Risky Extubation. Andy Higgs. Warrington Hospitals Cheshire UK
|
|
|
- Joy Pearson
- 5 years ago
- Views:
Transcription
1 Andy Higgs Warrington Hospitals Cheshire UK
2 Declaration COOKMEDICAL
3 Extubation plan DAS guideline
4
5
6
7
8 Airway Exchange Catheters # 11 CAEC post maxillo-facial surgery Used as intubation stylets
9 Airway Exchange Catheters RELATIVELY SIMPLE, BUT REQUIRE ATTENTION TO DETAIL F scope through ETT - tip mid-trachea: facial landmark Insert AEC through ETT to same depth, just inside ETT tip Never advance AECs against resistance Remove ETT over AEC, maintaining AEC s tracheal position Position AEC at correct depth & secure it (circumferential tape) Check ETCO 2 & check leak around AEC Label AEC do not confuse with nasogastric tube NPO Observe closely in PACU or HDU Annotate correct depth on the chart & CXR Remove when re-intubation unlikely (2...8 hours...3/7)
10 AECs EVIDENCE Mort et al 9 year prospective practice analysis; 354 pts extubated over AEC 72% = known DI; 28% suspected DI 87 reintubated: 51 re-intubated whilst AEC in situ 36 re-intubated after AEC electively removed # 11 & 14 COOK AEC (> 90% well tolerated) Overall success rate = 47/51 = 92% 1 st attempt = 41/47 2 nd attempt =5/47 need ETT 3 rd attempt = 1/47 AEC migrated = 3/51 Failed AEC re-intubation = 1/51 : Fastrach LMA Mort T. et al 2007
11 AECs EVIDENCE Mort et al Process re-intubation : 44/51 = bag/mask 7/51 = 3-6 L/min insufflation none needed jet ventilation 27% local to airway or NIL 73% sedated (midaz / propofol / etomidate); NMB = 2 DL / jaw thrust / tongue retraction used
12 AECs EVIDENCE Mort et al Process re-intubation : 44/51 = bag/mask 7/51 = 3-6 L/min insufflation none needed jet ventilation 27% local to airway or NIL 73% sedated (midaz / propofol / etomidate); NMB = 2 DL / jaw thrust / tongue retraction used
13 AECs EVIDENCE - Mort et al 36 patients in 2 nd group DL 3+ : 3 LMA / Fastrach: 20 Fibrescope: 6 Rigid fibrescope: 4 GEB: 3 Surgical airway: 4 (2 FM ventilation & 2 LMA ventilation) Mort has confirmed AECs are safe & effective P Biro. Anesth Anal. 2007
14
15 Oxygenation through AECs
16 AECs: Planned ICU Extubation 37 year old Dental abscess Trismus: 1cm Awake FO Intubation #6.0mm Alfentanil 1mg/hr
17 AECs: Planned ICU Extubation
18 Extubation wires Risky Extubation
19 AECs: If patient deteriorates If medical - Treat the cause If airway - Sit-up 100% O 2 : face mask +/- AEC (depth & leak) Epinephrine nebs (?Heliox easier said than done!) CPAP / NIV Summon help -? surgeon Check equipment? in theatre, consider transfer : judgement ETCO 2 & check depth
20 AECs: If patient deteriorates Railroading the ETT If ETT size: smallest possible Flexible ETT +/- Sedation Position sitting up Full inspiration +/- protrude tongue Gentle direct laryngoscopy to displace tongue only 90 anti-clockwise rotation? VL / FO to try ID site of hold-up 86% first time success rate (see above)
21 AECs: If patient deteriorates Railroading the ETT Any railroading procedure Mind the gap between ETT & stylet # 11 COOK AEC Aintree Catheter # 7.0mm ETT Higgs et al 2010
22 Airway Exchange Catheters Catheter Catheter Catheter ETT Fr Length /cm ID / mm ID / mm Extra Firm Soft Tipped
23 Step 3: Leave the ETT in situ for the medical SHO
24 Step 4: Post extubation care Observations & warning signs communication! Early Red flags: Stridor Obstructed breathing Swelling Bleeding, haematoma Agitation; I can t breath Change in voice cough, swallow, drool Stridor Lethargy, LOC Silent airway!
