◽  
Difficult Airway ◽  
Difficult Airway Management ◽  
Intubation Technique

Interprofessional simulation training in difficult airway management: a narrative review

2020 ◽  
Vol 29 (1) ◽  
pp. 36-43 ◽  
Author(s):  
Maria Coyle ◽  
Daphne Martin ◽  
Karen McCutcheon
Keyword(s):  
Literature Review ◽  
Airway Management ◽  
Difficult Airway ◽  
Patient Outcomes ◽  
Simulation Training ◽  
Vital Role ◽  
Difficult Airway Management ◽  
Narrative Literature ◽  
Narrative Literature Review ◽  
The Impact

The aim of this narrative literature review was to explore the impact of interprofessional simulation-based team training on difficult airway management. The Fourth National Audit Project of The Royal College of Anaesthetists and The Difficult Airway Society identified recurrent deficits in practice that included delayed recognition of critical events, inadequate provision of appropriately trained staff and poor collaboration and communication strategies between teams. Computerised databases were assessed to enable data collection, and a narrative literature review and synthesis of eight quantitative studies were performed. Four core themes were identified: debriefing, measures of assessment and evaluation, non-technical skills and patient safety, and patient outcomes. There are many benefits to be gained from interprofessional simulation training as a method of teaching high-risk and infrequent clinical airway emergencies. The practised response to emergency algorithms is crucial and plays a vital role in the reduction of errors and adverse patient outcomes.

scholarly journals Dexmedetomidine in the Management of Awake Fiberoptic Intubation

2019 ◽  
Vol 13 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Aniello Alfieri ◽  
Maria B. Passavanti ◽  
Sveva Di Franco ◽  
Pasquale Sansone ◽  
Paola Vosa ◽  
...  
Keyword(s):  
Airway Management ◽  
Difficult Airway ◽  
Practice Guidelines ◽  
Gold Standard ◽  
Fibreoptic Intubation ◽  
Patient Comfort ◽  
Fiberoptic Intubation ◽  
Difficult Airway Management ◽  
Patient Discomfort ◽  
Awake Fiberoptic Intubation

Awake Fibreoptic Intubation (AFOI) is, nowadays, the gold standard in predicted difficult airway management. Numerous practice guidelines have been developed to assist clinicians facing with a difficult airway. If conducted without sedation, it is common that this procedure may lead to high patient discomfort and severe hemodynamic responses. Sedation is frequently used to make the process more tolerable to patients even if it is not always easy to strike a balance between patient comfort, safety, co-operation, and good intubating conditions. In the last years, many drugs and drug combinations have been described. This minireview aims to discuss the evidence supporting the use of Dexmedetomidine (DEX) in the AFOI management.

scholarly journals Tracheal Intubation with Aura-i and aScope-2: How to Minimize Apnea Time in an Unpredicted Difficult Airway

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Vittorio Pavoni ◽  
Valentina Froio ◽  
Alessandra Nella ◽  
Martina Simonelli ◽  
Lara Gianesello ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Tracheal Intubation ◽  
Airway Management ◽  
Difficult Airway ◽  
Laryngeal Mask ◽  
Difficult Airway Management ◽  
Ventilation Technique ◽  
The Subject ◽  
Airway Devices ◽  
Entire Procedure

The supraglottic airway’s usefulness as a dedicated airway is the subject of continuing development. We report the case of an obese patient with unpredicted difficult airway management in which a new “continuous ventilation technique” was used with the Aura-i laryngeal mask and the aScope-2 devices. The aScope-2/Aura-i system implemented airway devices for the management of predictable/unpredictable difficult airway. The original technique required the disconnection of the mount catheter from Aura-i, the introduction of the aScope-2 into the laryngeal mask used as a conduit for video assisted intubation and then towards the trachea, followed by a railroading of the tracheal tube over the aScope-2. This variation in the technique guarantees mechanical ventilation during the entire procedure and could prevent the risk of hypoventilation and/or hypoxia.

scholarly journals ¿ Caminamos hacia el manejo del videolaringoscopio como primera opción en una vía aérea difícil?

2020 ◽  
Vol 12 (7) ◽  
pp. 1
Author(s):  
Juan José Correa Barrera ◽  
Mónica San Juan Álvarez ◽  
Blanca Gómez Del Pulgar Vázquez ◽  
Gholamian Ovejero Soraya
Keyword(s):  
Decision Making ◽  
Tracheal Intubation ◽  
Airway Management ◽  
Difficult Airway ◽  
The Other ◽  
Optimal Decision ◽  
Difficult Airway Management ◽  
Toma De Decisiones ◽  
Failed Airway ◽  
Optimal Decision Making

