scholarly journals Airway Management Failure after Delayed Extubation in a Patient with Oral Malignant Melanoma Who Underwent Partial Mandibulectomy and Reconstruction with a Free Flap

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Min A. Kwon ◽  
Jaegyok Song ◽  
Seokkon Kim ◽  
Pyeung-wha Oh ◽  
Minji Kang
Keyword(s):  
Airway Management ◽  
Free Flap ◽  
Radical Neck Dissection ◽  
Maxillofacial Surgery ◽  
Supraglottic Airway ◽  
Surgical Trauma ◽  
Emergency Tracheostomy ◽  
Delayed Extubation ◽  
Failed Airway ◽  
Bag Mask Ventilation

Maxillofacial surgery may cause severe complications in perioperative airway management. We report a case of failed airway management in a patient who underwent segmental mandibulectomy, radical neck dissection, and reconstruction with a free flap. The patient was extubated approximately 36 hours after surgery. Approximately 7 hours after extubation, the patient complained of dyspnoea, and respiratory failure followed. Bag-mask ventilation, direct laryngoscopy, video laryngoscopy, and supraglottic airway access were ineffective. The surgical airway was secured with an emergency tracheostomy while performing cardiopulmonary resuscitation. However, the patient experienced permanent hypoxic brain damage. The airway of patients with oral cancer may be compromised postoperatively due to surgical trauma and bulky flap reconstruction. Patients should be closely monitored during the postoperative period to prevent airway failure. Early diagnosis and airway management before airway failure occurs are important. Medical staff should be aware of airway management algorithms, be trained to perform difficult airway management, and have the required equipment readily available.

Failed Airway Management in a Patient with Wound Hematoma After Partial Mandibulectomy and Reconstruction with Free Flap

2013 ◽  
Vol 13 (3) ◽  
pp. 127
Author(s):  
Seokkon Kim ◽  
Jaegyok Song ◽  
Bongjin Kang ◽  
Cheolwhan Choi ◽  
Gyuwoon Choi
Keyword(s):  
Airway Management ◽  
Free Flap ◽  
Failed Airway

Unrecognized failed airway management using a supraglottic airway device

Resuscitation ◽  
2017 ◽  
Vol 119 ◽  
pp. 1-4 ◽  
Author(s):  
Veer D. Vithalani ◽  
Sabrina Vlk ◽  
Steven Q. Davis ◽  
Neal J. Richmond
Keyword(s):  
Airway Management ◽  
Airway Device ◽  
Supraglottic Airway ◽  
Supraglottic Airway Device ◽  
Failed Airway

Airway Management

2019 ◽  
Author(s):  
James M. Dargin ◽  
Lillian L. Emlet
Keyword(s):  
Airway Management ◽  
Critically Ill ◽  
Endotracheal Intubation ◽  
Critically Ill Patients ◽  
Supraglottic Airway ◽  
Positive Pressure ◽  
Emergency Airway ◽  
Rapid Sequence ◽  
Bag Mask Ventilation ◽  
Upper Gastrointestinal

Endotracheal intubation is a commonly performed procedure in the intensive care unit (ICU). Active upper gastrointestinal bleeding, emesis in the airway, and the presence of a cervical collar are just a few examples of conditions encountered in critically ill patients that can make endotracheal intubation difficult. Furthermore, critically ill patients usually require intubation because they have exhausted their physiologic reserve and can deteriorate rapidly due to vasodilation from induction medications, reduction in preload from positive pressure ventilation, hypercapnia and acidosis during periods of apnea, hypoxia from failed attempts at intubation, and an increase in intracranial pressure during laryngoscopy attempts. Up to one third of patients undergoing emergency airway management will develop serious complications, including hypoxemia, hypotension, aspiration, or cardiac arrest. Careful planning, provision of the appropriate equipment and personnel, and an understanding of an individual patient’s physiologic derangements can help to prevent complications during intubation.  This review 13 figures, 4 tables, and 27 references.  Keywords: airway, intubation, endotracheal, rapid sequence, pre-oxygenation, bag-mask ventilation, laryngoscopy, cricothyrotomy, supraglottic airway 