25 Late red flags If difficult intubation, be alert for Cx traumatic intubation: DI - pharyngeal / oesophageal; Routine - laryngeal Mediastinitis Difficult to diagnose and deadly Have a high index of suspicion: sore throat, deep Cx pain, chest pain, fever, odynophagia, dysphagia Classic signs - crepitus, PTHx, Pneumomediastinum < 50% Sepsis after difficult airway Mx: consider leak or deep infection Low threshold CT
26
27 LMA Exchange Inappropriate if reintubation is difficult Inappropriate in un-fasted patients
28
29 Advanced Techniques* 1. Awake + remifentanil technique 2. LMA Exchange
30 Laryngeal Mask Exchange Replacement of a tracheal tube with a LMA Advanced technique
31
32
(ix) Difficult & Failed Intubation Queen Charlotte s Hospital
(ix) Difficult & Failed Intubation Queen Charlotte s Hospital Pre-operative Assessment Clinical assessment of airway and risk of difficult intubation: (can be performed in a matter of seconds): 1. Mouth
Difficult Airway. Victor M. Gomez, M.D. Pulmonary Critical Care Medicine Medical City Dallas Hospital
Difficult Airway Victor M. Gomez, M.D. Pulmonary Critical Care Medicine Medical City Dallas Hospital Difficult Airway Definition Predicting a difficult airway Preparing for a difficult airway Extubation
DIFFICULT AIRWAY MANAGMENT. Dr.N.SANTHOSH KUMAR MD ANESTHESIA (2 nd Yr)
DIFFICULT AIRWAY MANAGMENT Dr.N.SANTHOSH KUMAR MD ANESTHESIA (2 nd Yr) AIRWAY MANAGEMENT AND MAINTAINING OXYGENATION ARE THE FUNDAMENTAL RESPONSIBILITIES OF ANY BASIC DOCTOR. TO MANAGE A DIFFICULT AIRWAY,
Airway Anatomy. Soft palate. Hard palate. Nasopharynx. Tongue. Oropharynx. Hypopharynx. Thyroid cartilage
Airway Anatomy Hard palate Soft palate Tongue Nasopharynx Oropharynx Hypopharynx Thyroid cartilage Airway Anatomy Hyoid bone Thyroid cartilage Cricoid cartilage Trachea Cricothyroid membrane Airway Anatomy
Airway management problem during anaesthesia. Airway management problem in ICU / HDU. Airway management problem occurring in the Emergency Department
4th National Audit Project of the Royal College of Anaesthetists: Major Complications of Airway Management in the UK Please select one form from the list below Airway management problem during anaesthesia
Recent Advances in Airway Management HA Convention 2014
Recent Advances in Airway Management HA Convention 2014 Dr. HK Cheng Chief of Service (Dept. of Anaesthesia & OT) Service Director (Ambulatory Surgery Centre) Tseung Kwan O Hospital Recent Advances in
RELEVANT AREAS OF THE ANAESTHETIC CURRICULUM
LARYNGOSPASM MODULE: CRITICAL INCIDENTS TARGET: ALL ANAESTHETISTS & INTENSIVISTS BACKGROUND: Laryngospasm is a common complication around the time of airway handling in adults and in paediatric patients.
Airway/Breathing. Chapter 5
Airway/Breathing Chapter 5 Airway/Breathing Introduction Skillful, rapid assessment and management of airway and ventilation are critical to preventing morbidity and mortality. Airway compromise can occur
Emergency ENT Anaesthesia. Richard Semenov
Emergency ENT Anaesthesia Richard Semenov Emergency ENT Anaesthesia Dr Richard Semenov MBBS (Adel) FRCA (UK) FANZCA Dept of Anaesthesia Royal Adelaide Hospital My Experience in Emergency ENT Anaesthesia
Cricoid pressure: useful or dangerous?
Cricoid pressure: useful or dangerous? Francis VEYCKEMANS Cliniques Universitaires Saint Luc Bruxelles (2009) Controversial issue - Can J Anaesth 1997 JR Brimacombe - Pediatr Anesth 2002 JG Brock-Utne
Preface... Acknowledgements... Contributors... 1 The Difficult Airway: Definitions and Algorithms The Expected Difficult Airway...
