638 results match your criteria airway scenarios

Critical Care Education and Skills Validation Course for Internal Medicine Physicians in the Military.

Mil Med 2021 Jun 23. Epub 2021 Jun 23.

Pulmonary & Critical Care Medicine Service, Department of Medicine, Brooke Army Medical Center, San Antonio, TX 78234, USA.

Introduction: Military internist and internal medicine (IM) subspecialist physicians must be prepared to function in both traditional inpatient and outpatient settings, as well as manage critically ill patients within a deployed austere environment. As many critical care procedures are not performed on a routine basis in general IM practice, many active duty IM physicians experience skills degradation and lack confidence in performing these procedures. In order to address this perceived deficiency, the U. Read More

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Extracorporeal Oxygenation Techniques in Adult Critical Airway Obstruction: A Review.

Prague Med Rep 2021 ;122(2):61-72

Departments of General Anesthesiology and Outcomes Research, Cleveland Clinic, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, USA.

Extracorporeal life support has been increasingly utilized in different clinical settings to manage either critical respiratory or heart failure. Complex airway surgery with significant or even total perioperative airway obstruction represents an indication for this technique to prevent/overcome a critical period of severe hypoxaemia, hypoventilation, and/or apnea. This review summarizes the current published scientific evidence on the utility of extracorporeal respiratory support in airway obstruction associated with hypoxaemia, describes the available methods, their clinical indications, and possible limitations. Read More

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Anesthesia for Obstetric Disasters.

Adv Anesth 2020 Dec;38:229-250

Department of Anesthesiology, Yale School of Medicine, 333 Cedar Street, PO Box 208051, New Haven, CT 06520-8051, USA.

Over the past 30 years, maternal mortality has increased in the United States to 18 deaths per 100,000 live births. Obstetric emergencies, including hemorrhage, hypertensive disorders in pregnancy, HELLP syndrome, and amniotic fluid embolism, and anesthesia complications, including high neuraxial blockade, local anesthetic systemic toxicity, and the difficult obstetric airway, contribute to maternal cardiac arrest and maternal and fetal morbidity and mortality. Expeditious intervention by the obstetric anesthesiologist is critical in these emergent scenarios, and knowledge of best practices is essential to improve maternal and fetal outcomes. Read More

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December 2020

Effect of Repetitive Simulation Training on Emergency Medical Services Team Performance in Simulated Pediatric Medical Emergencies.

AEM Educ Train 2021 Jul 5;5(3):e10537. Epub 2020 Nov 5.

Department of Pediatrics Section of Pediatric Emergency Medicine University of Colorado School of Medicine Aurora CO USA.

Objective: Emergency medical services (EMS) professionals infrequently transport children leading to difficulty in recognition and management of pediatric critical illness. Simulation provides an opportunity to train EMS professionals on pediatric emergencies. The objective of this study was to examine the effect of serial simulation training over 6 months on EMS psychomotor and cognitive performance during team-based care. Read More

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Low-cost versus high-fidelity pediatric simulators for difficult airway management training: a randomized study in continuing medical education.

Braz J Anesthesiol 2021 Jun 2. Epub 2021 Jun 2.

CHU Nantes, Hôtel Dieu - Hôpital Mère Enfant, Service d'Anesthésie Réanimation Chirurgicale, Nantes, France; Laboratoire Expérimental de Simulation de Médecine Intensive de l'Université (LESiMU) de Nantes, Nantes, France.

Background: High-fidelity (HF) pediatric patient simulators are expensive. This randomized study aimed to compare the quality and educational impact of a full-scale simulation workshop with an HF infant simulator (SimBaby™, Laerdal) or with a low-cost (LC) simulator composed of an inert infant manikin with SimBaby™ software that displays respiratory/hemodynamic parameters on a monitor for medical education in pediatric difficult airway management.

Methods: After written informed consent, anesthetists and emergency or ICU physicians participated in teams (4 to 6 participants) in a training session that included direct participation and observation of two difficult intubation scenarios. Read More

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Comparison of learning direct laryngoscopy using a McGrath videolaryngoscope as a direct versus indirect laryngoscope: a randomized controlled trial.

J Int Med Res 2021 May;49(5):3000605211016740

Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, South Korea.

