Management of the Airway
|
|
|
- Shana Long
- 5 years ago
- Views:
Transcription
1 Management of the Airway Kristen Bridges, M.D. Kings County Hospital Center November 12 th 2015
2 Case Presentation 64F PMHx CHF EF 5-10%, NYHF III-IV, atrial fibrillation/la thrombus, CVA x2, DM, HTN Home meds: coumadin, ASA, metoprolol, lasix, atorvastatin, tramadol, hydralazine, enalapril Admitted for lower extremity pain, difficulty ambulating INR>10, BNP 3980, trop 0.8, HCO3 15, BUN/Cr 35/2.14 Admitted for acute CVA, klebsiella UTI
3 Hospital Course HD#2: Code 88 for unresponsiveness, GCS 3, intubated, tachycardic Hypotensive, started on dopamine gtt Found to have embolic disease to brain
4 Hospital Course WBC rose to 49K Klebsiella UTI treated, c diff neg ECHO LA thrombus (no vegetations) CSF negative Bullae of LE- CT neg for nec infection MRI brain multiple recent ischemic infarcts likely 2/2 emboli
5 Hospital Course POD#9 s/p percutaneous tracheostomy Medical team noted an air leak, SVT, consulted CT surgery Losing 100cc tidal volume ABG 7.6/203/28 NAD Decision made to exchange tracheostomy
6 Hospital Course Tracheostomy removed, replaced with distal XLT, no end tidal CO2- Removed, replaced, still no ETCO2 Patient desaturated, code 88 called Bradycardia- asystole ACLS started, code 99- Patient expired
7 Questions?
8 Airway Management
9 ABCs Airway is first step in ATLS primary survey Look and listen, pulse oximetry Ask patient their name
10 Mallampatti/Cormack-Lehane
11 Definitive Airway Indications Hypoventilation Hypoxemia Airway obstruction Severe hemorrhagic shock Cardiac arrest GCS </= 8
12 Questions to Ask Is intubation required? How quickly does this need to be done? How difficult will it be? Which method should I choose? What are my back up plans?
13 Three Components 3 manuevers can identify difficult airways: Examination of oropharynx Evaluation range of motion at atlanto-axial joint Measurement of mandibular displacement area
14 Supraglottic Techniques
15 Head-Tilt/Chin Lift/Jaw Thrust
16 Oropharyngeal/Nasopharyngeal Airway
17 Bag-Valve Mask Essential skill!! The most important airway skill Almost every patient can be managed this way 2 person technique
18 Supraglottic Airway Devices Laryngeal mask airway Multilumen esophageal airway (CombiTube) Laryngeal tube airway All do not require direct visualization of the glottis DO NOT REPRESENT DEFNITIVE AIRWAY Require unconscious patient with NO gag reflex
19 LMA
20 Combitube
21 Contraindications to CombiTube Intact gag reflex Wrong height Known esophageal disease Caustic substance injection Inhalation burns
22 Infraglottic Techniques
23 Awake Fiberoptic Intubation Use with suspicion of cervical spinal cord injuries and non emergent intubation Minimizes cervical spine movements Premedicate with glycopyrrolate Lidocaine for airway anesthesia Oral airway Insert fiberoptic scope, visualize cords, spray the vocal cords with lidocaine Insert endotracheal tube with a videolaryngoscope or over a fiberoptic brocnchoscope
24 Rapid Sequence Intubation Sedation/hypnotic agent + paralysis to facilitate emergent intubation of conscious patients Non-paralysis intubations had more airway trauma, aspiration injury, death Use when need to intubate quickly, efficiently, risk of aspiration of gastric contents is high Avoid bag valve mask ventilation
25 Seven P s of RSI Preparation Preoxygenation Pretreatment Paralysis Protection/Positioning Placement/Proof Post Intubation management
26 Medications- Versed Midazolam Fat soluble benzodiazepine Induces sedation/amnesia CI: shock, hypotension Dose: 0.2 mg/kg Onset 2-3 min Duration min
27 Medications- Propofol Alkylphenol derivative with hypnotic properties Induction Caution if hypotensive, causes decreased systemic vascular resistance Dose: 2mg/kg Onset: sec Duration 8-10 min
28 Medications- Etomidate Dose 0.3 mg/kg Onset sec Duration min Hemodynamically neutral
29 Medications- Paralytics Succinylcholine Dose 1.5 mg/kg Can administer IM Contraindicated in burns, open globe injuries, neuromuscular disorders, hyperkalemia, pseudocholinesterase deficiency, severe crush injury, chronic paralysis Duration: 6-10 min Rocuronium Dose mg/kg Duration: 45 min
30 Endotracheal Intubation First line airway in trauma patients Cricoid pressure Need: Bag valve mask Laryngoscope Endotracheal tube Stylet Suction End tidal CO2 detector stethoscope
31 Direct Laryngoscopy
32 Video Laryngoscope/Glidescope
33 Stylets
34
35 Surgical Airway
36 Cricothyroidotomy Indications: Absolute need for definitive airway + Inability to perform endotracheal intubation (structural reasons, upper airway obstruction, unsuccessful attempts) What you ll need: Scalpel 6mm endotracheal tube Mask/gloves +/- lidocaine, gown, betadine, hemostat, trousseau dilator, tracheal hook
37
38
39
40
41
42
43 Cricothyroidotomy cm incision over the cricothyroid membrane with 10/11 scalpel Insert hemostat into the incision and open the airway Insert cuffed ETT (5 or 6 size) or tracheostomy tube through incision
