scholarly journals Acute Airway Obstruction from Megaoesophagus Secondary to Achalasia Evaluated with Flexible Bronchoscope

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Jun D. Parker
Keyword(s):  
Emergency Department ◽  
Airway Management ◽  
Airway Obstruction ◽  
Diagnostic Tool ◽  
Flexible Bronchoscope ◽  
Management Planning ◽  
Tracheal Compression ◽  
Acute Airway Obstruction

A 94-year-old female presented to the emergency department with acute expiratory stridor. In the absence of an otorhinolaryngologist, an urgent laryngoscopy was performed using a flexible bronchoscope by an anaesthesiologist in the emergency department leading to a change in management. Subsequent radiographs confirmed severe tracheal compression from megaoesophagus secondary to achalasia as the cause of acute airway obstruction. Use of flexible bronchoscope as a diagnostic tool by an anaesthesiologist to evaluate a patient presenting with signs of acute airway obstruction may lead to a safer and more careful airway management planning. Suggestions are also made regarding establishment of emergency surgical airways when conventional approaches fail.

scholarly journals Life–threatening Pulmonary Oedema Secondary to Tracheal Compression

2002 ◽  
Vol 30 (6) ◽  
pp. 804-806 ◽  
Author(s):  
H. Butterell ◽  
R. H. Riley
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Airway Obstruction ◽  
Pulmonary Oedema ◽  
Negative Pressure ◽  
Upper Airway ◽  
Tracheal Compression ◽  
Negative Pressure Pulmonary Oedema ◽  
Life Threatening ◽  
Thyroid Goitre

We present a case of negative pressure pulmonary oedema due to an overlooked cause. A 45-year-old female patient presented to the emergency department unconscious with severe pulmonary oedema. Subsequent investigations revealed a thyroid goitre causing significant tracheal compression. This case report highlights an extremely rare but potentially dangerous sequela of upper airway obstruction.

Corticosteroids in Airway Management

1983 ◽  
Vol 91 (6) ◽  
pp. 593-596 ◽  
Author(s):  
Donald B Hawkins ◽  
Dennis M Crockett ◽  
Tony K Shum
Keyword(s):  
Airway Management ◽  
Airway Obstruction ◽  
Intramuscular Injection ◽  
Upper Airway ◽  
Suppressive Effect ◽  
Upper Airway Obstruction ◽  
Blood Levels ◽  
High Concentration ◽  
Acute Airway Obstruction ◽  
Inflamed Tissue

Adrenal corticosteroids exert a strong suppressive influence on the basic inflammatory response that leads to tissue swelling. The corticosteroid effect is nonspecific. In upper airway obstruction caused by edema from infection, allergy, or trauma, corticosteroids will exert some degree of suppressive effect. The steroid effect is local and directly proportional to the concentration of steroids in the inflamed tissue. In upper airway obstruction steroids should be delivered to the inflamed tissue in high concentration with the least delay. Dexamethasone and methylprednisolone produce high blood levels within 15 to 30 minutes of intramuscular injection. Recommended initial doses for acute airway obstruction are dexamethasone, 1.0 to 1.5 mg/kg, or methylprednisolone, 5 to 7 mg/kg. The risk of harm from steroid therapy of 24 hours or less is negligible.

Nebulised N-acetylcysteine used in acute tracheostoma obstruction

2014 ◽  
Vol 128 (12) ◽  
pp. 1123-1124 ◽  
Author(s):  
A Patel ◽  
C Theokli
Keyword(s):  
At Risk ◽  
Emergency Department ◽  
Case Report ◽  
Airway Obstruction ◽  
Current Management ◽  
Partial Obstruction ◽  
Acute Airway Obstruction

AbstractBackground:Patients with laryngectomy tracheostomas are at risk of developing acute airway obstruction due to mucous crusting. Current management relies on saline nebulisers, followed by suction and manual evacuation to remove the obstruction. This paper describes the first reported case of using N-acetylcysteine nebulisers in addition to saline to adequately soften the mucous plugs in order to facilitate removal.Case report:A 68-year-old female attended the emergency department with a partial obstruction of her laryngectomy tracheostoma as a result of mucous crusting. Saline nebulisers did not provide adequate softening to allow the obstructing mucous plugs to be removed. N-acetylcysteine nebulisers were used to further soften the mucous plugs which successfully resulted in their removal.Conclusion:N-acetylcysteine nebulisers can be used to assist in the removal of mucous plugs in saline-resistant cases.

