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.

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

Management of the Difficult Airway

2018 ◽  
pp. 8-12
Keyword(s):  
Airway Management ◽  
Difficult Airway ◽  
Brain Damage ◽  
Retrospective Review ◽  
Historical Study ◽  
Difficult Airway Management ◽  
Management Planning ◽  
Review Analysis ◽  
Malpractice Claims ◽  
Difficult Airways

This chapter focuses on a study reviewing management of difficult airways to address the question: What are the patterns of liability associated with malpractice claims arising from cases involving difficult airway management? This was a historical study of cases of difficult airway claims occurring between 1985 and 1999, which were reviewed in conjunction with the success of the Difficult Airway Guidelines published in 1993. Although this is a retrospective review, analysis of difficult airway claims demonstrated a reduction in death or brain damage with induction of anesthesia in 1993–1999 compared with 1985–1992, suggesting that the Difficult Airway Guidelines published in 1993 improved airway management planning in cases with anticipated difficult airways.

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.

Formal Instruction in Difficult Airway Management: A Survey of Anesthesiology Residency Programs

1995 ◽  
Vol 83 (6) ◽  
pp. 1343-1346 ◽  
Author(s):  
James N. Koppel ◽  
Allan P. Reed
Keyword(s):  
Airway Management ◽  
Difficult Airway ◽  
Difficult Airway Management ◽  
Residency Programs ◽  
Formal Instruction ◽  
Difficult Airways ◽  
Mechanical Devices

Abstract Background Up to 30% of all deaths attributable to anesthesia are related to difficulties with airway management. The purpose of this study was to determine whether anesthesiology residents are receiving specialized instruction in the various techniques and mechanical devices currently recommended for airway management in patients with anticipated or unanticipated difficult airways.

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 Application of Gum Elastic Bougie to Nasal Intubation

2010 ◽  
Vol 57 (3) ◽  
pp. 112-113 ◽  
Author(s):  
Hirofumi Arisaka ◽  
Shigeki Sakuraba ◽  
Munetaka Furuya ◽  
Kazutoshi Higuchi ◽  
Hitoshi Yui ◽  
...  
Keyword(s):  
Airway Management ◽  
Difficult Airway ◽  
Tracheal Tube ◽  
Oral Surgery ◽  
Nasotracheal Intubation ◽  
Nasal Intubation ◽  
Difficult Airway Management ◽  
Dental Procedures ◽  
Difficult Airways

Abstract Gum elastic bougie (GEB), a useful device for difficult airway management, has seldom been used for nasotracheal intubation. Among 632 patients undergoing dental procedures or oral surgery, GEB was used successfully in 16 patients in whom conventional nasal intubation had failed because of anatomical problems or maldirection of the tip of the tracheal tube. We recommend that GEB should be applied from the first attempt for nasal intubation in patients with difficult airways.

scholarly journals An Algorithm for Difficult Airway Management, Modified for Modern Optical Devices (Airtraq Laryngoscope; LMA CTrach ™)

2011 ◽  
Vol 114 (1) ◽  
pp. 25-33 ◽  
Author(s):  
Roland Amathieu ◽  
Xavier Combes ◽  
Widad Abdi ◽  
Loutfi El Housseini ◽  
Ahmed Rezzoug ◽  
...  
Keyword(s):  
Tracheal Intubation ◽  
Airway Management ◽  
Difficult Airway ◽  
Macintosh Laryngoscope ◽  
Patient Characteristics ◽  
Routine Practice ◽  
Difficult Airway Management ◽  
Management Algorithm ◽  
Airway Devices ◽  
Risk Of Aspiration

Background Because algorithms for difficult airway management, including the use of new optical tracheal intubation devices, require prospective evaluation in routine practice, we prospectively assessed an algorithm for difficult airway management that included two new airway devices. Methods After 6 months of instruction, training, and clinical testing, 15 senior anesthesiologists were asked to use an established algorithm for difficult airway management in anesthetized and paralyzed patients. Abdominal, gynecologic, and thyroid surgery patients were enrolled. Emergency, obstetric, and patients considered at risk of aspiration were excluded. If tracheal intubation using a Macintosh laryngoscope was impossible, the Airtraq laryngoscope (VYGON, Ecouen, France) was recommended as a first step and the LMA CTrach™ (SEBAC, Pantin, France) as a second. A gum elastic bougie was advocated to facilitate tracheal access with the Macintosh and Airtraq laryngoscopes. If ventilation with a facemask was impossible, the LMA CTrach™ was to be used, followed, if necessary, by transtracheal oxygenation. Patient characteristics, adherence to the algorithm, efficacy, and early complications were recorded. Results Overall, 12,225 patients were included during 2 yr. Intubation was achieved using the Macintosh laryngoscope in 98% cases. In the remainder of the cases (236), a gum elastic bougie was used with the Macintosh laryngoscope in 207 (84%). The Airtraq laryngoscope success rate was 97% (27 of 28). The LMA CTrach™ allowed rescue ventilation (n = 2) and visually directed tracheal intubation (n = 3). In one patient, ventilation by facemask was impossible, and the LMA CTrach™ was used successfully. Conclusions Tracheal intubation can be achieved successfully in a large cohort of patients with a new management algorithm incorporating the use of gum elastic bougie, Airtraq, and LMA CTrach™ devices.

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