44 Needle Cricothyroidotomy Insufficient time for full cricothyroidotomy 12 or 14 gauge needle attached to 5-10 ml syringe to puncture the skin directly over the cricothyroid membrane Drop angle to 45 degrees after through skin and angle 45 degrees caudally Aspirate air remove syringe Connect needle to jet ventilation device or ETT connector
45 Management Convert to formal tracheostomy by hours
46
47 Question #1 Patient with severe head injury had a percutaneous tracheostomy performed with a #8 tracheostomy tube. Two days later, the tube is no longer in the airway and the patient has labored breathing. What is your next step? Replace the tube through the existing tract Repeat the percutaneous tracheostomy Perform oral intubation Peform a cricothyroidotomy Perform an open tracheostomy
48 Question #2 A 5-year-old boy is struck by a car at a high rate of speed. Paramedics are unable to intubate the patient and he presents to the trauma bay with a GCS score of 7 and an open right femur fracture. He is being bag~valve mask ventilated. His pulse oximeter reads 98%. Which is CONTRAINDICATED in this child? Needle cricothyroidotorny Surgical cricothyroidotomy Endotracheal intubation Tracheostomy Laryngeal Mask Airway
49 References Hall J, Schmidt G. Critical Care: Just the Facts. McGraw Hill Education, 2007 Spiegel J, Shah V. Surgical Management of the Failed Airway. Anesthesiology News, 2014 Cameron, JL. (2014). Airway Management in the Trauma Patient (pp ). (11 th Ed). Current Surgical Therapy. Philadephia, PA: Elsevier Saunders
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
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
Physical Exam. T 97.4, HR 76, BP 90/51, Sat 96% Lethargic Lungs clear Heart regular Abdomen soft, epigastric tenderness, distension
Case Report 58yM with non-bilious non-bloody vomiting for one week. Also reported epigastric abdominal pain. PMH: obesity, HTN, HIV, prior CVA with left sided weakness, bipolar disorder PSH: none SH: former
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
The Advanced Airway Management protocol should be used on all patients requiring advanced airway management procedures. This protocol is divided into three sections the Crash Airway Algorithm, the Rapid
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:
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
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
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
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
Adult Advanced Cardiovascular Life Support. Emergency Procedures in PT
Adult Advanced Cardiovascular Life Support Emergency Procedures in PT BLS Can be learned & practiced by the general public Includes: CPR First Aid (e.g. choking relief) Use of AED ACLS Used by healthcare
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
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
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
INTUBATION/RSI. PURPOSE: A. To facilitate secure, definitive control of the airway by endotracheal intubation in an expeditious and safe manner
Manual: LifeLine Patient Care Protocols Section: Adult/Pediatrics Protocol #: AP1-009 Approval Date: 03/01/2018 Effective Date: 03/05/2018 Revision Due Date: 12/01/2018 INTUBATION/RSI PURPOSE: A. To facilitate
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
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
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
RAPID SEQUENCE INTUBATION FOR THE RURAL DOC
Society of Rural Physicians of Canada 26TH ANNUAL RURAL AND REMOTE MEDICINE COURSE ST. JOHN'S NEWFOUNDLAND AND LABRADOR APRIL 12-14, 2018 Dr. Braam de Klerk VICTORIA BC 240 RAPID SEQUENCE INTUBATION FOR
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
Advanced Airway Management PRESENTED BY: JOSIAH POIRIER RN, JOHN GRUBER FP-C
Advanced Airway Management PRESENTED BY: JOSIAH POIRIER RN, JOHN GRUBER FP-C Advanced Airway Objectives Advanced airway management is a relatively low frequency, high risk intervention. The following education
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
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.,
Advanced Airway Management
CHAPTER 37 Advanced Airway Management Airway Anatomy and Physiology Review Respiratory System: The Airway Respiratory System (Supine) Physiology: Factors of Adequate Breathing Functioning brainstem Open
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
A Successful RSI Program
RSI A Successful RSI Program Requires understanding of: Indications Contraindications Limitations Requires knowledge of: Physiology Pharmacology Airway techniques Goals of RSI Success rates comparable
Difficult Airway. Department of Anesthesiology University of Colorado Health Sciences Center (prepared by Brenda A. Bucklin, M.D.)