Prolapsed Nasal Polyp Causing Acute Airway Obstruction: An Exceptional Presentation

ORL ◽  
2021 ◽  
pp. 1-3
Author(s):  
Krupa R. Patel ◽  
Ashton E. Lehmann ◽  
Aria Jafari ◽  
Daniel L. Faden
Keyword(s):  
Airway Obstruction ◽  
Nasal Polyp ◽  
Nasal Polyposis ◽  
Upper Airway ◽  
Rare Presentation ◽  
First Case ◽  
Acute Airway Obstruction ◽  
History Of ◽  
Sinonasal Symptoms ◽  
Or History

Although nasal polyposis is a common clinical entity, there is limited literature describing the rare presentation of sudden prolapse of a massive nasal polyp resulting in an airway emergency in an adult. We present the first case report to our knowledge of a patient without any preceding sinonasal symptoms or history of anticoagulation who experienced acute upper airway obstruction due to sudden hemorrhage and prolapse of a large nasal polyp. Based on our experience treating this patient, we discuss special considerations in all phases of care to ensure safe and effective management of such an exceptional clinical scenario.

scholarly journals Emergency medicine airway leads: a rapid response distributed educational model for emergency department COVID-19 airway management

CJEM ◽  
2021 ◽  
Author(s):  
Adam Harris ◽  
Lorri Beatty ◽  
Nicholas Sowers ◽  
Sam G. Campbell ◽  
David Petrie ◽  
...  
Keyword(s):  
Emergency Department ◽  
Emergency Medicine ◽  
Airway Management ◽  
Rapid Response ◽  
Educational Model

Treacher Collins syndrome with acute airway obstruction

2000 ◽  
Vol 54 (1) ◽  
pp. 41-43 ◽  
Author(s):  
Fahim Ahmed Shah ◽  
S. Ramakrishna ◽  
Vijendra Ingle ◽  
J.E. Dada ◽  
Mazin Al Khabori ◽  
...  
Keyword(s):  
Airway Obstruction ◽  
Treacher Collins Syndrome ◽  
Acute Airway Obstruction

Pre-emptive veno-venous ECMO in advanced tracheal malignancy prior to tracheal stenting

2021 ◽  
Vol 14 (8) ◽  
pp. e243596
Author(s):  
Mohammad Salman Siddiqi ◽  
Adil H Al Kindi ◽  
Ahmed Fahmy Mandisha ◽  
Rashid Al Sukaiti
Keyword(s):  
Carbon Dioxide ◽  
Extracorporeal Membrane Oxygenation ◽  
Airway Obstruction ◽  
Jugular Vein ◽  
Femoral Vein ◽  
Ventilatory Support ◽  
Successful Management ◽  
Flexible Bronchoscope ◽  
Carbon Dioxide Levels ◽  
Vv Ecmo

Extracorporeal membrane oxygenation (ECMO) is helpful in providing ventilatory support when other conventional methods of ventilation fail. We report a case of successful management of advanced tracheal malignancy with impeding airway obstruction where veno-venous ECMO (VV-ECMO) was instituted prior to performing critical endotracheal procedure. After securing the VV-ECMO through right jugular vein and left femoral vein under local anaesthesia, the tracheal stent placement was conducted under flexible bronchoscope and fluoroscope control. Oxygenation and carbon dioxide levels were maintained by the ECMO. VV-ECMO is a useful adjunct in the management of subglottic difficult airway obstruction due to complex tracheal pathology where conventional ventilation may not be possible or adequate.

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