Mask Ventilation, Direct Laryngoscopy, and Supraglottic Airway Placement Procedures

2021 ◽  
pp. 17-36
Author(s):  
Jennifer Anderson
Keyword(s):  
Airway Management ◽  
Direct Laryngoscopy ◽  
Respiratory Arrest ◽  
Supraglottic Airway ◽  
Spontaneous Respiration ◽  
Positive Pressure ◽  
Mask Ventilation ◽  
Airway Patency ◽  
Bag Mask Ventilation ◽  
Respiratory Assistance

The basic skills required for competence in pediatric airway management include mask ventilation, supraglottic airway placement, direct laryngoscopy, and intubation. Although techniques used for children are similar to those used for adults, there are some nuances that pertain only to the pediatric patient. This chapter describes and illustrates these basic airway management procedures for pediatric patients. Bag mask ventilation is used extensively in the operating room, emergency department, and intensive care unit. Effective bag mask ventilation can save a child’s life in emergent situations.1 Respiratory assistance is provided to the patient through a mask on the patient’s face, held in a specialized way to maximize airway patency (described later), that is attached to a device capable of delivering positive pressure manually or automatically. Oxygenation is achieved by compressing air/oxygen through the delivery device into the lungs, and ventilation is ensured by maintaining airway patency as the patient exhales with chest wall recoil. Intubation is indicated in any patient who is unable to maintain adequate spontaneous respiration or who is at risk for aspiration. Examples are patients in respiratory arrest, those in cardiac arrest, or sometimes those experiencing neurologic issues such as seizures. Patients undergoing surgical procedures will often require intubation because of the apnea and risk for aspiration caused by the anesthetics and the surgical procedure itself.

scholarly journals Airway Management of Severe Subglottic Stenosis with a Novel Airway Device

2019 ◽  
Author(s):  
Girish Kumar Singh ◽  
Ankita Kabi ◽  
Nishith Govil ◽  
Vijay Adabala
Keyword(s):  
Airway Management ◽  
Endotracheal Tube ◽  
Guide Wire ◽  
Airway Device ◽  
Subglottic Stenosis ◽  
Supraglottic Airway ◽  
Suction Catheter ◽  
Upper Respiratory Tract ◽  
Unsuccessful Attempt ◽  
Emergency Tracheostomy

S ubglottic stenosis (SS) is the leading cause of stridor in pediatric age group. It involves narrowing of subglottic lumen due to incomplete recanalization during embryogenesis (congenital) or after trauma (post intubation). Stridor is the important symptom of SS and usually present in both phases of respiration. Airway management becomes a challenging task to the anesthesiologist in SS due to difficulty in maneuvering endotracheal tube (ETT) through the noncompliant stricture. Location and extent of stricture also pose difficulty in securing front of neck access [1].  After taking consent of the child’s parent for possible publication in a medical journal, we present a case of subglottic stenosis posted for emergency tracheostomy and ventilated with a novel airway device prepared by simple equipments present in operation theatre. Case Report A one-year-old baby of 11 kg presented to the emergency with chief complaint of noisy breathing developed after upper respiratory tract infection (URTI), fever and cough since 2 days. Child’s stridor started since birth that was progressive in severity and frequency, aggravated by recurrent URTI. At the time of admission, child was in severe respiratory distress with intercostals and suprasternal retraction. Nasal flaring was present with weak cry. Bilateral air entry was decreased with harsh bronchial sounds on auscultation. Hemodynamically child was unstable with heart rate 200 per minute, blood pressure 60/36 mmHg, respiratory rate 44 per minute, axillary temperature 38.5 degree Celsius and SpO2 62% at room air and 88% with Oxygen given by facemask and reservoir at 10 liters per minute. ABG showed pH 7.32, PO2 52 mm Hg, PCO2 68 mm Hg, HCO3 20.2 meq/l and Hb 10.6 mg/dl. Emergency CECT was done which showed the subglottic stenosis of 2.6 mm in length and 2.0 mm of patent airway in diameter at the narrowest point [Figure 1]. Securing the airway was planned with endotracheal intubation followed by surgical tracheostomy and definite correction. Tracheostomy could be done under sedation in a spontaneously breathing child with the aid of facemask or supraglottic airway device. However, an unsuccessful attempt in tracheostomy could completely obstruct the airway and patient may suffer hypoxia. ETT of 2.0 mm ID was not available that day so we decided to make a novel device in place of ETT. We developed a novel airway device by using 6F suction catheter (SC), 18 G intravenous needle catheter, 3.5 mm ID Endotracheal tube connector and guide wire of 10 F Foleys catheter. We cut the connecting end of SC to resize it equivalent to the length of 2.5mm ID ETT and marking the SC with marker at 6 to 10 cm, 1 cm apart. Foleys guide wire was inserted in the SC and whole

