airway management in penetrating trauma

... endotracheally intubated, with all intubations occurring within 24 hours of admission, and prolonged ventilator dependence was anticipated and was the indication for a surgical airway in all patients ... larynx positioned in the thoracic inlet rather than the neck proper, resulting in intrathoracic placement of the trachea virtually in its entire length These challenges of individual anatomy ... discharge in the tracheostomy group None of the deaths in either group were airway related Table Follow-up telephone interviews assessed wound healing, voice changes, breathing or swallowing difficulties...

Ngày tải lên: 12/08/2014, 19:21

... progressive airway edema It must be appreciated that active airway interventions such as intubation are not without complications Intubation for the indications of obtaining and maintaining a patent airway ... impending complete airway obstruction Intubation is indicated in this patient to obtain and maintain a patent airway and for predicted clinical deterioration While making preparations for intubation, ... resume, although intubation may still be indicated to maintain ongoing airway patency In the apneic patient, initial BLS maneuvers are still indicated to assess and establish airway patency, but...

Ngày tải lên: 10/08/2014, 18:20

... FUNCTIONAL AIRWAY ANATOMY The Upper Airway The immediate goal of airway management during resuscitation is to obtain a patent upper airway and ensure adequate oxygenation The upper airway may be defined ... to the airway ᭤ AIRWAY INNERVATION Knowledge of the innervation of the airway is important to the airway manager contemplating application of airway anesthesia to facilitate an “awake” intubation ... greater in infants and young children Optimal airway angulation for laryngoscopy is achieved in infants by placing a towel under the shoulders Preschoolers are usually in good intubating position...

Ngày tải lên: 10/08/2014, 18:20

... help align airway axes, in turn helping attain a direct line-ofsight view from the clinician’s eye to the laryngeal inlet (Fig 3–8, Chap 3) The sniffing position can be attained by placing folded ... the supine position If an awake intubation is 61 planned, the patient can be intubated in the sitting or semisitting position using DL or other intubation technique In this situation, the clinician ... Continuously reading capnographs are being used increasingly in out-of-operating room (OR) environments, using infrared spectrometry to measure and display carbon dioxide concentration in inspired and...

Ngày tải lên: 10/08/2014, 18:20

... are expensive to attain and maintain, and skills acquisition is also an issue, resulting in these instruments rarely being used for intubation by non-anesthesia clinicians Having said this, flexible ... routine use can be espoused over EGDs with a long history of safe use In addition, using an EGD that is in common use in an institution’s operating rooms increases the opportunity for obtaining ... laryngoscopy in teaching and in managing the difficult airway Surg Endosc 2006;20 Suppl 2:S479–483 53 Agro F, Barzoi G, Montecchia F Tracheal intubation using a Macintosh laryngoscope or a GlideScope in...

Ngày tải lên: 10/08/2014, 18:20

... over saline).6–9 B The nares can be anesthetized by applying 2% lidocaine jelly to, and inserting a nasopharyngeal airway, or using a cotton pledget soaked with 2% lidocaine with epinephrine Alternatively, ... not be expected All contraindications to BNTI (including apnea) are relative, and include upper airway foreign bodies, bleeding diathesis (including heparinized, warfarinized, or recently thrombolyzed ... facilitate tracheal intubation, and that intubation in turn is only one facet of airway management Trauma Life Support (ATLS) now supports the use of RSI to facilitate airway management in trauma patients.4...

Ngày tải lên: 10/08/2014, 18:20

... intubation alone does not define an endpoint in airway management Although a priority, airway management is just one component in the resuscitation of the acutely ill patient The managing clinician ... laryngoscopy may ᭤ INTRODUCTION The indications for endotracheal intubation have been reviewed in Chap For the patient requiring intubation in an emergency, assuming an attending clinician with requisite ... patients requiring airway management in emergencies will need to be intubated Most intubations in emergencies are facilitated by direct laryngoscopy, so a good starting point for the airway evaluation...

Ngày tải lên: 10/08/2014, 18:20

... supporting the use of defasciculating agents prior to succinylcholine use in brain-injured patients In practice, succinylcholine is commonly used to facilitate intubation in this population.72 Succinylcholine ... aid in airway management It has a relatively slow onset time, taking up to 15 minutes for peak effect following an IV injection In addition, morphine can result in histamine release, making it ... following a repeat dose of succinylcholine In this regard, it is recommended that atropine be administered prior to giving a second dose of succinylcholine, even in a tachycardic patient Succinylcholine...

Ngày tải lên: 10/08/2014, 18:20

... scenarios ᭤ PENETRATING NECK TRAUMA Penetrating trauma to the neck can involve the upper or lower airway, and bears special mention Case series reporting experience with penetrating neck injuries ... RSI is, in fact, probably safe in penetrating neck injuries involving no direct or indirect (e.g., distortion of the airway by an adjacent neck hematoma) trauma to the airway However, clinically ... Sealy B Airway management in penetrating trauma of the neck in a Canadian tertiary trauma centre Can J Emerg Med, in press 2007 Martin R, Girouard Y, Cote DJ Use of a laryngeal mask in acute airway...

Ngày tải lên: 10/08/2014, 18:20

... patient safety In an attempt to address this problem, training using human patient simulators is becoming increasingly common Indeed, most trainees in airway management techniques will begin their ... understanding comparable to that of clinicians staffing the emergency department (ED) They must understand the indications and contraindications for advanced airway management, including tracheal intubation ... training) dilemmas Going forward, there is a significant need for training programs using airway management simulators4 of increased fidelity, coupled with multimedia presentations5 and expert instructors...