Contents Preface... Acknowledgements... Contributors... vii ix xvii 1 The Difficult Airway: Definitions and Algorithms... 1 Zdravka Zafirova and Avery Tung Introduction 1 Definitions 2 Incidence 3 Algorithms
Postoperative management of the difficult airway
BJA Education, 17 (7): 235 241 (2017) doi: 10.1093/bjaed/mkw077 Advance Access Publication Date: 15 February 2017 Matrix reference 1C01, 2A01, 3A01 Postoperative management of the difficult airway B Batuwitage
GENERAL ANAESTHESIA AND FAILED INTUBATION
GENERAL ANAESTHESIA AND FAILED INTUBATION INTRODUCTION The majority of caesarean sections in the UK are performed under regional anaesthesia. However, there are situations where general anaesthesia (GA)
Other methods for maintaining the airway (not definitive airway as still unprotected):
Page 56 Where anaesthetic skills and drugs are available, endotracheal intubation is the preferred method of securing a definitive airway. This technique comprises: rapid sequence induction of anaesthesia
If you suspect airway problems, get a second opinion before you anaesthetise, not after!
Assessing the airway It is more important to be aware of the various methods of dealing with difficult laryngoscopy than to expect to be able to accurately identify the rare difficult patients without
Diagnosis & Management of the Difficult Airway
Diagnosis & Management of the Difficult Airway Dr. E. Rawlings Plymouth Anaesthetic Department Complications of Airway Management Medicolegal Serious morbidity Mortality Complications of Airway Management
Use of the Aintree Intubation Catheter with the Laryngeal Mask Airway and a Fiberoptic Bronchoscope in a Patient with an Unexpected Difficult Airway
Case Report Use of the Aintree Intubation Catheter with the Laryngeal Mask Airway and a Fiberoptic Bronchoscope in a Patient with an Unexpected Difficult Airway Andrew Zura MD, D. John Doyle MD PhD FRCPC,
All bedside percutaneously placed tracheostomies
Page 1 of 5 Scope: All bedside percutaneously placed tracheostomies Population: All ICU personnel Outcomes: To standardize and outline the steps necessary to safely perform a percutaneous tracheostomy
Cricothyroidotomy. Andy Higgs. Warrington Hospitals Cheshire UK
Andy Higgs Warrington Hospitals Cheshire UK Declaration COOKMEDICAL Incidence Differential diagnosis Physiology Rationale Ideal technique Anatomy Management Options Evidence Recommendations Videos Incidence
Airway/Breathing. Chapter 5
Airway/Breathing Chapter 5 Airway/Breathing Introduction Skillful, rapid, assessment and management of airway and ventilation are critical to preventing morbidity and mortality. Airway compromise can occur
Emergency Department/Trauma Adult Airway Management Protocol
Emergency Department/Trauma Adult Airway Management Protocol Purpose: A standardized protocol for management of the airway in the setting of trauma in an academic center, with the goal of maximizing successful
Advanced Airway Management. University of Colorado Medical School Rural Track
Advanced Airway Management University of Colorado Medical School Rural Track Advanced Airway Management Basic Airway Management Airway Suctioning Oxygen Delivery Methods Laryngeal Mask Airway ET Intubation
Equipment: NRP algorithm, MRSOPA table, medication chart, SpO 2 table Warm
NRP Skills Stations Performance Skills Station OR Integrated Skills Station STATION: Assisting with and insertion of endotracheal tube (ETT) Equipment: NRP algorithm, MRSOPA table, medication chart, SpO
1 Chapter 40 Advanced Airway Management 2 Advanced Airway Management The advanced airway management techniques discussed in this chapter are to
1 Chapter 40 Advanced Airway Management 2 Advanced Airway Management The advanced airway management techniques discussed in this chapter are to introduce the EMT-B student to these procedures only. In
Case Report Complete Obstruction of Endotracheal Tube in an Infant with a Retropharyngeal and Anterior Mediastinal Abscess
Hindawi Case Reports in Pediatrics Volume 2017, Article ID 1848945, 4 pages https://doi.org/10.1155/2017/1848945 Case Report Complete Obstruction of Endotracheal Tube in an Infant with a Retropharyngeal
Chapter 40 Advanced Airway Management
1 2 3 4 5 Chapter 40 Advanced Airway Management Advanced Airway Management The advanced airway management techniques discussed in this chapter are to introduce the EMT-B student to these procedures only.