Perception and success rate of using advanced airway management by hospital-based paramedics in the Kingdom of Saudi Arabia

2021 ◽  
Vol 6 (3) ◽  
pp. 24-30
Author(s):  
Amani Alenazi ◽  
Bashayr Alotaibi ◽  
Najla Saleh ◽  
Abdullah Alshibani ◽  
Meshal Alharbi ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Airway Management ◽  
Success Rate ◽  
Phase 1 ◽  
Adult Patients ◽  
Supraglottic Airway ◽  
Future Research ◽  
Phase 2 ◽  
Advanced Airway ◽  
Supraglottic Airway Devices

Objective: The study aimed to measure the success rate of pre-hospital tracheal intubation (TI) and supraglottic airway devices (SADs) performed by paramedics for adult patients and to assess the perception of paramedics of advanced airway management.Method: The study consisted of two phases: phase 1 was a retrospective analysis to assess the TI and SADs’ success rates when applied by paramedics for adult patients aged >14 years from 2012 to 2017, and phase 2 was a distributed questionnaire to assess paramedics’ perception of advanced airway management.Result: In phase 1, 24 patients met our inclusion criteria. Sixteen (67%) patients had TI, of whom five had failed TI but then were successfully managed using SADs. The TI success rate was 69% from the first two attempts compared to SADs (100% from first attempt). In phase 2, 63/90 (70%) paramedics responded to the questionnaire, of whom 60 (95%) completed it. Forty-eight (80%) paramedics classified themselves to be moderately or very competent with advanced airway management. However, most of them (80%) performed only 1‐5 TIs or SADs a year.Conclusion: Hospital-based paramedics (i.e. paramedics who are working at hospitals and not in the ambulance service, and who mostly respond to small restricted areas in Saudi Arabia) handled few patients requiring advanced airway management and had a higher competency level with SADs than with TI. The study findings could be impacted by the low sample size. Future research is needed on the success rate and impact on outcomes of using pre-hospital advanced airway management, and on the challenges of mechanical ventilation use during interfacility transfer.

Safe emergency neonatal airway management: current challenges and potential approaches

2021 ◽  
pp. fetalneonatal-2020-319398
Author(s):  
Joyce E O'Shea ◽  
Alexandra Scrivens ◽  
Gemma Edwards ◽  
Charles Christoph Roehr
Keyword(s):  
Laryngeal Mask Airway ◽  
Airway Management ◽  
Neonatal Resuscitation ◽  
Laryngeal Mask ◽  
Viable Alternative ◽  
Supraglottic Airway ◽  
Success Rates ◽  
Facemask Ventilation

This review examines the airway adjuncts currently used to acutely manage the neonatal airway. It describes the challenges encountered with facemask ventilation and intubation. Evidence is presented on how to optimise intubation safety and success rates with the use of videolaryngoscopy and attention to the intubation environment. The supraglottic airway (laryngeal mask airway) is emerging as a promising neonatal airway adjunct. It can be used effectively with little training to provide a viable alternative to facemask ventilation and intubation in neonatal resuscitation and be used as an alternative conduit for the administration of surfactant.

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