Tracheal Intubation
Rahul Jandial, Danielle D. Jandial in Code Blue, 2014
This chapter provides information for performing tracheal intubation. It begins with a case scenario of a 38-year-old woman who is presented with sudden neurologic deterioration after a head injury; she is unresponsive to pain, mumbling, and her eyes are closed to pain. The chapter then includes details on indications, contraindications, and information about supplies, positioning and technique. Pearls and pitfalls are also incorporated, providing additional insights and practical advice not always available in other textbooks or articles. Between intubation attempts, bag-mask ventilation of the lungs should be performed.
The Second Half of the Nineteenth Century
Arturo Castiglioni in A History of Medicine, 2019
The beginning of the microbiological concept can be differently dated according to the values placed on the various discoveries that opened the paths. The student of the progress of clinical medicine becomes aware of a special characteristic that underwent a marked development: namely, the improvement in the field of diagnosis, thanks to the steady improvement in research methods and accomplishments. This in turn brought about a closer connection between clinical medicine and pathology, which was largely responsible for these improvements. In the advancement of knowledge of internal medicine in the second half of the century, when the laboratory specialties were making their most striking contributions, the german and austrian universities took a very prominent part. One of the greatest masters of French clinical medicine was Armand trousseau, the first in Paris to practise tracheotomy, thoracentesis, and intubation.
Foreign body
Mohammad Ibrarullah in Atlas of Diagnostic Endoscopy, 2019
This chapter presents various types of foreign bodies detected in the UGI tract. Endoscopy also plays a therapeutic role in removing the foreign bodies. Esophageal inlet is the commonest site of foreign body (FB) impaction. Dysphagia, odynophagia, chest pain and excessive salivation are the usual symptoms. Contrary to the common practice, FB extraction should always be performed under general anesthesia. It is our practice to use intravenous propofol anesthesia in adults and intubation anesthesia in the pediatric age group. A quiet patient, relaxed cricopharyngeus, secure airway and proper instrument are paramount in successful removal of a FB from the UGI tract.
Risk factors for decannulation failure after single-stage reconstruction of adult post-intubation tracheal stenosis: 10-year experience at a tertiary center
Published in Acta Oto-Laryngologica, 2020
Background: Although the risk factors for decannulation failure have been discussed in the literature, there are many unclear points on this issue. Aims and objectives: To identify risk factors for developing decannulation failure after single-stage surgical reconstruction of post-intubation tracheal stenosis (TS). Material and methods: A total of 45 adult patients with post-intubation TS admitted to our institution and underwent single-stage surgical reconstruction between April 2008 and May 2018. Nine patients developed decannulation failure by postoperative 6 months (Failed Decannulation Group), and 36 patients were decannulated successfully (Successful Decannulation Group). Causal factors of intubation were noted. Patient-related risk factors of decannulation failure were compared between two groups. Results: Failed Decannulation Group had a significantly higher body mass index (p = .034) and were more likely to have diabetes (p = .025). Patients who were previously intubated for more than 48 h (p = .043) were significantly more likely to have decannulation failure. The presence of comorbid diseases did not place a patient under statistically significant risk of decannulation failure. Conclusion: Patients with high body mass index, the ones with diabetes, and patients who were previously intubated for more than 48 h were more likely to develop decannulation failure.
Out-of-Hospital Intubation and Bronchoscopy Using a New Disposable Device: The Initial Case
Published in Prehospital Emergency Care, 2020
Sunao Yamauchi, Ammundeep Tagore, Navin Ariyaprakai, Josephine V. Geranio, Mark A. Merlin
Airway management is one of the critically important skills in practicing emergency medicine. However, intubation in the prehospital setting is quite different from those done in controlled environment and still poses significant risks for serious complications. Although checking for clinical findings and end-tidal carbon dioxide detection system (ETCO2) are well-established and widely adopted way to verify ETT placement in the prehospital setting, there are certain situations that the use of these methods could be unreliable. The use of advanced flexible bronchoscopy technology allows us to directly visualize the tube placement and can also assist difficult intubation. Studies have shown that the verification of tube placement utilizing bronchoscopy is an easy and highly reliable methods and this is especially beneficial in the prehospital settings. Although the use of bronchoscopy in prehospital setting currently is somehow limited, this new, rapidly advancing technology and technique is believed to be a game changer in our prehospital intubation/post-intubation practice in the near future.
Inverse intubation: An important alternative for intubation in the streets
Published in Prehospital Emergency Care, 1999
Tatjana Hilker, Harald V. Genzwuerker
One of the highest priorities for prehospital emergency personnel is airway management. Several rescuer positions for intubation on the ground have been published. Only recently, the inverse intubation method as an additional approach for intubation in the out-of-hospital setting has received further attention. Using four case reports, situations in which inverse intubation may be an important tool for successful airway management are discussed. Other uses of the method are listed.
Related Knowledge Centers
- Catheterization
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