Airway Workshop Lecture. University of Ottawa
Airway Workshop Lecture Department of Anesthesiology University of Ottawa Overview Ventilation Airway assessment Difficult airways Airway management equipment aids Intubation/Improving Intubation Success
Case Presentation Topic: Difficult to Ventilate Difficult to Intubate
Case Presentation Topic: Difficult to Ventilate Difficult to Intubate Dr. K. Shruthi Jeevan 1 st Year Post Graduate Department of Anaesthesiology CASE SCENARIO : 1 A 65 years old female patient, resident
Changing tracheostomy tubes
Changing tracheostomy tubes Changing the tracheostomy tube should be a multidisciplinary decision. The first change should always be performed or supervised by a suitably trained member of the medical
Airway/Breathing. Chapter 5
Airway/Breathing Chapter 5 Airway/Breathing Introduction Rapid assessment and management of airway and ventilation are critical to preventing morbidity and mortality. Airway compromise can occur rapidly
General OR Rotations GOALS & OBJECTIVES
General OR Rotations GOALS & OBJECTIVES Goals At the end of the CA 1 year General OR rotations, the resident should competently manage uncomplicated ambulatory, orthopedic, maxillo-facial, ENT, gynecologic,
Review. 1. How does a child s anatomy differ from an adult s anatomy?
Chapter 32 Review Review 1. How does a child s anatomy differ from an adult s anatomy? A. The child s trachea is more rigid B. The tongue is proportionately smaller C. The epiglottis is less floppy in
AIRWAY MANAGEMENT AND VENTILATION
AIRWAY MANAGEMENT AND VENTILATION D1 AIRWAY MANAGEMENT AND VENTILATION Basic airway management and ventilation The laryngeal mask airway and Combitube Advanced techniques of airway management D2 Basic
A CRITICALLY ILL CHILD PRESENTING AT AN ACUTE TRUST- A CLINICAL AND ETHICAL CHALLENGE
A CRITICALLY ILL CHILD PRESENTING AT AN ACUTE TRUST- A CLINICAL AND ETHICAL CHALLENGE DR SRIKANTH UPPUGONDURI CONSULTANT ANAESTHESTIST NEW CROSS HOSPITAL CALL FROM PAEDIATRIC TEAM CALL FROM PAEDIATRIC
Combitube insertion in the situation of acute airway obstruction after extubation in patients underwent two-jaw surgery
Case Report pissn 2383-9309 eissn 2383-9317 J Dent Anesth Pain Med 2015;15(4):235-239 http://dx.doi.org/10.17245/jdapm.2015.15.4.235 Combitube insertion in the situation of acute airway obstruction after
LMA Supreme Second Seal. Maintain the airway. Manage gastric contents. Meet NAP4 recommendations.
LMA Supreme Second Seal Maintain the airway. Manage gastric contents. Meet NAP4 recommendations. A proven double seal The importance of the Second Seal (oesophageal seal) is significant: it can minimise
Collaborative Regional Benchmarking Group (North of England, North Yorkshire & Humber and West Yorkshire)
Collaborative Regional Benchmarking Group (North of England, North Yorkshire & Humber and West Yorkshire) Best Practice Guidance Endo Tracheal Tube Care These recommendations are based on the current evidence
Dr.Bharghavi.M 2 nd year post graduate Dept of Anaesthesia
DIFFICULT AIRWAY CANNOT VENTILATE, CANNOT INTUBATE. Dr.Bharghavi.M 2 nd year post graduate Dept of Anaesthesia Difficult airway According to AMERICAN SOCIETY OF ANAESTHESIOLOGISTS Difficult Airway is defined
Airway Management. Teeradej Kuptanon, MD
Airway Management Teeradej Kuptanon, MD Outline Anatomy Detect difficult airway Rapid sequence intubation Difficult ventilation Difficult intubation Surgical airway access ICU setting Intubation Difficult
Domino KB: Closed Malpractice Claims for Airway Trauma During Anesthesia. ASA Newsletter 62(6):10-11, 1998.