Objective: Tracheal intubation using a direct laryngoscope is difficult to teach. The McGrath videolaryngoscope, a Macintosh-like device with a camera, can be used as a direct laryngoscope to educate novices under supervision using the screen. We compared the effect on Macintosh laryngoscopy skills following training with a McGrath videolaryngoscope as a direct versus indirect laryngoscope. Read More

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Pre-tracheotomy for Potentially Emergent Airway Scenarios: Indications and Outcomes.

Laryngoscope 2021 May 22. Epub 2021 May 22.

Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A.

Objectives/hypothesis: Airway access in the setting of unsuccessful ventilation and intubation typically involves emergent cricothyrotomy or tracheotomy, procedures with associated significant risk. The potential for such emergent scenarios can often be predicted based on patient and disease factors. Planned tracheotomy can be performed in these cases but is not without its own risks. Read More

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Unexpected difficult tracheal intubation secondary to subglottic stenosis leading to emergency front-of-neck airway.

Anaesth Rep 2021 Jan-Jun;9(1):90-94. Epub 2021 May 9.

Department of Anaesthesia Prince Charles Hospital Llantrisant UK.

A 26-year-old woman presenting for an elective day case procedure under general anaesthesia had undiagnosed subglottic stenosis leading to a life threatening airway emergency requiring emergency front-of-neck airway. We outline the case and discuss key anaesthetic considerations in subglottic stenosis, including concerning features of a medical/anaesthetic history and the potential for rapid deterioration of a stenotic airway following manipulation. We also consider the effect of anaesthesia on the calibre of subglottic stenosis and the effects of positive pressure ventilation. Read More

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Glutathione S-Transferase Gene Associations and Gene-Environment Interactions for Asthma.

Curr Allergy Asthma Rep 2021 May 10;21(5):31. Epub 2021 May 10.

Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Level 3 207 Bouverie Street, Parkville, VIC, 3010, Australia.

Purpose Of Review: Asthma is one of the most common chronic inflammatory airway diseases. Airway oxidative stress is defined as an imbalance between oxidative and antioxidative processes in the airways. There is evidence that chronic damage caused by oxidative stress may be involved in asthmatic inflammation and reduced lung function. Read More

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Comparative Analysis of the Effectiveness of Performing Advanced Resuscitation Procedures Undertaken by Two- and Three- Person Basic Medical Rescue Teams in Adults under Simulated Conditions.

Int J Environ Res Public Health 2021 04 30;18(9). Epub 2021 Apr 30.

Division of Public Health and Social Medicine, Faculty of Health Sciences with the Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, Tuwima 15, 80-210 Gdańsk, Poland.

(1) Objective: Paramedics as a profession are a pillar of the State Medical Rescue system. The basic difference between a specialist and a basic team is the composition of members. The aim of the study was to benchmark the effectiveness of performing advanced resuscitation procedures undertaken by two- and three-person basic emergency medical teams in adults under simulated conditions. Read More

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Comparison of Four Methods of Paramedic Continuing Education in the Management of Pediatric Emergencies.

Prehosp Emerg Care 2021 May 7:1-19. Epub 2021 May 7.

Department of Emergency Medicine, Western Michigan University Homer Stryker, Kalamazoo, Michigan (RLL, MJW-B, WDF); Department of Epidemiology and Biostatistics, Western Michigan University Homer Stryker, Kalamazoo, Michigan (DGV).

Finite resources limit the amount of time EMS agencies can dedicate to continuing education in pediatric emergencies. EMS instructors need effective, efficient, and affordable educational strategies for these high-risk, low frequency events. To compare the effectiveness of four training methods in management of pediatric emergencies for paramedics. Read More

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Nasopharyngeal tubes in pediatric anesthesia: Is the flow-dependent pressure drop across the tube suitable for calculating oropharyngeal pressure?

Paediatr Anaesth 2021 Jul 6;31(7):809-819. Epub 2021 May 6.

Medical Engineering Laboratory, Department of Civil Engineering and Computer Science Engineering, University of Rome "Tor Vergata", Rome, Italy.

Background: Nasopharyngeal tubes are useful in pediatric anesthesia for insufflating oxygen and anesthetics. During nasopharyngeal tube-anesthesia, gas insufflation provides some positive oropharyngeal pressure that differs from the proximal airway pressure owing to the flow-dependent pressure drop across the nasopharyngeal tube (ΔP ).

