BET 3: Do head elevation and neck flexion improve laryngeal view and the likelihood of successful intubation

2011 ◽  
Vol 28 (9) ◽  
pp. 811-813
Keyword(s):  
Neck Flexion ◽  
Successful Intubation ◽  
Laryngeal View ◽  
Head Elevation

How Do Drivers Hold Their Phone? Age, Prevalence, & Handedness

2020 ◽  
Vol 64 (1) ◽  
pp. 1254-1257
Author(s):  
Trey Roady ◽  
Kyle Wilson ◽  
Jonny Kuo ◽  
Michael G. Lenné
Keyword(s):  
Law Enforcement ◽  
Mobile Phone ◽  
Eye Movement ◽  
Older Drivers ◽  
Neck Flexion ◽  
Insufficient Evidence ◽  
Mobile Phone Use

Objective Research shows frequent mobile phone use in vehicles but says little regarding how drivers hold their phone. This knowledge would inform countermeasures and benefit law enforcement in detecting phone use. Methods 934 participants were surveyed over phone-use prevalence, handedness, traffic-direction, and where they held their device. Results The majority (66%) reported using their phone while driving. Younger drivers were more likely to use their device. Of device-users, 67% preferred their passenger-side hand, 25% driver-side, and 8% both. Height- wise: 22% held in-lap, 52% even with the wheel, and 22% at wheel-top. Older drivers were more likely to hold the phone in the highest position The three most popular combinations were passenger-middle (35%), passenger-low (19%), and passenger-high (13.9%). There was insufficient evidence of differences based on handedness, prevalence, or traffic-direction. Conclusion Driver-preferred attention regions often require substantial neck flexion and eye-movement, which facilitates distraction detection. However, behavior may change in response to future interventions.

scholarly journals Effect of Head Elevation on Passive Upper Airway Collapsibility in Normal Subjects during Propofol Anesthesia

2011 ◽  
Vol 115 (2) ◽  
pp. 273-281 ◽  
Author(s):  
Masato Kobayashi ◽  
Takao Ayuse ◽  
Yuko Hoshino ◽  
Shinji Kurata ◽  
Shunji Moromugi ◽  
...  
Keyword(s):  
Upper Airway ◽  
Normal Subjects ◽  
Target Concentration ◽  
Airway Patency ◽  
Head Elevation ◽  
Jaw Opening ◽  
Airway Collapsibility ◽  
Upper Airway Collapsibility ◽  
Head Flexion ◽  
Male Subjects

Background Head elevation can restore airway patency during anesthesia, although its effect may be offset by concomitant bite opening or accidental neck flexion. The aim of this study is to examine the effect of head elevation on the passive upper airway collapsibility during propofol anesthesia. Method Twenty male subjects were studied, randomized to one of two experimental groups: fixed-jaw or free-jaw. Propofol infusion was used for induction and to maintain blood at a constant target concentration between 1.5 and 2.0 μg/ml. Nasal mask pressure (PN) was intermittently reduced to evaluate the upper airway collapsibility (passive PCRIT) and upstream resistance (RUS) at each level of head elevation (0, 3, 6, and 9 cm). The authors measured the Frankfort plane (head flexion) and the mandible plane (jaw opening) angles at each level of head elevation. Analysis of variance was used to determine the effect of head elevation on PCRIT, head flexion, and jaw opening within each group. Results In both groups the Frankfort plane and mandible plane angles increased with head elevation (P < 0.05), although the mandible plane angle was smaller in the free-jaw group (i.e., increased jaw opening). In the fixed-jaw group, head elevation decreased upper airway collapsibility (PCRIT ~ -7 cm H₂O at greater than 6 cm elevation) compared with the baseline position (PCRIT ~ -3 cm H₂O at 0 cm elevation; P < 0.05). Conclusion : Elevating the head position by 6 cm while ensuring mouth closure (centric occlusion) produces substantial decreases in upper airway collapsibility and maintains upper airway patency during anesthesia.