Difficult Airway Department of Anesthesiology University of Colorado Health Sciences Center (prepared by Brenda A. Bucklin, M.D.) Objectives Definition & incidence of the difficult airway Evaluation of
Emergency Airway Management. Richard P. Dutton, M.D., M.B.A. Chief Quality Officer US Anesthesia Partners
Emergency Airway Management Richard P. Dutton, M.D., M.B.A. Chief Quality Officer US Anesthesia Partners Disclosures I have studied a lot of airway gizmos over the years. I have no financial interest in
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
Kelowna June 2011 Airway Assessment and Management. Golden, BC
Kelowna June 2011 Airway Assessment and Management Dr. Bruce Starke Golden, BC Not really... I am unable to identify any potential conflict of interest and I am unable to identify any potential conflict
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
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
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
Airway Management and Ventilation. Eric V. Ernest, M.D., EMT-P Department of Emergency Medicine University of Nebraska Medical Center
Airway Management and Ventilation Eric V. Ernest, M.D., EMT-P Department of Emergency Medicine University of Nebraska Medical Center Airway/Ventilation Overview Respiratory Assessment Supplemental Oxygen
Prehospital Medication Assisted Intubation
Prehospital Medication Assisted Intubation Supersedes: 09-11-06 Effective: 01-29-10 This document includes the protocol for prehospital medication assisted intubation (MAI). Also included are clinical
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
Pearls and Pitfalls of Rapid Sequence Intubation
Transcript Details This is a transcript of an educational program accessible on the ReachMD network. Details about the program and additional media formats for the program are accessible by visiting: https://reachmd.com/programs/clinicians-roundtable/pearls-and-pitfalls-of-rapid-sequenceintubation/3829/
Waitin In The Wings. Esophageal/Tracheal Double Lumen Airway (Combitube ) Indications and Use for the Pre-Hospital Provider
Waitin In The Wings Esophageal/Tracheal Double Lumen Airway (Combitube ) Indications and Use for the Pre-Hospital Provider 1 CombiTube Kit General Description The CombiTube is A double-lumen tube with
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,
PEMSS PROTOCOLS INVASIVE PROCEDURES
PEMSS PROTOCOLS INVASIVE PROCEDURES Panhandle Emergency Medical Services System SURGICAL AND NEEDLE CRICOTHYROTOMY Inability to intubate is the primary indication for creating an artificial airway. Care
When I started. 10/27/2009. Gerald Wydro, MD Clinical Associate Professor Emergency Medicine Temple University School of Medicine
When I started. Gerald Wydro, MD Clinical Associate Professor Emergency Medicine Temple University School of Medicine When I started. When I started. When I started. When I started. How To Make A Fertile
NOTE: EPISODE CONTENT IS BASED ON ROSEN S EMERGENCY MEDICINE (9TH ED.)
