Difficult and failed airway in small neonates: Lightwand revisited

Introduction: Trauma resuscitations are plagued with high stress and require time sensitive and intensive interventions. It is a landscape that is a perfect hot bed for clinical errors and adverse events for patients. We sought to describe the adverse events and errors that occur during trauma resuscitation and any associated outcomes. Methods: Medline was searched for a combination of key terms involving trauma resuscitation, adverse events and errors from January 2000 to May 2019. Studies that described adverse events or errors in initial adult trauma resuscitations were included. Two reviewers analyzed papers for inclusion and exclusion criteria with a third reviewer for any discrepancies. Descriptions of errors, adverse events and associated outcomes were collated and presented. Results: A total of 3,462 papers were identified by our search strategy. 18 papers met our inclusion and exclusion criteria and were selected for full review. Adverse events and errors reported in trauma resuscitation included missed injuries, aspiration, failed airway, and deviation from protocol. Rates of adverse events and errors were reported where applicable. Mortality outcomes or length of stay were not directly correlated to adverse events or errors experienced in the trauma resuscitation. Conclusion: Our study highlights the predominance of adverse events and errors experienced during initial trauma resuscitation. We described a multitude of adverse events and errors and their rates but further study is needed to determine outcome differences for patients and possibility for quality improvement.

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High Flow Humidified Nasal Oxygen in Pregnant Women

Anaesthesia and Intensive Care ◽

10.1177/0310057x1804600106 ◽

2018 ◽

Vol 46 (1) ◽

pp. 36-41 ◽

Cited By ~ 8

Author(s):

P. C. F. Tan ◽

A. T. Dennis

Keyword(s):

Pregnant Woman ◽

Airway Management ◽

Pregnant Women ◽

Current Literature ◽

Clinical Applications ◽

High Flow ◽

Failed Airway ◽

Obstetric Population ◽

Apnoeic Oxygenation ◽

Safety Strategy

Failed airway management in the obstetric patient undergoing general anaesthesia is associated with major sequelae for the mother and/or fetus. Effective and adequate pre-oxygenation is an important safety strategy and a recommendation in all current major airway guidelines. Pre-oxygenation practice in the obstetric population may be suboptimal based on current literature. Recently, clinical applications for high flow nasal oxygen, also known as transnasal humidified rapid insufflation ventilatory exchange or THRIVE, are expanding in the non-obstetric population and may have theoretical benefits if used for pre-oxygenation and apnoeic oxygenation in the obstetric population. We review the current literature surrounding high flow nasal oxygen relevant to the pregnant woman. We also propose a basis for potential advantages and complications for its use in this context.

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TF-9 Staying Out of Trouble: A Systematic Approach to a Failed Airway

Annals of Emergency Medicine ◽

10.1016/j.annemergmed.2012.06.484 ◽

2012 ◽

Vol 60 (4) ◽

pp. S159

Author(s):

M. DeLaney

Keyword(s):

Systematic Approach ◽

Failed Airway

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(P1-62) The Risk Factors for Difficult or Failed Airway: A Prosepctive Cohor Study

Prehospital and Disaster Medicine ◽

10.1017/s1049023x11003943 ◽

2011 ◽

Vol 26 (S1) ◽

pp. s118-s118

Author(s):

C. Hsu

Keyword(s):

Risk Factors ◽

Airway Management ◽

Difficult Airway ◽

Healthcare Providers ◽

Positive Association ◽

Daily Practice ◽

Trauma Patients ◽

Airway Trauma ◽

Failed Airway ◽

Airway Devices

The risk factors for difficult airway or failed airway: a prospective cohort study Airway management is always the first priority and time-treasures in critical ill-patients. Improper managementof difficult airway or resultant fail airway would bring poor prognosis to patients. We investigated the risk factors of difficult or fail airway from the multiple dimension of factors including patients, healthcare and airway devices. We enrolled 252 intubated patients, including 37 trauma patients, 55 patients (22%) with difficult airway, and 22 patients (8.7%) with fail airway. In analysis of risk factors of difficult airway, factors including obesity, short neck or thickness of soft tissue, facial deformities and oral-nasal bleeding have positive association with fail airway, but the seniority of healthcare providers had no effect. However, experienced healthcare providers have more success rate after the occurrence of fail airway. The most complications of fail airway include airway trauma and hypoxia. As compared with non-trauma patients, trauma patients have more episodes of fail airway, difficult airway, and use of RSI, rescue airway for fail airway, airway trauma and vomiting. Therefore, it is necessary to establish an easy and safe standard guideline in daily practice of difficult and urgent airway management for healthcare providers.

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