Lethal mechanisms in cases of inverted suspension from the lap component of seat belts

2021 ◽  
pp. 002580242199399
Author(s):  
Siobhan O’Donovan ◽  
Neil EI Langlois ◽  
Corinna van den Heuvel ◽  
Roger W Byard
Keyword(s):  
Motor Vehicle ◽  
Seat Belt ◽  
South Australia ◽  
Upper Airway ◽  
Motor Vehicle Crashes ◽  
Blood Alcohol ◽  
Neck Flexion ◽  
Seat Belts ◽  
Respiratory Compromise ◽  
Positional Asphyxia

A retrospective review of autopsy files at Forensic Science South Australia in Adelaide, Australia, was undertaken over a five-year period from January 2014 to December 2018 for all motor vehicle crashes with rollovers ending with the vehicle inverted and the occupants suspended by the lap component of their seat belts. There were five cases, all male drivers (aged 18–67 years; Mage = 32 years). Acute neck flexion or head wedging was noted in four cases, with facial petechiae in four and facial congestion in one. Deaths were due to positional asphyxia in four cases, with the combined effects of positional asphyxia and head trauma accounting for the remaining case. Although all drivers had evidence of head impact which may have caused incapacitation, in only one case was this considered severe enough to have contributed to death. A blood alcohol level above the legal limit for driving was detected in two cases, but no other drugs were detected. This series demonstrates another subset of cases of seat belt–associated deaths where suspension upside down by the lap component of a seat belt had occurred after vehicle rollovers. Predisposing factors include incapacitation of the victim and delay in rescue. The postulated lethal mechanism involved respiratory compromise from the weight of abdominal viscera on the diaphragm, as well as upper airway compromise due to kinking of the neck and wedging of the head.

The Effect of Successful Intubation on Patient Outcomes After Out-of-Hospital Cardiac Arrest in Taipei

2018 ◽  
Vol 71 (3) ◽  
pp. 387-396.e2 ◽  
Author(s):  
Wen-Chu Chiang ◽  
Ming-Ju Hsieh ◽  
Hsin-Lan Chu ◽  
Albert Y. Chen ◽  
Shin-Yi Wen ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Patient Outcomes ◽  
Successful Intubation ◽  
Hospital Cardiac Arrest

Effects of Head Posture on Cerebral Hemodynamics: Its Influences on Intracranial Pressure, Cerebral Perfusion Pressure, and Cerebral Oxygenation

Neurosurgery ◽  
2004 ◽  
Vol 54 (3) ◽  
pp. 593-598 ◽  
Author(s):  
Ivan Ng ◽  
Joyce Lim ◽  
Hwee Bee Wong
Keyword(s):  
Mean Arterial Pressure ◽  
Head Injury ◽  
Intracranial Pressure ◽  
Cerebral Perfusion ◽  
Perfusion Pressure ◽  
Cerebral Oxygenation ◽  
Closed Head Injury ◽  
Head Posture ◽  
Head Elevation ◽  
Closed Head