Determinar los factores predictivos de una vía aérea difícil constituye un reto para el médico anestesiólogo. La mayoría de guías actuales, sitúan los videolaringoscopios como elementos de rescate de una vía aérea fallida, tras una laringoscopia tradicional óptima. Establecer un algoritmo que en base a unas características físicas, permita determinar qué pacientes se beneficiarán del uso del videolaringoscopio como primera opción, puede suponer una ventaja y una disminución en los problemas relacionados con la vía aérea. Por otra parte, establecer cuáles de estos factores predicen con más fuerza una dificultad con el videolaringoscopio, nos ayudará a realizar mejores planes de abordaje y una óptima toma de decisiones sobre una vía aérea difícil. Este algoritmo ha sido capaz de conseguir la intubación traqueal de todos los pacientes en los que se ha previsto una laringoscopia difícil. ABSTRACT Moving towards videolaryngoscopy handling as first option in difficult airway management? Determining the predictors of a difficult airway is a challenge for the anesthesiologist. Most current guides place videolaryngoscopes as recue elements of a failed airway, after an optimal traditional laryngoscopy. Establishing an algorithm which, based on physical charcteristics, allows to determine which patients will benefit from the use of videolaryngoscopy as a first option, may lead to a potential advantage and a net decrease in airway related problems. On the other hand, establishing which of those factors predict in a more reliable way a difficulty with the videolaryngoscopy, will contribute to make better plans of approach as well as an optimal decision making on a difficult airway. This algorithm has been able to achieve tracheal intubation of all patients for which a difficult laryngoscopy is expected.

scholarly journals An Audit of Fibreoptic Intubation Training Opportunities in a UK Teaching Hospital

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
M. D. Wiles ◽  
R. A. McCahon ◽  
J. A. M. Armstrong
Keyword(s):  
Tracheal Intubation ◽  
Confidence Interval ◽  
Airway Management ◽  
Teaching Hospital ◽  
Fibreoptic Intubation ◽  
Adult Patients ◽  
The Uk ◽  
Training Opportunities ◽  
Safe Anaesthesia

Airway management is the foundation upon which anaesthesia is built, and fibreoptic intubation (FOI) is a key facet of this skill. Despite this, many trainee anaesthetists in the UK have been unable to perform sufficient FOIs to gain competence. We aimed to establish the incidence of FOI in adult patients, in a UK teaching hospital, in order to determine what FOI training opportunities actually exist. During the study period (from October 1st, 2008, to September 30th, 2009) an estimated 11 712 general anaesthetics were undertaken that necessitated tracheal intubation. In 141 of these cases FOIs were performed giving an incidence of FOI of 1.2% (95% confidence interval 1%–1.4%). Of these, 86 (61%) were in awake and 55 (39%) in anaesthetised patients. Only 16 (11%) of the FOIs were done solely for the purposes of training. We suggest that a greater number of FOIs should be undertaken to allow trainees to gain and consultants to maintain the FOI expertise necessary for the provision of safe anaesthesia.

Awake Fiberoptic or Awake Laryngoscopic Tracheal Intubation in Patients With Anticipated Difficult Airway Management

2013 ◽  
Vol 57 (1) ◽  
pp. 46
Author(s):  
Charlotte V. Rosenstock ◽  
Bente Thøgersen ◽  
Arash Afshari ◽  
Anne-Lise Christensen ◽  
Claus Eriksen ◽  
...  
Keyword(s):  
Tracheal Intubation ◽  
Airway Management ◽  
Difficult Airway ◽  
Difficult Airway Management

scholarly journals Impacted tooth brush in retromolar area: a practical management of difficult airway

2015 ◽  
Vol 1 (1) ◽  
pp. 51-54 ◽  
Author(s):  
Gopendra Prasad Deo ◽  
Prakash Chandra Majhi
Keyword(s):  
Case Report ◽  
Foreign Body ◽  
Tracheal Intubation ◽  
Airway Management ◽  
Difficult Airway ◽  
Foreign Bodies ◽  
Impacted Tooth ◽  
Operative Complications ◽  
Retromolar Region ◽  
The Right

Proper airway management is an important skill for an Anaesthesiologist. This case report deals with airway management performed in a forty five years lady, with impacted tooth brush in the retromolar region on the right side. She was intubated and the foreign body was removed surgically without any peri-operative complications. This case report discusses the complications and management of oropharyngeal injuries by stick-like foreign bodies such as a toothbrush or a chopstick. The article also focuses on basic airway management and some tracheal intubation techniques that may be performed to solve a difficult airway.Journal of Society of Anesthesiologists 2014 1(1): 51-54

scholarly journals Managing Known Difficult Airways in Obstetric Patients Using a Flexible Bronchoscope and IRRIS: A Case-Illustrated Guide for Nonexpert Anesthesiologists, without Surgical Backup

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Kjartan E. Hannig ◽  
Rasmus W. Hauritz ◽  
Christian Jessen ◽  
Jan Herzog ◽  
Anders M. Grejs ◽  
...  
Keyword(s):  
Tracheal Intubation ◽  
Airway Management ◽  
Difficult Airway ◽  
Physiological Changes ◽  
Difficult Airway Management ◽  
Successful Intubation ◽  
Flexible Bronchoscope ◽  
Difficult Airways ◽  
Invasive Techniques ◽  
Nose And Throat

Pregnancy is associated with anatomical and physiological changes leading to potential difficult airway management. Some pregnant women have known difficult airways and cannot be intubated even with a hyperangulated videolaryngoscope. If neuraxial techniques are also impossible, awake tracheal intubation with a flexible bronchoscope may be one of the few available options to avoid more invasive techniques. The Infrared Red Intubation System (IRRIS) may help nonexpert anesthesiologists in such situations and may enhance the chance of successful intubation increasing safety for the mother and the fetus, especially in hospitals without the ear, nose, and throat surgical backup.

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