Chapter 1 Airway NOTE: EPISODE CONTENT IS BASED ON ROSEN S EMERGENCY MEDICINE (9TH ED.) NOTE: Italicized text is quoted directly from Rosen s. Key Concepts: 1. Anticipating the clinical course of the patient
VUMC Multidisciplinary Surgical Critical Care Service
VUMC Multidisciplinary Surgical Critical Care Service SICU Standard Operating Procedure: Guidelines for Intubation I. Definition Intubation is required for SICU patients who cannot maintain a patent airway,
Blind Insertion Airway Devices (BIAD)
P03 Procedures 2017-05-12 All ages Office of the Medical Director Blind Insertion Airway Devices (BIAD) Primary Intermediate Advanced Critical From AIRWAY & BREATHING MANAGEMENT or AIRWAY OBSTRUCTION Yes
ADVANCED AIRWAY PROCEDURES
ADVANCED AIRWAY PROCEDURES This procedure includes the following: Endotracheal intubation (plus use of Supraglottic Airway Laryngopharyngeal Tube (S.A.L.T. device), gum elastic bougie assisted tracheal
Anesthesia Final Exam
Anesthesia Final Exam 1) For a patient who is chronically taking the following medications, which two should be withheld on the day of surgery? a) Lasix b) Metoprolol c) Glucophage d) Theodur 2) A 51 year
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
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
CARDIAC EMERGENCIES Other Cardiac Dysrhythmias C9
CARDIAC EMERGENCIES Other Cardiac Dysrhythmias C9 ATRIAL FLUTTER Variable rate depending on block. Atrial rate between 250-350, saw-tooth pattern. (see Appendix B for energy settings for bi-phasic low
Orotracheal Intubation
T h e n e w e ng l a nd j o u r na l o f m e dic i n e videos in clinical medicine Orotracheal Intubation Christopher Kabrhel, M.D., Todd W. Thomsen, M.D., Gary S. Setnik, M.D., and Ron M. Walls, M.D.
and most critical steps in the initial assessment of every patient you will encounter.
1 Chapter 8 Airway Management and Ventilation 2 Airway management and ventilation are the and most critical steps in the initial assessment of every patient you will encounter. 3 Respiratory Problems 4
student handbook BARS handbook September 2012.indd Front Cover 27/11/12 12:08 PM
student handbook BARS handbook September 2012.indd Front Cover 27/11/12 12:08 PM All materials regarding the Basic Airway Resuscitation Strategy Course were written and developed by Dr. Richard Morris
VANDERBILT UNIVERSITY MEDICAL CENTER DIVISION OF ANESTHESIOLOGY CRITICAL CARE MEDICINE AIRWAY MANAGEMENT
These guidelines are based upon medical literature review and expert opinion and are intended to provide recommendations for in the care of critically ill patients. Best Practice Guidelines Checklist for
Joint Trauma System. Airway Trauma Injury Management
Joint Trauma System Airway Trauma Injury Management 1 Agenda Contributors Purpose Summary Key Principles of CPG Performance Improvement (PI) Monitoring References List of Appendices in CPG 2 Contributors
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
RAPID SEQUENCE INTUBATION FOR THE RURAL DOC
Society of Rural Physicians of Canada 26TH ANNUAL RURAL AND REMOTE MEDICINE COURSE ST. JOHN'S NEWFOUNDLAND AND LABRADOR APRIL 12-14, 2018 Dr. Braam de Klerk VICTORIA BC 240 RAPID SEQUENCE INTUBATION FOR
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 2015 Updates in Emergency Airway Management
Airway 2015 Updates in Emergency Airway Management Gerry Maloney, DO, FACOEP Associate Medical Director, Metro Life Flight Attending Physician, Emergency Medicine, CWRU/MetroHealth Medical Center None
PRACCTICE GUIDELINE EM015 RAPID SEQUENCE INTUBATION
PRACTICE GUIDELINE EM015 RAPID SEQUENCE INTUBATION This Practice Guideline sets out algorithms for Intubation in the emergency environment. The evidence review supporting this Practice Guideline is presented
The Primary Survey. C. Clay Cothren, MD FACS. Attending Surgeon, Denver Health Medical Center Assistant Professor of Surgery, University of Colorado
The Primary Survey C. Clay Cothren, MD FACS Attending Surgeon, Denver Health Medical Center Assistant Professor of Surgery, University of Colorado Outlining the ABCs Why do we need such an approach? The
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
ANESTHESIA EXAM (four week rotation)
SPARROW HEALTH SYSTEM ANESTHESIA SERVICES ANESTHESIA EXAM (four week rotation) Circle the best answer 1. During spontaneous breathing, volatile anesthetics A. Increase tidal volume and decrease respiratory