Aims: This study aimed to investigate whether ΔP could be used for calculating oropharyngeal pressure during nasopharyngeal tube-assisted anesthesia. Read More

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The mechanical characteristics and performance evaluation of a newly developed silicone airway stent (GINA stent).

Sci Rep 2021 Apr 12;11(1):7958. Epub 2021 Apr 12.

Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwan-doro, Dong-gu, Ulsan, 44033, Korea.

Central airway obstruction (CAO) can be attributed to several benign or malignant conditions. Although surgery is the preferred therapeutic option for the management of CAO, bronchoscopic treatment can be performed in scenarios where the surgical procedure is not possible. Recent years have witnessed several improvements in the field of bronchoscopic treatment, especially with regard to airway stents. Read More

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Airflow dispersion during common neonatal resuscitation procedures: A simulation study.

Pediatr Pulmonol 2021 07 7;56(7):2057-2066. Epub 2021 Apr 7.

Academic Child Health, School of Medicine, University of Nottingham, Nottingham, UK.

Background: Aerosol generating medical procedures (AGMPs) are common during newborn resuscitation. Neonates with respiratory viruses such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may pose a risk to healthcare workers. International guidelines differ on methods to minimize the risk due to limited data. Read More

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The impact of introducing a videolaryngoscope in the initial training of laryngoscopy for undergraduate medical students: a simulation randomized trial.

Braz J Anesthesiol 2021 Apr 3. Epub 2021 Apr 3.

CET/SBA da Santa Casa de São Paulo, São Paulo, SP, Brazil.

Introduction: Adequate and continuous airway management by health professionals is fundamental to ensure patient safety and protection. Among several techniques, laryngoscopy for orotracheal intubation is considered a basic skill, so it is taught and learned in medical school and used during the future years of professional practice. However, in some clinical scenarios, physical and anatomical characteristics can make laryngoscopy exceedingly difficult. Read More

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Simulation of Adult Surgical Cricothyrotomy for Anesthesiology and Emergency Medicine Residents: Adapted for COVID-19.

MedEdPORTAL 2021 04 1;17:11134. Epub 2021 Apr 1.

Professor and Department Chair, Département d'anesthésiologie et de soins intensifs, Faculté de médecine, Université Laval; Chairholder of the Educational Leadership Chair in Health Sciences Simulation, Université Laval and Université Côte d'Azur.

Introduction: In a CICO (cannot intubate, cannot oxygenate) situation, anesthesiologists and acute care physicians must be able to perform an emergency surgical cricothyrotomy (front-of-neck airway procedure). CICOs are high-acuity situations with rare opportunities for safe practice. In COVID-19 airway management guidelines, bougie-assisted surgical cricothyrotomy is the recommended emergency strategy for CICO situations. Read More

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In situ interprofessional operating room simulations: Empowering learners in crisis resource management principles.

Surgery 2021 Mar 23. Epub 2021 Mar 23.

Department of Surgery, Stanford University School of Medicine, Palo Alto, CA. Electronic address:

Background: Given the multifaceted nature of operating room teams, miscommunication at various perioperative stages leads to lapses in teamwork and communication, which potentiates adverse events. In situ interprofessional operating room simulations are a valuable tool in identifying the possible threats to patient safety in the operating room. Participant confidence may also increase; however, perceived confidence in specific areas of team communication in the clinical environment remains unclear. Read More

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Role of Trachway versus Conventional Modes of Intubation in Difficult Airway Management in COVID-19 Setups.

Emerg Med Int 2021 25;2021:6614523. Epub 2021 Feb 25.

Department of Emergency Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, 231 New Taipei, Taiwan.

Difficult airway management in critically ill patients remains a difficult task associated with high morbidity and mortality rates. In difficult airway populations, prompt effective intubation is more important to prevent hypoxia and neurological injury. During the ongoing COVID-19 pandemic, prolonged intubation time and repeated intubation can lead to an increase in the risk of infection. Read More

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February 2021

Videolaryngoscopy Bails us out of Difficult Intubation Scenarios in Syndromic Children: A Case Series.

Turk J Anaesthesiol Reanim 2021 Feb 18;49(1):78-82. Epub 2020 May 18.

Department of Anaesthesiology, Pain Medicine and Critical Care, AIIMS, New Delhi, India.