Ngày tải lên: 10/08/2014, 18:20

... secure an airway in trauma patients with limited airway access [11] The aim of this study was to compare the use of iGEL™ and LTSII™ with ETI in manikins in settings designed to mimic airway management ... performed in the two different scenarios In addition, scenario B was constructed so that a significant increase in time spending could be anticipated if there was no training effect The finding of ... an increase in time for scenario B compared to scenario A of 2.4 seconds (p = 0.19) for the iGel™ Discussion Main findings Our results show that airway management with iGel™, LTSII™ and ETI in...

Ngày tải lên: 13/08/2014, 23:20

... trial investigating the influence of intravenous fluid titration using oesophageal Doppler monitoring during bowel surgery Anaesthesia 2002, 57:845-849 Carrasco G: Instruments for monitoring intensive ... Esophageal Doppler monitoring measurements were obtained using the Hemosonic 100 device (Arrow International, Inc., Reading, PA, USA), which enables continuous measurement of descending thoracic aorta ... interdisciplinary ICU of our university teaching hospital from 2003 to 2005 were considered for inclusion in this study We excluded patients younger than 18 years old, patients with traumatic brain injury...

Ngày tải lên: 13/08/2014, 03:20

... isolates the injury while it maintains the blood flow in the IVC by bypassing the injury site, is challenging to perform: just consider a tense inexperienced surgeon inserting a purse string in a flimsy ... organs and results in partial control of the intra abdominal hemorrhage, maintaining an acceptable blood pressure and facilitating effective intraabdominal dissection for direct bleeding control [2-4] ... parenchymal injury is noted, it is important to determine the integrity of the main pancreatic duct keeping in mind the intra operative criteria introduced by Heitsch et al which includes: direct...

Ngày tải lên: 13/08/2014, 23:20

... Feasibility of written instructions in airway management training of laryngeal tube Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2011 19:56 Competing interests The authors ... of training to insert and use The aim of our study was to evaluate how well emergency medical personnel can insert the LT-D and maintain ventilation in a manikin without other prior training than ... the risk for complications [14] Training of airway management in emergency care should consist of didactic lessons and simulation Page of training in manikins The possibility of prehospital staff...

Ngày tải lên: 13/08/2014, 23:20

... identified in the uncertainty assessment Effect on risk Uncertainty factor Minor Moderate Amount of training needed to maintain airway skills x Need for special training in pre-hospital airway management ... Most providers are inexperienced in pre-hospital medicine or are in- training - There is no system for training or retraining the providers in advanced airway management - No system for quality ... are trained and retrained regularly in all skills and procedures related to advanced airway management, including rescue techniques - Techniques and equipment used in advanced airway management...

Ngày tải lên: 13/08/2014, 23:21

... above investigation, integration is tentatively interpreted as an act or a process of joining or combining something with something else The integrated approach is a way of perceiving and solving ... problems by integrating information, scientific disciplines, tools, interests and other aspects in a systemic way in order to increases the efficiency of our actions 1.2.3 Integrated management ... play in the different phases of the systems evaluation framework These phases include the following activities: defining public concern, determining multiple issues, defining measurable indicators,...

Ngày tải lên: 06/11/2012, 10:35

... authenticates the user in this certificate authority using the PC obtained previously The paper [10] aims to introduce new concepts in cloud computing and security, focusing on heterogeneous and ... 6) Investigative support; 7) Long-term viability In [3], the paper describes the security of cloud computing in a layered framework, including: 1) Secure Hypervisors; 2) Secure Cloud Storage Management; ... selection approach with the data mining technique and the machine learning technique Figure decentralized IdM in cloud computing C Problem area As demonstrated in [5], current approaches to IdM...

Ngày tải lên: 31/07/2013, 09:43

... approach include the following: 1) Independent and trustworthy since the interaction is only between the SP and the user, 2) Gives minimum information to the SP SP receives only necessary inforormation ... IdP providing that certificate to the RP, thus the user needs to trust the IdP Another drawback is that, in a case where a single IdP and multiple RPs are involved in a single working session, ... Application: It includes ABC, which hosts Container ABC accepts from a user input including sensitive data, metadata, and the new destination for the AB Then, it creates an AB and gives it the input of...

Ngày tải lên: 31/07/2013, 09:43

... Computing: InterCloud Identity Management Infrastructure";Workshops on Enabling Technologies: Infrastructure for Collaborative Enterprises;2010 [19] He Yuan Huang, Bin Wang, Xiao Xi Liu, Jing Min ... IdP providing that certificate to the RP, thus the user needs to trust the IdP Another drawback is that, in a case where a single IdP and multiple RPs are involved in a single working session, ... engineering A malicious attack can be easily set up to lure users into entering their authentication information at a website that poses as an OpenID provider website [14, 15] 3.4 Higgins Higgins...

Ngày tải lên: 31/07/2013, 09:44

... the informal sector for solid waste management in developing countries in general and in HCMC in particular and to find out whether an integration of the informal sector in the formal waste management ... 9840238 THE INFORMAL SECTOR IN SOLID WASTE MANAGEMENT IN DEVELOPING COUNTRIES The motivation for recycling in developing and industrialised countries is rather different In the latter recycling is ... developing countries is the increased integration of the informal sector into the formal waste management system instead of investing the scarce financial resources in inappropriate high tech solutions...

Ngày tải lên: 24/08/2013, 18:48