Difficult Ventilation After Successful Intubation in the Emergency Setting due to a Ball Valve Clot

2016 ◽  
Vol 6 (10) ◽  
pp. 291-292
Author(s):  
Justin S. Liberman ◽  
Wade Weigel ◽  
Joseph M. Neal
Keyword(s):  
Ball Valve ◽  
Emergency Setting ◽  
Successful Intubation ◽  
Difficult Ventilation

Difficult Ventilation in an Infant After Successful Intubation

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

scholarly journals Unanticipated Difficult Airway Management in the Prehospital Emergency Setting

2011 ◽  
Vol 114 (1) ◽  
pp. 105-110 ◽  
Author(s):  
Xavier Combes ◽  
Patricia Jabre ◽  
Alain Margenet ◽  
Jean Claude Merle ◽  
Bertrand Leroux ◽  
...  
Keyword(s):  
Difficult Intubation ◽  
Upper Airway ◽  
Simple Algorithm ◽  
Patient Characteristics ◽  
Emergency Setting ◽  
Early Intubation ◽  
Intubating Laryngeal Mask Airway ◽  
Proven Efficacy ◽  
Prehospital Emergency ◽  
Difficult Ventilation

Background Difficult intubation management algorithms have proven efficacy in operating rooms but have rarely been assessed in a prehospital emergency setting. We undertook a prospective evaluation of a simple prehospital difficult intubation algorithm. Methods All of our prehospital emergency physicians and nurse anesthetists were asked to adhere to a simple algorithm in all cases of impossible laryngoscope-assisted tracheal intubation. They received a short refresher course and training in the use of the gum elastic bougie (GEB) and the intubating laryngeal mask airway (ILMA), which were techniques to be used as a first and a second step, respectively. In cases of difficult ventilation with arterial desaturation, IMLA was to be used first. Cricothyroidotomy was the ultimate rescue technique when ventilation through ILMA failed. Patient characteristics, adherence to the algorithm, management efficacy, and early complications were recorded (August 2005-December 2009). Results An alternative technique to secure the airway was needed in 160 of 2,674 (6%) patients undergoing intubation. Three instances of nonadherence to the algorithm were recorded. GEB was used first in 152 patients and was successful in 115. ILMA was used first in 8 patients and second in the 37 GEB-assisted intubation failures. Forty-five patients were successfully mask-ventilated, and 42 were blindly intubated before reaching the hospital. Cricothyroidotomy was used successfully in a patient with severe upper airway obstruction as a result of pharyngeal neoplasia. Early intubation-related complications occurred in 52% difficult cases. Conclusion Adherence to a simple algorithm using GEB, ILMA, and cricothyroidotomy solved all difficult intubation cases occurring in a prehospital emergency setting.

Bedside Cardiac Pocus in Emergency Setting: A Practice Review

2020 ◽  
Vol 15 ◽  
Author(s):  
Christian Zanza ◽  
Yaroslava Longhitano ◽  
Marco Artico ◽  
Gianmaria Cammarota ◽  
Andrea Barbanera ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Core Curriculum ◽  
Case Reports ◽  
Short Review ◽  
Rapid Identification ◽  
Cochrane Library ◽  
Emergency Setting ◽  
Holistic View ◽  
Questions And Answers ◽  
The Usa

Background: in the last years, ultrasound technology has entered in clinical practice as a tank and today, it has also allowed to no-cardiologists to extend and to deep their medical examination without the needing to call the consultant and having a good profile of diagnostic accuracy. The ultrasound bedside does not replace the consultant but it allows not to perform inappropriate consultations with more savings for hospitals. Objective: The aim was to review recently published literature to inform the clinician about the most up to date management of use bedside echography in emergency setting. In this short review we focused on two types of syndromes, no traumatichypotension and dyspnea, common to the three holistic disciplines of medicine, showing the main and basic questions and answers that ultrasound can give us for rapid identification of the problem Methods: We conducted a systematic review using Pubmed/Medline, Ovid/Willey and Cochrane Library, combining key terms such as “cardiac ultrasound, “cardiac diseases”,“emergency medicine”,“pocus”, “dyspnea”,“ hypotension”. We selected the most relevant clinical trials and review articles (excluding case reports) published in the last 19 years and in our opinion 59 publications appeared the best choice according to the PRISMA statement. In additional papers identified from individual article reference lists were also included. Conclusion: Recent studies have shown promise in establishing best practices for evaluation of heart, lung abdomen and deep vessels At the moment bedside US is widely used in an integrated ultrasound vision just like the holistic view have internal medicine, intensive care and emergency medicine and many medical schools in Europe and the USA are inserting ultrasonography into the core curriculum but we still have to find a standard method for the training program for minimum competence acquisition.

An Approach to diabetic ketoacidosis in an emergency setting.