Airway management in children with craniofacial anomalies can be complicated and may require multiple attempts with conventional direct laryngoscopy (DL). Videolaryngoscopes (VLs) have a well-established role in difficult airway management in adults; however, their role remains to be fully elucidated in paediatric age group. There is a relative paucity in the literature regarding the role of VLs in cases of syndromic children, and it is not clear whether they should be used as an initial option or as a rescue device. Read More

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February 2021

Contralateral Rerouting of Hypoglossal Nerve Implant Pulse Generator and Stimulation Lead.

Laryngoscope 2021 07 12;131(7):E2409-E2412. Epub 2021 Mar 12.

Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A.

As use of hypoglossal nerve stimulators has become more widespread in the treatment of obstructive sleep apnea, certain scenarios have dictated alterations to the previously described surgical technique. This report describes a situation in which revision of a hypoglossal nerve stimulator implant was required given the need for breast cancer surgery. It serves as the first description of the contralateral rerouting of a stimulation lead to a left-sided impulse generator and the first description of respiratory sensing lead placement within the left second intercostal space for such a device. Read More

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Does utilization of an intubation safety checklist reduce omissions during simulated resuscitation scenarios: a multi-center randomized controlled trial.

CJEM 2021 Jan 18;23(1):45-53. Epub 2020 Dec 18.

Division of Emergency Medicine, Department of Medicine, Western University, London, ON, Canada.

Objectives: Checklists have been used to decrease adverse events associated with medical procedures. Simulation provides a safe setting in which to evaluate a new checklist. The objective of this study was to determine if the use of a novel peri-intubation checklist would decrease practitioners' rates of omission of tasks during simulated airway management scenarios. Read More

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January 2021

Evidence and controversies in management of thyroglossal duct cyst carcinoma.

Curr Opin Otolaryngol Head Neck Surg 2021 Apr;29(2):113-119

Department of Otorhinolaryngology - Head and Neck Surgery, ASST Spedali Civili of Brescia.

Purpose Of Review: The aim of this study was to analyse the rational of the possible therapeutic approaches to thyroglossal duct cyst carcinomas (TGDCCa), especially in consideration of their potential airway involvement, discussing the most debated issues concerning employment of thyroidectomy, neck dissection and adjuvant treatments.

Recent Findings: The literature is unanimous in defining the Sistrunk procedure as the baseline of surgical treatment of TGDCCa, and in equating the vast majority of thyroid-like TGDCCas to classic thyroid cancers from a biological point of view, while the rarer squamous cell carcinomas seem to behave more aggressively. Thyroidectomy, neck dissection and radioactive iodine treatment are considered for high-risk lesions, with the addition of customized partial resection of laryngeal cartilages when airway involvement is encountered. Read More

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Model-based analysis of implanted hypoglossal nerve stimulation for the treatment of obstructive sleep apnea.

Sleep 2021 04;44(44 Suppl 1):S11-S19

Inspire Medical Systems, Inc., Minneapolis, MN.

Study Objectives: Individuals with obstructive sleep apnea (OSA), characterized by frequent sleep disruptions from tongue muscle relaxation and airway blockage, are known to benefit from on-demand electrical stimulation of the hypoglossal nerve. Hypoglossal nerve stimulation (HNS) therapy, which activates the protrusor muscles of the tongue during inspiration, has been established in multiple clinical studies as safe and effective, but the mechanistic understanding for why some stimulation parameters work better than others has not been thoroughly investigated.

Methods: In this study, we developed a detailed biophysical model that can predict the spatial recruitment of hypoglossal nerve fascicles and axons within these fascicles during stimulation through nerve cuff electrodes. Read More

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Endoscopic Lung Volume Reduction with Autologous Blood: What is the Evidence?

Aşkın Gülşen

Turk Thorac J 2021 Jan 1;22(1):67-74. Epub 2021 Jan 1.

Interdisciplinary Allergy Outpatient Clinic, Department of Pneumology, University of Lübeck, Lübeck, Germany.

Biological lung volume reduction (BioLVR) is a novel and low-cost endobronchial treatment method aimed at reducing the volume of the target lung lobe using biological agents, including fibrin-based hydrogel, fibrinogen, and autologous blood (AB) with thrombin. BioLVR induces local inflammation, resulting in acute airway obstruction, resorption atelectasis, fibrosis, and finally tissue remodeling by contraction of the target lobe and reduction in the lung volume, similar to the application of hot water vapor and foam. In addition, patients with severe impairment in lung function and quality of life may refuses to undergo surgery, resulting in limited treatment options. Read More

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January 2021

Quantification of the effect of body mass index on cricothyroid membrane depth: a cross-sectional analysis of clinical CT images.