Abstract OBJECTIVE Severely head-injured patients have traditionally been maintained in the head-up position to ameliorate the effects of increased intracranial pressure (ICP). However, it has been reported that the supine position may improve cerebral perfusion pressure (CPP) and outcome. We sought to determine the impact of supine and 30 degrees semirecumbent postures on cerebrovascular dynamics and global as well as regional cerebral oxygenation within 24 hours of trauma. METHODS Patients with a closed head injury and a Glasgow Coma Scale score of 8 or less were included in the study. On admission to the neurocritical care unit, a standardized protocol aimed at minimizing secondary insults was instituted, and the influences of head posture were evaluated after all acute necessary interventions had been performed. ICP, CPP, mean arterial pressure, global cerebral oxygenation, and regional cerebral oxygenation were noted at 0 and 30 degrees of head elevation. RESULTS We studied 38 patients with severe closed head injury. The median Glasgow Coma Scale score was 7.0, and the mean age was 34.05 ± 16.02 years. ICP was significantly lower at 30 degrees than at 0 degrees of head elevation (P = 0.0005). Mean arterial pressure remained relatively unchanged. CPP was slightly but not significantly higher at 30 degrees than at 0 degrees (P = 0.412). However, global venous cerebral oxygenation and regional cerebral oxygenation were not affected significantly by head elevation. All global venous cerebral oxygenation values were above the critical threshold for ischemia at 0 and 30 degrees. CONCLUSION Routine nursing of patients with severe head injury at 30 degrees of head elevation within 24 hours after trauma leads to a consistent reduction of ICP (statistically significant) and an improvement in CPP (although not statistically significant) without concomitant deleterious changes in cerebral oxygenation.

Difficult Ventilation in an Infant After Successful Intubation

2021 ◽  
Author(s):  
Kubra Evren Sahin ◽  
◽  
Canan Salman Onemli ◽  
Keyword(s):  
Successful Intubation ◽  
Difficult Ventilation

Evaluating optic nerve head elevation

2021 ◽  
Vol 25 (4) ◽  
pp. e73
Author(s):  
Robert A. Avery ◽  
Carmelina Trimboli-Heidler ◽  
Stacy Pineles ◽  
Gena Heidary
Keyword(s):  
Optic Nerve ◽  
Optic Nerve Head ◽  
Head Elevation

Mandibular Advancement Improves the Laryngeal View during Direct Laryngoscopy Performed by Inexperienced Physicians

2004 ◽  
Vol 100 (3) ◽  
pp. 598-601 ◽  
Author(s):  
Miki Tamura ◽  
Teruhiko Ishikawa ◽  
Rie Kato ◽  
Shiroh Isono ◽  
Takashi Nishino
Keyword(s):  
Direct Laryngoscopy ◽  
Statistical Difference ◽  
Elective Surgery ◽  
Muscle Relaxation ◽  
Mandibular Advancement ◽  
Friedman Test ◽  
Rating Score ◽  
Laryngeal View ◽  
Statistical Comparison ◽  
The Third

Background When oral or nasal fiberoptic laryngoscopy is attempted, mandibular advancement has been reported to improve the laryngeal view. The authors hypothesized that mandibular advancement may also improve the laryngeal view during direct laryngoscopy. Methods Forty patients undergoing elective surgery under general anesthesia were included in this study. After establishment of an adequate level of anesthesia and muscle relaxation, direct laryngoscopy was performed by inexperienced physicians. Four different maneuvers--simple direct laryngoscopy without any assistance (C), simple direct laryngoscopy with mandibular advancement (M), simple direct laryngoscopy with the BURP maneuver (backward, upward, rightward pressure maneuver of the larynx; B), and simple direct laryngoscopy with both mandibular advancement and the BURP maneuver (BM)--were attempted in each subject, and the laryngeal aperture was videotaped with each procedure. An instructor in anesthesiology who was blinded to the procedure evaluated the visualization by reviewing videotape off-line, using the Cormack-Lehane classification system (grades I-IV) and a rating score within each subject (1 = best view; 4 = poorest view). The Friedman test followed by the Student-Newman-Keuls test was performed for statistical comparison. P < 0.05 was considered significant. Results The laryngeal view was improved with M and B when compared with C (P < 0.05 by both rating and Cormack-Lehane evaluation). BM was the most effective method to visualize the laryngeal aperture (P < 0.05, vs. B and M by rating evaluation), whereas B and M were the second and the third most effective methods, respectively. No statistical difference was observed between B and M with the Cormack-Lehane classification. Conclusion Mandibular advancement improves the laryngeal view during direct laryngoscopy performed by inexperienced physicians.

Sign in / Sign up

Export Citation Format

Share Document