Case 1: Fast and noisy. The Ins and Outs of the Pediatric Airway. Airway: anatomic differences. Objectives 2/16/2014
Case 1: Fast and noisy The Ins and Outs of the Pediatric Airway Judith Klein, MD, FACEP Assistant Professor of Emergency Medicine UCSF-SFGH Department of Emergency Medicine 8 month old BIB parents for
EMS Subspecialty Certification Review Course. Learning Objectives
EMS Subspecialty Certification Review Course 1.1.2 Airway Compromise / Respiratory Failure 1.1.2.1 Devices for securing airway 1.1.2.2 Portable ventilator management 1.1.2.3 Pros and cons of drug assisted
ISPUB.COM. Rapid Sequence Induction for Prehospital Providers. R Pousman I. INTRODUCTION III. AIRWAY ANATOMY II. BRIEF HISTORY
ISPUB.COM The Internet Journal of Advanced Nursing Practice Volume 3 Number 2 R Pousman Citation R Pousman.. The Internet Journal of Advanced Nursing Practice. 1998 Volume 3 Number 2. Abstract I. INTRODUCTION
Overview. Chapter 37. Advanced Airway Techniques. Sellick Maneuver 9/11/2012
Chapter 37 Advanced Airway Techniques Slide 1 Sellick Maneuver Purpose Anatomic Location Technique Special Considerations Overview Advanced Airway Management of Adults Esophageal Tracheal Combitubes Tracheal
Emergency Cricothyrotomy
Emergency Cricothyrotomy SWORBHP Live Paramedic Rounds June 15, 2012 Sameer Mal PGY4 Emergency Medicine Dwayne Cottel Regional Paramedic Educator Overview BVM Ventilation Intro to Cricothyrotomy Relevant
INTUBATION APPENDIX II. INDICATIONS AND CONTRAINDICATIONS II. COMPLICATIONS: APPENDIX: 2 TITLE: INTUBATION PROCEDURES. REVISED: May 1, 2016
APPENDIX: TITLE: PROCEDURES REVISED: May 1, 016 I. BACKGROUND Advanced Airway Procedures and competency are the cornerstones of Paramedicine. True competency involves knowing not only how to control the
North Carolina College of Emergency Physicians Standards for EMS Medications and Skills Use
. The baseline medications and skills required in all systems and Specialty Care Transport Programs) with EMS personnel credentialed at the specified level. S. The equipment required in all Specialty Care
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
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
ANESTHESIOLOGY CASE LOG CHANGES 2015
ANESTHESIOLOGY CASE LOG CHANGES 2015 I. Case Information FORMER: 1. Role removed. 2. Setting removed. 3. Involved Morbidity has been renamed Life-Threatening Pathology. a. All former cases that included
PRODUCTS FOR THE DIFFICULT AIRWAY. Courtesy of Cook Critical Care
PRODUCTS FOR THE DIFFICULT AIRWAY Courtesy of Cook Critical Care EMERGENCY CRICOTHYROTOMY Thyroid Cartilage Access Site Cricoid Cartilage Identify the cricothyroid membrane between the cricoid and thyroid
Adult Intubation Skill Sheet
Adult Intubation 2. Opens the airway manually and inserts an oral airway *** 3. Ventilates the patient with BVM attached to oxygen at 15 lpm *** 4. Directs assistant to oxygenate the patient 5. Selects
How do you use a bougie as an airway adjunct for endotracheal intubation?
Ruth Bird, MBBCh -Specialist Registrar: Anaesthesia & Paediatric Trauma Fellow Daniel Nevin, MBBCh -Consultant in Anaesthesia & Pre-Hospital Care The Royal London Hospital London s Air Ambulance (HEMS)
Trauma operating room
Section 1 Chapter 1 Operating Room General Conduct Trauma operating room Kenji Inaba and Lisa L. Schlitzkus Operating room A large operating room (OR) situated near the emergency department, elevators,
SESSION 3 OXYGEN THERAPY
SESSION 3 OXYGEN THERAPY Harith Eranga Yapa Department of Nursing Faculty of Health Sciences The Open University of Sri Lanka 1 Outline Methods of delivery Complications of oxygen therapy Artificial airways
(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
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
Jason Zurba BSc RRT Supervisor Royal Columbian Hospital
Jason Zurba BSc RRT Supervisor Royal Columbian Hospital Outline Why we started looking at this What our own data has shown us What the literature tells us about intubation What we have changed How this
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
Rapid Sequence Intubation 2 CEUs By: Louis Durkin MD INTRODUCTION
Rapid Sequence Intubation 2 CEUs By: Louis Durkin MD INTRODUCTION A 2-hour course, covering the pharmacology and risk/benefits of various rapid sequence intubation medications. This lecture stresses the