Emerg Med J 2021 Feb 24. Epub 2021 Feb 24.

Division of Medical and Radiological Sciences, University of Edinburgh, Edinburgh, UK.

Objectives: The recommended front of neck access procedure in can't intubate, can't oxygenate scenarios relies on palpation of the cricothyroid membrane (CTM), or dissection of the neck down to the larynx if CTM is impalpable. CTM palpation is particularly challenging in obese patients, most likely due to an increased distance between the skin and the CTM (CTM depth). The aims of this study were to measure the CTM depth in a representative clinical sample, and to quantify the relationship between body mass index (BMI) and CTM depth. Read More

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February 2021

Incidence of pulmonary embolism in patients with non-invasive respiratory support during COVID-19 outbreak.

Respir Med 2021 03 4;178:106325. Epub 2021 Feb 4.

Respiratory Medicine Department, Hospital del Mar (PSMAR) - IMIM. Barcelona, Spain; CIBER, Área de Enfermedades Respiratorias (CIBERES), ISCIII, Spain; Departamento de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.

While the incidence of thrombotic complications in critically ill patients is very high, in patients under non-invasive respiratory support (NIS) is still unknown. The specific incidence of thrombotic events in each of the clinical scenarios within the broad spectrum of severity of COVID-19, is not clearly established, and this has not allowed the implementation of thromboprophylaxis or anticoagulation for routine care in COVID-19. Patients admitted in a semi-critical unit treated initially with NIS, especially Continuous-Positive Airway Pressure (CPAP), were included in the study. Read More

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Nasopharyngeal metastasis from colorectal cancer: a case report.

Ann Palliat Med 2021 Apr 26;10(4):4911-4816. Epub 2021 Jan 26.

Department of Thyroid & Breast Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.

Metastases from colorectal cancer can occur either through the lymphatic or by hematogenous spread. The most common metastatic sites are the lung and liver. Nasopharyngeal metastasis from colorectal cancer has never been previously reported in the literature on the internet databases we can found. Read More

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Bag-Valve-Mask versus Laryngeal Mask Airway Ventilation in Cardiopulmonary Resuscitation with Continuous Compressions: A Simulation Study.

Prehosp Disaster Med 2021 Apr 1;36(2):189-194. Epub 2021 Feb 1.

Emergency Medicine Department, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey.

Introduction: The 2017 International Liaison Committee on Resuscitation (ILCOR) guideline recommends that Emergency Medical Service (EMS) providers can perform cardiopulmonary resuscitation (CPR) with synchronous or asynchronous ventilation until an advanced airway has been placed. In the current literature, limited data on CPR performed with continuous compressions and asynchronous ventilation with bag-valve-mask (BVM) are available.

Study Objective: In this study, researchers aimed to compare the effectiveness of asynchronous BVM and laryngeal mask airway (LMA) ventilation during CPR with continuous chest compressions. Read More

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Natural history and mechanisms of COPD.

Respirology 2021 Apr 28;26(4):298-321. Epub 2021 Jan 28.

Department of Respiratory Diseases, University of Montpellier, CHU Montpellier, INSERM, Montpellier, France.

The natural history of COPD is complex, and the disease is best understood as a syndrome resulting from numerous interacting factors throughout the life cycle with smoking being the strongest inciting feature. Unfortunately, diagnosis is often delayed with several longitudinal cohort studies shedding light on the long 'preclinical' period of COPD. It is now accepted that individuals presenting with different COPD phenotypes may experience varying natural history of their disease. Read More

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Oxygenation laryngoscope vs. nasal standard and nasal high flow oxygenation in a technical simulation of apnoeic oxygenation.

BMC Emerg Med 2021 01 22;21(1):12. Epub 2021 Jan 22.

Department of Anaesthesiology and Intensive Care Medicine, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Kerpener Str. 67, 50937, Cologne, Germany.

Background: Failed airway management is the major contributor for anaesthesia-related morbidity and mortality. Cannot-intubate-cannot-ventilate scenarios are the most critical emergency in airway management, and belong to the worst imaginable scenarios in an anaesthetist's life. In such situations, apnoeic oxygenation might be useful to avoid hypoxaemia. Read More

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January 2021