Gastric Foreign Bodies
John F. Pohl, Christopher Jolley, Daniel Gelfond in Pediatric Gastroenterology, 2014
Endoscopy is typically performed with a flexible upper endoscope. Due to the increased airway compliance in younger patients and risk of obstruction, tracheal intubation is typically performed during the procedure. Retrieval devices include retrieval forceps, retrieval nets, polypectomy snares, polyp graspers, retrieval baskets, magnetic probes, banding caps, and sutures (Table 16.1, 16.2). If the patient is large enough, the use of an overtube will help to protect the airway, facilitate multiple passages for removal of several objects or piecemeal removal of a bezoar, and protect the GI tract during removal of sharp or long objects. Currently, there are no pediatric-sized overtubes. Protecting the mucosa from further injury during the removal of a sharp item can also be performed with the use of a latex hood or friction fit adaptor.
Critical Care and Anaesthesia
Tjun Tang, Elizabeth O'Riordan, Stewart Walsh in Cracking the Intercollegiate General Surgery FRCS Viva, 2020
What are the indications for tracheal intubation?Airway obstructionAirway protectionHypoxia or hypercapnoea (i.e. respiratory failure); to provide invasive ventilatory supportUnconscious patients or those with impaired laryngeal reflexes Prevent soiling by blood or gastric contentsAirway toilet − facilitate aspiration of secretions/sputumTo facilitate mechanical ventilationAnaesthesia When muscle relaxation or mechanical ventilation is requiredProlonged surgeryOne lung ventilationProne positioning
Anesthesia for pediatric trauma
David E. Wesson, Bindi Naik-Mathuria in Pediatric Trauma, 2017
The choice of tracheal intubation technique depends on many factors including the patient’s condition as well as the provider’s training, preference, and equipment availability. The anesthesiologist should initially assume that most pediatric trauma patients have a cervical spine injury and are at increased risk for pulmonary aspiration of gastric contents [16]. Physical examination of the head and neck should be performed, if feasible, prior to performing airway management. Although several predictors of a difficult airway in adults have been reported, none have been reliably established in children. However, physical examination of the airway in children should attempt to identify characteristics that have an increased association with a difficult airway such as decreased mouth opening, reduced neck extension, and the presence of congenital disorders (Table 14.2) [17–19].
Incidence, Complications, and Factors Associated with Out-of-Hospital First Attempt Intubation Failure in Adult Patients: A Secondary Analysis of the CURASMUR Trial Data
Published in Prehospital Emergency Care, 2022
Thomas Nicol, Cédric Gil-Jardiné, Patricia Jabre, Frederic Adnet, Patrick Ecollan, Bertrand Guihard, Cyril Ferdynus, Xavier Combes
Tracheal intubation is one of the most critical interventions performed by emergency physicians (1). Moreover, emergency airway management is often considered to be more difficult in the out-of-hospital setting than in hospital situations. In patients with spontaneous cardiac activity needing emergency intubation, it is well established that a rapid sequence intubation (RSI) lowers the difficult intubation rate and increase the first attempt intubation success rate (2–4). Most studies that assessed first attempt intubation failure rate in out-of-hospital emergency setting have included both patients in cardiac arrest and with spontaneous cardiac activity during their airway control process (5, 6). In these studies, 35% and 50% of patients were respectively in cardiac arrest at the moment of intubation and thus, it was not possible to assess only those patients intubated using RSI (5, 6). If first attempt intubation failure rate in emergency context has been already reported in several studies, assessment of its associated factors for patients intubated under a RSI technique have rarely been evaluated in a large cohort of patients managed in an out-of-hospital setting (7–9). The aim of this further analysis of the CURASMUR data was to assess the first intubation attempt failure rate and to assess its associated factors and related complications in a large population of adult patients intubated for life-threatening distress using RSI as a systematic procedure.
Efficacy of dexmedetomidine-based opioid-free anesthesia on the control of surgery-induced inflammatory response and outcomes in patients undergoing open abdominal hysterectomy
Published in Egyptian Journal of Anaesthesia, 2022
Mohamed A Lotfy, Mohamed G Ayaad
Anesthesia was induced by propofol 2 mg/kg, rocuronium 0.5 mg/kg for patients of OB-GA, while was induced using the loading doses of DEX and LID directly intravenously for patients of OF-GA. For patients of both groups, tracheal intubation was aided by gentle tracheal pressure, and an endotracheal tube measuring 6.5 mm was inserted. After intubation of the trachea, the lungs were ventilated with 100% O2 in the air using a semi-closed circle system. For patients of the OF-GA group, DEX and LID infusions were applied at a rate of 0.3 ml/kg/h and 2 mg/kg/h, respectively. During surgery, ventilation was controlled with a tidal volume of 6–8 ml/kg, and the ventilatory rate was adjusted to maintain an end-tidal carbon dioxide (paCO2) of 32–35 mmHg. For intraoperative analgesia fentanyl, 1 µg/kg was given for patients of OB-GA and adjustment of infusions’ rates for patients of OF-GA. Anesthesia was maintained with sevoflurane 1.7 MAC and top-up doses of rocuronium if needed. Muscle relaxant was reversed using neostigmine 0.05 mg/kg with atropine 0.01 mg/kg.
Cardioprotective Efficacy of Coriandrum sativum (L.) Seed Extract in Heart Failure Rats Through Modulation of Endothelin Receptors and Antioxidant Potential
Published in Journal of Dietary Supplements, 2020
Neha Dhyani, Adila Parveen, Aisha Siddiqi, M. Ejaz Hussain, Mohammad Fahim
After the completion of treatment, animals of each group were anesthetized with urethane (1 g/kg; intraperitoneally). Tracheal intubation was done to allow free air breathing. Body temperature of the rats was maintained at 37 °C to 38 °C. Femoral artery of one side was exposed and a polyethylene catheter filled with heparin solution (500 IU/ml, v/v) was inserted in the artery through a small incision for recording arterial blood pressure (ABP). The catheter was attached to a 23-gauge needle connected via three-way stopcock to a pressure transducer (Statham P23Db, Oxnard, California, USA). The femoral vein of the other limb was cannulated for injecting drugs. Arterial blood pressure (ABP) was measured after 20 min of stabilization period. Systolic, diastolic, and mean arterial pressures and heart rate were monitored and recorded on Power Lab data-acquisition system (4SP, AD Instruments, Australia) with a computerized analysis program (Chart 7, AD Instruments, Australia).
Related Knowledge Centers
- Breathing
- Respiratory Tract
- Trachea
- Tracheal Tube
- Tracheotomy
- Larynx
- Intubation
- Catheter
- Mechanical Ventilation
- Cricothyrotomy