Airway Management: Evaluation, planning, and use of a range of procedures and airway devices for the maintenance or restoration of a patient's ventilation.Laryngeal Masks: A type of oropharyngeal airway that provides an alternative to endotracheal intubation and standard mask anesthesia in certain patients. It is introduced into the hypopharynx to form a seal around the larynx thus permitting spontaneous or positive pressure ventilation without penetration of the larynx or esophagus. It is used in place of a facemask in routine anesthesia. The advantages over standard mask anesthesia are better airway control, minimal anesthetic gas leakage, a secure airway during patient transport to the recovery area, and minimal postoperative problems.Intubation, Intratracheal: A procedure involving placement of a tube into the trachea through the mouth or nose in order to provide a patient with oxygen and anesthesia.Laryngoscopy: Examination, therapy or surgery of the interior of the larynx performed with a specially designed endoscope.Airway Obstruction: Any hindrance to the passage of air into and out of the lungs.Laryngoscopes: Endoscopes for examining the interior of the larynx.Anesthesiology: A specialty concerned with the study of anesthetics and anesthesia.Fiber Optic Technology: The technology of transmitting light over long distances through strands of glass or other transparent material.ManikinsDisposable Equipment: Apparatus, devices, or supplies intended for one-time or temporary use.Tracheotomy: Surgical incision of the trachea.Cricoid Cartilage: The small thick cartilage that forms the lower and posterior parts of the laryngeal wall.Emergency Medical Services: Services specifically designed, staffed, and equipped for the emergency care of patients.Intubation: Introduction of a tube into a hollow organ to restore or maintain patency if obstructed. It is differentiated from CATHETERIZATION in that the insertion of a catheter is usually performed for the introducing or withdrawing of fluids from the body.Anesthesia, General: Procedure in which patients are induced into an unconscious state through use of various medications so that they do not feel pain during surgery.Airway Remodeling: The structural changes in the number, mass, size and/or composition of the airway tissues.Airway Resistance: Physiologically, the opposition to flow of air caused by the forces of friction. As a part of pulmonary function testing, it is the ratio of driving pressure to the rate of air flow.Pierre Robin Syndrome: Congenital malformation characterized by MICROGNATHIA or RETROGNATHIA; GLOSSOPTOSIS and CLEFT PALATE. The mandibular abnormalities often result in difficulties in sucking and swallowing. The syndrome may be isolated or associated with other syndromes (e.g., ANDERSEN SYNDROME; CAMPOMELIC DYSPLASIA). Developmental mis-expression of SOX9 TRANSCRIPTION FACTOR gene on chromosome 17q and its surrounding region is associated with the syndrome.Tracheostomy: Surgical formation of an opening into the trachea through the neck, or the opening so created.Emergencies: Situations or conditions requiring immediate intervention to avoid serious adverse results.Emergency Medicine: The branch of medicine concerned with the evaluation and initial treatment of urgent and emergent medical problems, such as those caused by accidents, trauma, sudden illness, poisoning, or disasters. Emergency medical care can be provided at the hospital or at sites outside the medical facility.Air Ambulances: Fixed-wing aircraft or helicopters equipped for air transport of patients.Respiration, Artificial: Any method of artificial breathing that employs mechanical or non-mechanical means to force the air into and out of the lungs. Artificial respiration or ventilation is used in individuals who have stopped breathing or have RESPIRATORY INSUFFICIENCY to increase their intake of oxygen (O2) and excretion of carbon dioxide (CO2).Equipment Reuse: Further or repeated use of equipment, instruments, devices, or materials. It includes additional use regardless of the original intent of the producer as to disposability or durability. It does not include the repeated use of fluids or solutions.Epiglottis: A thin leaf-shaped cartilage that is covered with LARYNGEAL MUCOSA and situated posterior to the root of the tongue and HYOID BONE. During swallowing, the epiglottis folds back over the larynx inlet thus prevents foods from entering the airway.Laryngopharyngeal Reflux: Back flow of gastric contents to the LARYNGOPHARYNX where it comes in contact with tissues of the upper aerodigestive tract. Laryngopharyngeal reflux is an extraesophageal manifestation of GASTROESOPHAGEAL REFLUX.Laryngeal Diseases: Pathological processes involving any part of the LARYNX which coordinates many functions such as voice production, breathing, swallowing, and coughing.Bronchoscopes: Endoscopes for the visualization of the interior of the bronchi.Equipment Design: Methods of creating machines and devices.Clinical Competence: The capability to perform acceptably those duties directly related to patient care.Glottis: The vocal apparatus of the larynx, situated in the middle section of the larynx. Glottis consists of the VOCAL FOLDS and an opening (rima glottidis) between the folds.Neck Injuries: General or unspecified injuries to the neck. It includes injuries to the skin, muscles, and other soft tissues of the neck.Suction: The removal of secretions, gas or fluid from hollow or tubular organs or cavities by means of a tube and a device that acts on negative pressure.Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures.Larynx: A tubular organ of VOICE production. It is located in the anterior neck, superior to the TRACHEA and inferior to the tongue and HYOID BONE.Immobilization: The restriction of the MOVEMENT of whole or part of the body by physical means (RESTRAINT, PHYSICAL) or chemically by ANALGESIA, or the use of TRANQUILIZING AGENTS or NEUROMUSCULAR NONDEPOLARIZING AGENTS. It includes experimental protocols used to evaluate the physiologic effects of immobility.Aerospace Medicine: That branch of medicine dealing with the studies and effects of flight through the atmosphere or in space upon the human body and with the prevention or cure of physiological or psychological malfunctions arising from these effects. (from NASA Thesaurus)Tracheal StenosisRespiratory Aspiration: Inhaling liquid or solids, such as stomach contents, into the RESPIRATORY TRACT. When this causes severe lung damage, it is called ASPIRATION PNEUMONIA.Anesthesia, Inhalation: Anesthesia caused by the breathing of anesthetic gases or vapors or by insufflating anesthetic gases or vapors into the respiratory tract.Respiratory Therapy: Care of patients with deficiencies and abnormalities associated with the cardiopulmonary system. It includes the therapeutic use of medical gases and their administrative apparatus, environmental control