Citation Domino KB: Closed Malpractice Claims for Airway Trauma During Anesthesia. ASA Newsletter 62(6):1-11, 18. Full Text As experts in airway management, anesthesiologists are at risk for liability
Airway management problem occurring in the Emergency Department
NAP4EM Airway management problem occurring in the Emergency Department Inclusion criteria 1. Please indicate the inclusion criteria by selecting one or more from the list below: Death Brain damage Emergency
Interfacility Protocol Protocol Title:
Interfacility Protocol Protocol Title: Mechanical Ventilator Monitoring & Management Original Adoption Date: 05/2009 Past Protocol Updates 05/2009, 12/2013 Date of Most Recent Update: March 23, 2015 Medical
Airway Management. Key points. Rapid Sequence Intubation. Rapid Sequence Intubation Recognizing difficult airway Managing difficult airway
Airway Management Prasha Ramanujam and Guy Shochat Department of Emergency Medicine UCSF Medical Center Key points Rapid Sequence Intubation Recognizing difficult airway Managing difficult airway Rapid
Educational Session: Evaluation and Management of the Difficult Airway
Educational Session: Evaluation and Management of the Difficult Airway Diane M. Birnbaumer, MD, FACEP 3/24/2010 7:30 AM - 8:30 AM The Difficult Airway What s Up YOUR Sleeve? Diane M. Birnbaumer, M.D.,
Introducing the Fastrach-LMA. Prepared by Jim Medeiros, NREMT-P Regional Field Coordinator Lord Fairfax EMS Council
Introducing the Fastrach-LMA Prepared by Jim Medeiros, NREMT-P Regional Field Coordinator Lord Fairfax EMS Council Objectives Review Anatomy of the Upper Airway Review LFEMSC LMA Protocol Discuss Indications
Recognizing the Difficult Airway in Pediatric Patients. Nancy L. Glass, MD, MBA,
Recognizing the Difficult Airway in Pediatric Patients Nancy L. Glass, MD, MBA, FAAP nglass@bcm.edu @DrNancyGlass1 None Disclosures Learning Objectives At the end of this presentation, participants will
Airway Anaesthesia for Final FRCA
Airway Anaesthesia for Final FRCA Final FRCA Teaching July 2018 Dr Kate Henderson Learning Outcomes Popular exam topics Anatomy Case based discussions Exam questions Potential Topics Recent publications
Airway management problem during anaesthesia. Airway management problem occurring in the Emergency Department
4th National Audit Project of the Royal College of Anaesthetists: Major Complications of Airway Management in the UK Please select one form from the list below Airway management problem during anaesthesia
General Medical Procedure. Emergency Airway Techniques (General Airway Protocol)
General Medical Procedure Appropriate airway management is often the most important intervention a prehospital care provider makes, as ensuring adequate oxygenation and ventilation is crucial to the survival
Fiberoptic bronchoscope and C-MAC video laryngoscope assisted nasal-oral tube exchange: two case reports
Case Report pissn 2383-9309 eissn 2383-9317 J Dent Anesth Pain Med 2017;17(3):219-223 https://doi.org/10.17245/jdapm.2017.17.3.219 Fiberoptic bronchoscope and C-MAC video laryngoscope assisted nasal-oral
PAEDIATRIC ANAESTHETIC EMERGENCIES PART I. Dr James Cockcroft, South West School of Anaesthesia. Dr Sarah Rawlinson, Derriford Hospital, Plymouth, UK
PAEDIATRIC ANAESTHETIC EMERGENCIES PART I Original Article by: Dr Claire Todd, South West School of Anaesthesia Dr James Cockcroft, South West School of Anaesthesia Dr Sarah Rawlinson, Derriford Hospital,
Angkana Lurngnateetape,, MD. Department of Anesthesiology Siriraj Hospital
AIRWAY MANAGEMENT Angkana Lurngnateetape,, MD. Department of Anesthesiology Siriraj Hospital Perhaps the most important responsibility of the anesthesiologist is management of the patient s airway Miller
Epiglottitis. Bronchitis. Bronchiolitis. Pneumonia. Croup syndrome. Miss. kamlah 2
Miss. kamlah 1 Epiglottitis. Bronchitis. Bronchiolitis. Pneumonia. Croup syndrome. Miss. kamlah 2 Acute Epiglottitis Is an infection of the epiglottis, the long narrow structure that closes off the glottis
INternational observational study To Understand the impact and BEst practices of airway management in critically ill patients CASE REPORT FORM
INternational observational study To Understand the impact and BEst practices of airway management in critically ill patients Study acronym identifier: INTUBE CASE REPORT FORM Centre ID number: Patient
Anatomy and Physiology. The airways can be divided in to parts namely: The upper airway. The lower airway.