Overview. The Team Concept. Chapter 7. Assisting the ALS Provider 9/11/2012. The Team Concept ALS Procedures and Equipment
Chapter 7 Assisting the ALS Provider Slide 1 Overview The Team Concept ALS Procedures and Equipment Electrocardiogram (ECG) Monitoring Slide 2 The Team Concept Prehospital care involves many individuals
Addendum D. Procedural Sedation Test MERCY MEDICAL CENTER- SIOUX CITY. Procedural Sedation Questions
Addendum D. Procedural Sedation Test MERCY MEDICAL CENTER- SIOUX CITY Procedural Sedation Questions Individuals applying for moderate sedation privileges must achieve a score of 80%. PRACTITIONER NAME
APPROACH TO THE EMERGENCY AIRWAY. Scott B. Davidson MD, FACS Trauma Surgery Service Bronson Methodist Hospital
APPROACH TO THE EMERGENCY AIRWAY Scott B. Davidson MD, FACS Trauma Surgery Service Bronson Methodist Hospital Objectives History Initial recognition Get your act together Surgical options Complications
9/29/2014 CHALLENGING PEDIATRIC TRAUMA CASES: PEARLS FOR CARE. Traumatic injuries are the #1 cause of death for age 1-18 years old
CHALLENGING PEDIATRIC TRAUMA CASES: PEARLS FOR CARE UW Medicine EMS & Trauma Conference Jamie Shandro MD MPH Associate Professor, Emergency Medicine Harborview Medical Center September 29, 2014 WHY IS
Pediatric Patients. BCFPD Paramedic Education Program. EMS Education Paramedic Level
Pediatric Patients BCFPD Program Basic Considerations Much of the initial patient assessment can be done during visual examination of the scene. Involve the caregiver or parent as much as possible. Allow
Effectiveness of Fiberoptic Intubation in Anticipated Difficult Airway
Original Article Effectiveness of Fiberoptic Intubation in Anticipated Difficult Airway Khawaja Kamal Nasir, Faraz Mansoor From Department of Anesthesia, Pakistan Institute of Medical Sciences, Islamabad.
Delayed Complications of Emergency Airway Management: A Study of 533 Emergency Department Intubations
Original Research Delayed Complications of Emergency Airway Management: A Study of 533 Emergency Department Intubations John C. Sakles, MD* John M. Deacon, MD Aaron E. Bair, MD, MSc Samuel M. Keim, MD,
ATLS 10th ed. Course Structure and Content Changes. Current Update on ATLS For Trauma Patients
ATLS 10th ed. Course Structure and Content Changes Current Update on ATLS For Trauma Patients ATLS 10th ed. Course Structure and Content Changes International ATLS 86 countries > 1 million trained > 50%
The Ins and Outs of the Pediatric Airway
The Ins and Outs of the Pediatric Airway Judith Klein, MD, FACEP Assistant Professor of Emergency Medicine UCSF-SFGH Department of Emergency Medicine Case 1: Fast and noisy 8 month old BIB parents for
Fundamental Clinical Concepts PART I
Fundamental Clinical Concepts PART I Chapter 1 Airway Ron M. Walls Section One Critical Management Principles PERSPECTIVE Airway management is the cornerstone of resuscitation and is a defining skill for
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,
Airway Management Adult
Airway Management Adult Goals: Provide effective oxygenation and ventilation; recognize and alleviate respiratory distress or failure; provide necessary interventions quickly and safely to patients who
Basic Airway Management
Basic Airway Management Dr. Madhurita Singh, Assoc. Professor, Dept. of Critical Care, CMC Vellore. This is the first module in a series on management of airway and ventilation in critically ill patients.
Acute Respiratory Failure
Acute Respiratory Failure Family Medicine Update Big Sky, Montana January, 2014 Mark Tieszen, MD, FCCM, FCCP Sanford Medical Center Fargo Critical Care Medicine mark.tieszen@sanfordhealth.org Acute Respiratory
Airway management and ventilation are the and most critical steps in the initial assessment of every patient you will encounter.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Chapter 8 Airway Management and Ventilation Airway management and ventilation are the and most critical steps in the initial assessment of every patient you will encounter.
DON T PRACTICE UNTIL YOU GET IT RIGHT. PRACTICE UNTIL YOU CAN T GET IT WRONG.
ADVANCED AIRWAY MANAGEMENT AND THE DIFFICULT AIRWAY DON T PRACTICE UNTIL YOU GET IT RIGHT. PRACTICE UNTIL YOU CAN T GET IT WRONG. The Decision to Intubate n Can the patient protect their airway? n Can
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,