systems, humidification, aerosols, ventilatory support, bronchopulmonary drainage and exercise, respiratory rehabilitation, assistance with cardiopulmonary resuscitation, and maintenance of natural, artificial, and mechanical airways.Life Support Care: Care provided patients requiring extraordinary therapeutic measures in order to sustain and prolong life.Succinylcholine: A quaternary skeletal muscle relaxant usually used in the form of its bromide, chloride, or iodide. It is a depolarizing relaxant, acting in about 30 seconds and with a duration of effect averaging three to five minutes. Succinylcholine is used in surgical, anesthetic, and other procedures in which a brief period of muscle relaxation is called for.Disease Management: A broad approach to appropriate coordination of the entire disease treatment process that often involves shifting away from more expensive inpatient and acute care to areas such as preventive medicine, patient counseling and education, and outpatient care. This concept includes implications of appropriate versus inappropriate therapy on the overall cost and clinical outcome of a particular disease. (From Hosp Pharm 1995 Jul;30(7):596)Gravitation: Acceleration produced by the mutual attraction of two masses, and of magnitude inversely proportional to the square of the distance between the two centers of mass. It is also the force imparted by the earth, moon, or a planet to an object near its surface. (From NASA Thesaurus, 1988)Hypoxia, Brain: A reduction in brain oxygen supply due to ANOXEMIA (a reduced amount of oxygen being carried in the blood by HEMOGLOBIN), or to a restriction of the blood supply to the brain, or both. Severe hypoxia is referred to as anoxia, and is a relatively common cause of injury to the central nervous system. Prolonged brain anoxia may lead to BRAIN DEATH or a PERSISTENT VEGETATIVE STATE. Histologically, this condition is characterized by neuronal loss which is most prominent in the HIPPOCAMPUS; GLOBUS PALLIDUS; CEREBELLUM; and inferior olives.Video Recording: The storing or preserving of video signals for television to be played back later via a transmitter or receiver. Recordings may be made on magnetic tape or discs (VIDEODISC RECORDING).Intraoperative Complications: Complications that affect patients during surgery. They may or may not be associated with the disease for which the surgery is done, or within the same surgical procedure.Bronchi: The larger air passages of the lungs arising from the terminal bifurcation of the TRACHEA. They include the largest two primary bronchi which branch out into secondary bronchi, and tertiary bronchi which extend into BRONCHIOLES and PULMONARY ALVEOLI.Critical Care: Health care provided to a critically ill patient during a medical emergency or crisis.High-Frequency Jet Ventilation: Respiratory support system used primarily with rates of about 100 to 200/min with volumes of from about one to three times predicted anatomic dead space. Used to treat respiratory failure and maintain ventilation under severe circumstances.Medical Audit: A detailed review and evaluation of selected clinical records by qualified professional personnel for evaluating quality of medical care.Respiratory System: The tubular and cavernous organs and structures, by means of which pulmonary ventilation and gas exchange between ambient air and the blood are brought about.Tongue: A muscular organ in the mouth that is covered with pink tissue called mucosa, tiny bumps called papillae, and thousands of taste buds. The tongue is anchored to the mouth and is vital for chewing, swallowing, and for speech.Patient Positioning: Moving a patient into a specific position or POSTURE to facilitate examination, surgery, or for therapeutic purposes.Prospective Studies: Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.Cervical Vertebrae: The first seven VERTEBRAE of the SPINAL COLUMN, which correspond to the VERTEBRAE of the NECK.Bronchial Hyperreactivity: Tendency of the smooth muscle of the tracheobronchial tree to contract more intensely in response to a given stimulus than it does in the response seen in normal individuals. This condition is present in virtually all symptomatic patients with asthma. The most prominent manifestation of this smooth muscle contraction is a decrease in airway caliber that can be readily measured in the pulmonary function laboratory.Pharyngitis: Inflammation of the throat (PHARYNX).Asthma: A form of bronchial disorder with three distinct components: airway hyper-responsiveness (RESPIRATORY HYPERSENSITIVITY), airway INFLAMMATION, and intermittent AIRWAY OBSTRUCTION. It is characterized by spasmodic contraction of airway smooth muscle, WHEEZING, and dyspnea (DYSPNEA, PAROXYSMAL).Respiratory Mucosa: The mucous membrane lining the RESPIRATORY TRACT, including the NASAL CAVITY; the LARYNX; the TRACHEA; and the BRONCHI tree. The respiratory mucosa consists of various types of epithelial cells ranging from ciliated columnar to simple squamous, mucous GOBLET CELLS, and glands containing both mucous and serous cells.Wounds and Injuries: Damage inflicted on the body as the direct or indirect result of an external force, with or without disruption of structural continuity.Lung: Either of the pair of organs occupying the cavity of the thorax that effect the aeration of the blood.Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Documentation: Systematic organization, storage, retrieval, and dissemination of specialized information, especially of a scientific or technical nature (From ALA Glossary of Library and Information Science, 1983). It often involves authenticating or validating information.Practice Guidelines as Topic: Directions or principles presenting current or future rules of policy for assisting health care practitioners in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery.Great BritainCase Management: A traditional term for all the activities which a physician or other health care professional normally performs to insure the coordination of the medical services required by a patient. It also, when used in connection with managed care, covers all the activities of evaluating the patient, planning treatment, referral, and follow-up so that care is continuous and comprehensive and payment for the care is obtained. (From Slee & Slee, Health Care Terms, 2nd ed)Hypnotics and Sedatives: Drugs used to induce drowsiness or sleep or to reduce psychological excitement or anxiety.Patient Care Management: Generating, planning, organizing, and administering medical and nursing care and services for patients.Bronchoconstriction: Narrowing of the caliber of the BRONCHI, physiologically or as a result of pharmacological intervention.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Internship and Residency: Programs of training in medicine and medical specialties offered by hospitals for graduates of medicine to meet the requirements established by accrediting authorities.