Airway management Anatomy and Physiology The airways can be divided in to parts namely: The upper airway. The lower airway. Non-instrumental airway management Head Tilt and Chin Lift Jaw Thrust Advanced
2/3/2015. Anterior Mediastinal Masses and Lower Airway Problems
es and Lower Airway Problems es and Lower Airway Problems 25 y.o. Female Ant. Mediastinal Mass Cervical Mediastinoscopy + Biopsy Most Important History? A) Dysphagia B) Fever C) Orthopnea D) Chest pain
The LMA CTrach TM, a new laryngeal mask airway for endotracheal intubation under vision: evaluation in 100 patients
British Journal of Anaesthesia 96 (3): 396 400 (2006) doi:10.1093/bja/ael001 Advance Access publication January 16, 2006 The LMA CTrach TM, a new laryngeal mask airway for endotracheal intubation under
Oral and Maxillofacial Surgeons and the seriously injured patient. Barts and The London NHS Trust
Oral and Maxillofacial Surgeons and the seriously injured patient Barts and The London NHS Trust How do you assess this? Primary Survey A B C D E Airway & Cervical Spine Breathing & Ventilation Circulation
Procedure No: Procedure Approved for Use By: WCCSS Divisional Quality Meeting. Date: May 2017
Standard Operating Procedure (SOP): Standard operating procedure for Neonatal Difficult Airway Kit and Intubation Pathway Procedure No: 1 Document replaced: Version 1 Version: 2.0 Procedure Written By:
Anesthetic consideration in Clefts & Craniofacial surgery
Anesthetic consideration in Clefts & Craniofacial surgery พญ.เด อนเพ ญ ห อร ตนาเร อง ภาคว ชาว ส ญญ ว ทยา คณะแพทย แพทยศาสตร มหาว ทยาล ยขอนแก น Preoperative evaluation Cleft lip & Cleft palate reconstruction
I. Subject: Continuous Positive Airway Pressure CPAP by Continuous Flow Device
I. Subject: Continuous Positive Airway Pressure CPAP by Continuous Flow Device II. Policy: Continuous Positive Airway Pressure CPAP by the Down's system will be instituted by Respiratory Therapy personnel
Case Report Laryngeal Radiation Fibrosis: A Case of Failed Awake Flexible Fibreoptic Intubation
Case Reports in Anesthesiology Volume 2011, Article ID 878910, 4 pages doi:10.1155/2011/878910 Case Report Laryngeal Radiation Fibrosis: A Case of Failed Awake Flexible Fibreoptic Intubation Johannes M.
Basic Scope Care and Handling
Basic Scope Care and Handling Basic principles behind fibre-optic instruments Light and image transfer via coherent(image transmission) and incoherent (light)bundles Fibre coating with lower refractory
Difficult Airway Society Guidelines for the management of tracheal extubation
Guidelines doi:10.1111/j.1365-2044.2012.07075.x Difficult Airway Society Guidelines for the management of tracheal extubation Membership of the Difficult Airway Society Extubation Guidelines Group: M.
Airway Management. DFMRT Casualty Care Examination Course. Revision notes for. January Les Gordon
Airway Management Revision notes for DFMRT Casualty Care Examination Course January 2013 Les Gordon Indicating special information in Revision Notes presentations New information since Casualty Care in
Contents. Dentistry Sedation 2. General Anaesthesia 2. Dental Extractions 3. Dental Abscess Surgery 4 Oral/Maxillofacial Surgery...
Contents Dentistry... 2 Sedation 2 General Anaesthesia 2 Dental Extractions 3 Dental Abscess Surgery 4 Oral/Maxillofacial Surgery... 5 General Principles 5 Extraction of Impacted Teeth 5 Orbito-Zygomatic
Major complications of airway management in the United Kingdom
The Royal College of Anaesthetists The Difficult Airway Society 4th National Audit Project of The Royal College of Anaesthetists and The Difficult Airway Society Major complications of airway management
CAN T INTUBATE, CAN T VENTILATE: PLAN A- D
CAN T INTUBATE, CAN T VENTILATE: PLAN A- D MODULE: AIRWAY TARGET: BASIC LEVEL TRAINEES & ALL ANAESTHETISTS BACKGROUND: Management of the Can t Intubate, Can t Ventilate situation is a core skill for all
Airway Management and The Difficult Airway
Airway Management and The Difficult Airway Gary McCalla, MD, FACEP Medical Director REACH Air Medical Services Services 1 It is not enough to do your best, unless you have prepared to be the best. -John
Joint Theater Trauma System Clinical Practice Guideline
Page 1 of 7 Joint Theater Trauma System Clinical Practice Guideline TRAUMA AIRWAY MANAGEMENT Original Release/Approval 18 Dec 2004 Note: This CPG requires an annual review. Reviewed: May 2012 Approved:
Respiratory Care Module. Clinical Skills School of Medicine 2015/16
Respiratory Care Module Clinical Skills School of Medicine 2015/16 Learning Objectives Students should be able to Identify the various Airway management Adjuncts and O2 delivery systems. Identify indications
ISSN X (Print) Research Article. *Corresponding author Dr. Souvik Saha
Scholars Journal of Applied Medical Sciences (SJAMS) Sch. J. App. Med. Sci., 2015; 3(6B):2238-2243 Scholars Academic and Scientific Publisher (An International Publisher for Academic and Scientific Resources)
What is the next best step?