2020 ◽  
Vol 15 ◽  
Author(s):  
Dario Pitocco ◽  
Mauro Di Leo ◽  
Linda Tartaglione ◽  
Emanuele Gaetano Rizzo ◽  
Salvatore Caputo ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Diabetic Ketoacidosis ◽  
Blood Glucose Concentration ◽  
Diabetic Complication ◽  
Emergency Setting ◽  
Online Activity

Background: Diabetic Ketoacidosis (DKA) is one of the most commonly encountered diabetic complication emergencies. It typically affects people with type 1 diabetes at the onset of the disease. It can also affect people with type 2 diabetes, although this is uncommon. Methods: Research and online content related to diabetes online activity is reviewed. DKA is caused by a relative or absolute deficiency of insulin and elevated levels of counter regulatory hormones. Results: Goals of therapy are to correct dehydration, acidosis and to reverse ketosis, gradually restoring blood glucose concentration to near normal. Conclusion: Furthermore it is essential to monitor potential complications of DKA and if necessary, to treat them and any precipitating events.

A Review on the Use of Reversal Agents of Direct Oral Anticogulant Drugs in Case of Gastrointestinal Bleeding

2020 ◽  
Vol 15 ◽  
Author(s):  
Veronica Ojetti ◽  
Angela Saviano ◽  
Mattia Brigida ◽  
Luisa Saviano ◽  
Alessio Migneco ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Major Bleeding ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Medical Emergency ◽  
Management Approach ◽  
Emergency Setting ◽  
Reversal Agents ◽  
Life Threatening ◽  
Andexanet Alfa

Background : Major bleeding is a life-threatening condition and a medical emergency with high mortality risk. It is often the complication of anticoagulant’s intake. Anticoagulants are commonly used for the prevention and the treatment of thrombotic events. The standard therapy with vitamin K antagonist (warfarin) has been frequently replaced by direct oral anticoagulants (DOACs). The latter agents (rivaroxaban, apixaban, edoxaban, dabigatran, betrixaban) showed a better efficacy and safety compared to standard warfarin treatment and they are recommended for the reduction of ischemic stroke. Literature data reported a high risk of gastrointestinal bleeding with DOACs, in particular with dabigatran and rivaroxaban. In case of life-threatening gastrointestinal bleeding, these patients could benefit from the use of reversal agents. Methods: We performed an electronic search on PUBMED of the literature concerning reversal agents for DOACs and gastrointestinal bleeding in the Emergency Department from 2004 to 2020. AIM: This review summarizes the current evidences about three reversal agents idarucizumab, andexanet alfa and ciraparantag, and the use of the first two in the emergency setting in patients with an active major bleeding or who need urgent surgery to offer physicians indications for a better management approach in order to increase patient’s safety. Conclusion: Although these agents have been marketed for five years (idarucizumab) and two years (andexanet alfa) respectively, and despite guidelines considering antidotes as first-line agents in treating life-threatening hemorrhage when available, these antidotes seem to gain access very slowly in the clinical practice. Cost, logistical aspects and need for plasma level determination of DOAC for an accurate therapeutic use probably have an impact on this phenomenon.. An expert multidisciplinary bleeding team should be established so as to implement international guidelines based on local resources and organization.

scholarly journals Imaging Evaluation of Pulmonary and Non-Ischaemic Cardiovascular Manifestations of COVID-19

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1271
Author(s):  
Sebastiano Cicco ◽  
Antonio Vacca ◽  
Christel Cariddi ◽  
Rossella Carella ◽  
Gianluca Altamura ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Myocardial Injury ◽  
Nuclear Imaging ◽  
Emergency Setting ◽  
Imaging Evaluation ◽  
Coagulation Abnormalities ◽  
Cardiovascular Involvement ◽  
Highly Sensitive ◽  
Inflammatory Syndrome ◽  
Inflammatory Burden

Coronavirus Disease 2019 (COVID-19) has been a pandemic challenge for the last year. Cardiovascular disease is the most described comorbidity in COVID-19 patients, and it is related to the disease severity and progression. COVID-19 induces direct damage on cardiovascular system, leading to arrhythmias and myocarditis, and indirect damage due to endothelial dysfunction and systemic inflammation with a high inflammatory burden. Indirect damage leads to myocarditis, coagulation abnormalities and venous thromboembolism, Takotsubo cardiomyopathy, Kawasaki-like disease and multisystem inflammatory syndrome in children. Imaging can support the management, assessment and prognostic evaluation of these patients. Ultrasound is the most reliable and easy to use in emergency setting and in the ICU as a first approach. The focused approach is useful in management of these patients due its ability to obtain quick and focused results. This tool is useful to evaluate cardiovascular disease and its interplay with lungs. However, a detailed echocardiography evaluation is necessary in a complete assessment of cardiovascular involvement. Computerized tomography is highly sensitive, but it might not always be available. Cardiovascular magnetic resonance and nuclear imaging may be helpful to evaluate COVID-19-related myocardial injury, but further studies are needed. This review deals with different modalities of imaging evaluation in the management of cardiovascular non-ischaemic manifestations of COVID-19, comparing their use in emergency and in intensive care.

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