Faculty Opinions recommendation of Supraglottic airway devices in difficult airway management: a retrospective cohort study of 658,104 general anaesthetics registered in the Danish Anaesthesia Database.

2018 ◽  
Author(s):  
Andrea Vannucci
Keyword(s):  
Cohort Study ◽  
Airway Management ◽  
Difficult Airway ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Supraglottic Airway ◽  
Difficult Airway Management ◽  
Supraglottic Airway Devices ◽  
Airway Devices

Difficult Airway

2017 ◽  
Author(s):  
Romina G. Ilic
Keyword(s):  
Airway Management ◽  
Difficult Airway ◽  
Awake Intubation ◽  
Supraglottic Airway ◽  
Patient Evaluation ◽  
Advanced Airway ◽  
Supraglottic Airway Devices ◽  
Surgical Airway ◽  
Airway Exchange ◽  
Airway Devices

The difficult airway chapter focuses on preparing the clinician for a challenging airway. Management of both the expected, as well as the unexpected, difficult airway is critical to the care of the perioperative patient. Proper patient evaluation, organization, and preparation with a variety of airway tools are imperative to successfully securing the airway. The chapter reviews the difficult airway algorithm and discusses advanced airway techniques such as the use of awake intubation, airway exchange catheters, supraglottic airway devices, and surgical airway. Gaining familiarity with and using these advanced airway techniques in non-urgent situations will help ensure success when they are needed in emergencies.

scholarly journals The Difficult Airway Trolley: A Narrative Review and Practical Guide

2019 ◽  
Vol 2019 ◽  
pp. 1-12 ◽  
Author(s):  
Martin F. Bjurström ◽  
Mikael Bodelsson ◽  
Louise W. Sturesson
Keyword(s):  
Airway Management ◽  
Difficult Airway ◽  
Airway Device ◽  
Supraglottic Airway ◽  
Future Research ◽  
Clinical Settings ◽  
Airway Equipment ◽  
National Expert ◽  
Airway Devices ◽  
Facemask Ventilation

Death and severe morbidity attributable to anesthesia are commonly associated with failed difficult airway management. When an airway emergency develops, immediate access to difficult airway equipment is critical for implementation of rescue strategies. Previously, national expert consensus guidelines have provided only limited guidance for the design and setup of a difficult airway trolley. The overarching aim of the current work was to create a dedicated difficult airway trolley (for patients>12 years old) for use in anesthesia theatres, intensive care units, and emergency departments. A systematic literature search was performed, using the PubMed, Embase, and Google Scholar search engines. Based on evidence presented in 11 national or international guidelines, and peer-reviewed journals, we present and outline a difficult airway trolley organized to accommodate sequential progression through a four-step difficult airway algorithm. The contents of the top four drawers correspond to specific steps in the airway algorithm (A = intubation, B = oxygenation via a supraglottic airway device, C = facemask ventilation, and D = emergency invasive airway access). Additionally, specialized airway equipment may be included in the fifth drawer of the proposed difficult airway trolley, thus enabling widespread use. A logically designed, guideline-based difficult airway trolley is a vital resource for any clinician involved in airway management and may aid the adherence to difficult airway algorithms during evolving airway emergencies. Future research examining the availability of rescue airway devices in various clinical settings, and simulation studies comparing different types of difficult airway trolleys, are encouraged.

scholarly journals Airway Management in Athletes Wearing Lacrosse Equipment

2018 ◽  
Vol 53 (3) ◽  
pp. 240-248 ◽  
Author(s):  
Thomas G. Bowman ◽  
Richard J. Boergers ◽  
Monica R. Lininger
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Airway Management ◽  
Significant Interaction ◽  
Ventilation Rate ◽  
Supraglottic Airway ◽  
Pharyngeal Airway ◽  
Supraglottic Airway Devices ◽  
Football Helmets ◽  
The Face ◽  
Airway Devices

Context:  Patient ventilation volume and rate have been found to be compromised due to the inability to seal a pocket mask over the chinstrap of football helmets. The effects of supraglottic airway devices such as the King LT and of lacrosse helmets on these measures have not been studied. Objective:  To assess the effects of different airway management devices and helmet conditions on producing quality ventilations while performing cardiopulmonary resuscitation on simulation manikins. Design:  Crossover study. Setting:  Simulation laboratory. Patients or Other Participants:  Thirty-six athletic trainers (12 men, 24 women) completed this study. Intervention(s):  Airway-management device (pocket mask, oral pharyngeal airway, King LT airway [KA]) and helmet condition (no helmet, Cascade helmet, Schutt helmet, Warrior helmet) served as the independent variables. Participant pairs performed 2 minutes of 2-rescuer cardiopulmonary resuscitation under 12 trial conditions. Main Outcome Measure(s):  Ventilation volume (mL), ventilation rate (ventilations/min), rating of perceived difficulty (RPD), and percentage of quality ventilations were the dependent variables. Results:  A significant interaction was found between type of airway-management device and helmet condition on ventilation volume and rate (F12,408 = 2.902, P < .0001). In addition, a significant interaction was noted between airway-management device and helmet condition on RPD scores (F6,204 = 3.366, P = .003). The no-helmet condition produced a higher percentage of quality ventilations compared with the helmet conditions (P ≤ .003). Also, the percentage of quality ventilations differed, and the KA outperformed each of the other devices (P ≤ .029). Conclusions:  The helmet chinstrap inhibited quality ventilation (rate and volume) in airway procedures that required the mask to be sealed on the face. However, the KA allowed quality ventilation in patients wearing a helmet with the chinstrap fastened. If a KA is not available, the helmet may need to be removed to provide quality ventilations.

Die Larynxmaske – Schritt für Schritt

2019 ◽  
Vol 144 (10) ◽  
pp. 690-694
Author(s):  
Rolf Dembinski ◽  
Daniel Scholtyschik
Keyword(s):  
Mechanical Ventilation ◽  
Critical Care ◽  
Pulmonary Aspiration ◽  
Supraglottic Airway ◽  
Difficult Airway Management ◽  
Clinical Routine ◽  
Laryngeal Masks ◽  
Supraglottic Airway Devices ◽  
Airway Devices ◽  
Airway Access

AbstractLaryngeal masks are supraglottic airway devices developed in the early 1980s. Today, they are frequently used in clinical routine to provide airway access for mechanical ventilation in patients undergoing surgery with a short duration. Moreover, the they have also become integral part of difficult airway management in patients who cannot be intubated by the use of conventional laryngoscopy.Relevant advances have been made to simplify their positioning and improve tightness with the aim to allow for the use of higher airway pressures during mechanical ventilation thereby reducing the risk of gastric insufflation and pulmonary aspiration. Focusing on this goal, several different prototypes have been developed and introduced in clinical practice until today. However, even these new developed laryngeal masks still do not provide reliable protection against pulmonary aspiration until today. Consequently, their use In critical care medicine is still limited to rescue situations with intubation failure.In this review some of the most popular lanryngeal masks are presented, indications for their use are outlined and their handling is described.

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