Noninvasive Ventilation William Janssen, M.D. Assistant Professor of Medicine National Jewish Health University of Colorado Denver Health Sciences Center What is the next best step? 65 year old female
CASE PRIMERS. Pediatric Anesthesia Fellowship Program. Laryngotracheal Reconstruction (LTR) Tufts Medical Center
CASE PRIMERS Pediatric Anesthesia Fellowship Program Tufts Medical Center Department of Anesthesiology and Perioperative Medicine Division of Pediatric Anesthesia 800 Washington Street, Box 298 Boston,
Introduction to Emergency Medical Care 1
Introduction to Emergency Medical Care 1 OBJECTIVES 8.1 Define key terms introduced in this chapter. Slides 12 15, 21, 24, 31-34, 39, 40, 54 8.2 Describe the anatomy and physiology of the upper and lower
This interdisciplinary clinical support document provides guidelines for the safe establishment of an artificial airway.
PURPOSE This interdisciplinary clinical support document provides guidelines for the safe establishment of an artificial airway. POLICY STATEMENTS Endotracheal intubation will be performed by the Most
TRACHEOSTOMY EMERGENCIES
TRACHEOSTOMY EMERGENCIES MODULE: AIRWAY TARGET: ALL ANAESTHETISTS, INTENSIVISTS, ED & ACUTE PHYSICIANS, FOUNDATION DOCTORS BACKGROUND: Around 16% of ICU patients may have a tracheostomy. Life- threatening
Citation British journal of anaesthesia, 104. pp ; 2010 is available onlin
NAOSITE: Nagasaki University's Ac Title Laryngeal mask airway Supreme for a Author(s) Murata, Hiroaki; Nagaishi, Chikako; Citation British journal of anaesthesia, 104 Issue Date 2010-03 URL Right http://hdl.handle.net/10069/24856
Nicolette Mosinski MPAS, PA-C
Nicolette Mosinski MPAS, PA-C 1. Impaired respiratory effort 2. Airway obstruction Observe patient for detection Rate Pattern Depth Accessory muscle use Evidence of injury Noises Silent manifestations
Australian and New Zealand College of Anaesthetists (ANZCA)
PS61 2017 Australian and New Zealand College of Anaesthetists (ANZCA) Guidelines for the Management of Evolving Airway Obstruction: Transition to the Can t Intubate Can t Oxygenate Airway Emergency 1.
NON INVASIVE LIFE SAVERS. Non Invasive Ventilation (NIV)
Table 1. NIV: Mechanisms Of Action Decreases work of breathing Increases functional residual capacity Recruits collapsed alveoli Improves respiratory gas exchange Reverses hypoventilation Maintains upper
FAILED ELECTIVE INTUBATION: PLAN A- C
FAILED ELECTIVE INTUBATION: PLAN A- C MODULE: AIRWAY TARGET: NOVICE, BASIC LEVEL TRAINEES & ALL ANAESTHETISTS BACKGROUND: Management of the unexpectedly difficult airway is a core skill for all anaesthetists.
Pediatric Airway and Respiratory Emergencies. Objectives 30/01/2009
Objectives Pediatric Airway and Respiratory Emergencies Patrick Mahar, MD Review the anatomical differences between adult and pediatric airways Recognize different causes of respiratory comprise in pediatric
Question: Is this patient an infant? A patient less than 12 months old is considered an infant. Please check the box next to the appropriate choice.
Question: Date of Intubation (Month, Day, Year): Question: Date of Data Entry This should be within 4 weeks to the day of intubation: Question: Is this patient an infant? A patient less than 12 months
Your anaesthetic for heart surgery
Your anaesthetic for heart surgery Information for patients and carers First Edition 2018 www.rcoa.ac.uk/patientinfo This leaflet gives you information about your anaesthetic for adult heart (cardiac)
Ventilating the paediatric patient. Lizzie Barrett Nurse Educator November 2016
Ventilating the paediatric patient Lizzie Barrett Nurse Educator November 2016 Acknowledgements Kate Leutert NE PICU Children's Hospital Westmead Dr. Chloe Tetlow VMO Anaesthetist and Careflight Overview
FAILED INTUBATION DURING RSI: PLAN A, C & D
FAILED INTUBATION DURING RSI: PLAN A, C & D MODULE: NOVICE & AIRWAY TARGET: NOVICE INITIAL ASSESSMENT OF COMPETENCY ALL ANAESTHETISTS BACKGROUND: Management of the Can t Intubate, Can t Ventilate situation
Provision of General Anesthesia Out of Hospital: Perspective from The Americas. Anthony Charles Caputo
Provision of General Anesthesia Out of Hospital: Perspective from The Americas Anthony Charles Caputo Welcome!! A Little About Me President, Southwest Dental Anesthesia Services Past President, American
Appendix (i) The ABCDE approach to the sick patient
Appendix (i) The ABCDE approach to the sick patient This appendix and the one following provide guidance on the initial approach and management of common medical emergencies which may arise in general
Liberation from Mechanical Ventilation in Critically Ill Adults
Liberation from Mechanical Ventilation in Critically Ill Adults 2017 ACCP/ATS Clinical Practice Guidelines Timothy D. Girard, MD, MSCI Clinical Research, Investigation, and Systems Modeling of Acute Illness
9/20/18. Ear To Sternal Notch. Primary Methods to Rescue & Prevent Failed Intubation. Ear to Sternal Notch Position
Primary Methods to Rescue & Prevent Failed Intubation Communicating and Working with a Knowledgeable Assistant External Laryngeal Manipulation Bimanual Larynogscopy Head-Elevated Larynogscopy Position
Michigan General Procedures EMERGENCY AIRWAY. Date: November 15, 2012 Page 1 of 16
Date: November 15, 2012 Page 1 of 16 Emergency Airway Effective airway management and ventilation are important lifesaving interventions that all EMS providers must be able to perform. The approach to
REVERSE LMA INSERTION IN A NEONATE WITH KLIPPEL-FEIL SYNDROME
REVERSE LMA INSERTION IN A NEONATE WITH KLIPPEL-FEIL SYNDROME - Case report - TARIQ AL ZAHRANI * Klippel-Feil syndrome (KFS) was first described by Maurice Klippel and Andre Feil in 1912 in a patient with
Airway Management in the Multiply Traumatized Patient
Airway Management in the Multiply Traumatized Patient Toronto Anesthesia Symposium April 18, 2015 Dr. Jeffrey Wassermann Department of Anesthesia St. Michael s Hospital University of Toronto Airway Management
Rapid Sequence Induction
Rapid Sequence Induction Virtual simultaneous administration, after preoxygenation, of a potent sedative agent and a rapidly acting neuromuscular blocking agent to facilitate rapid tracheal intubation
The Pediatric Airway. Andrew Wackett, MD
The Pediatric Airway Andrew Wackett, MD Objectives 1) Demonstrate understanding of the indications for intubation 2) Perform rapid sequence intubation 3) Learn the pharmacology behind emergency airway
Anesthetic challenges when elective case becomes emergent
Anesthetic challenges when elective case becomes emergent Shridevi Pandya Shah MD Asst Professor Dept of Anesthesiology Rutgers-NJMS Rutgers, The State University of New Jersey Conflicts of interest: none
Respiratory Anesthetic Emergencies in Oral and Maxillofacial Surgery. By: Lillian Han
Respiratory Anesthetic Emergencies in Oral and Maxillofacial Surgery By: Lillian Han Background: Respiratory anesthetic emergencies are the most common complications during the administration of anesthesia
Weaning from Mechanical Ventilation. Dr Azmin Huda Abdul Rahim
Weaning from Mechanical Ventilation Dr Azmin Huda Abdul Rahim Content Definition Classification Weaning criteria Weaning methods Criteria for extubation Introduction Weaning comprises 40% of the duration
Tracheostomy. Hope Building Neurosurgery
Tracheostomy Hope Building Neurosurgery 0161 206 5055 All Rights Reserved 2017. Document for issue as handout. Unique Identifier: CS36(17). Review date: November 2019 What is a tracheostomy? A tracheostomy