Rigid fibrescope Bonfils: use in simulated difficult airway by novices. (1/98)


A consensus-based template for uniform reporting of data from pre-hospital advanced airway management. (2/98)


Do videolaryngoscopes have a new role in the SIAARTI difficult airway management algorithm? (3/98)

The rigid standard Macintosh laryngoscope is the instrument used to obtain an adequate view of the larynx in most patients. In cases of unpredicted severe laryngoscopic difficulties, the SIAARTI guidelines suggest waking the patient and using fiberoptic intubation with topical anesthesia. In the last decade, many videolaryngoscopes have been produced and introduced into clinical use. They provide an excellent view of the glottis. Their role in the SIAARTI algorithm for difficult airway management is now better defined. In fact, their use could be suggested in cases of unpredicted severe laryngoscopic difficulty as a step before awakening the patient. Moreover, they could be used in predicted severe intubation difficulty as an alternative to flexible fiberscope.  (+info)

Self-poisoning suicide deaths in England: could improved medical management contribute to suicide prevention? (4/98)


Management of a patient with an unexpected obstructing carinal mass. (5/98)

Surgical procedures involving the airway or for mediastinal masses present considerable challenges for the anesthesiologist. Aside from the obvious technical challenges of providing ventilation, the anesthesiologist must share the airway with the surgeon. Careful and meticulous preoperative evaluation and preparation and intraoperative interaction with the surgical team is critical to assure control of the airway. We report a case of management of a patient with an unexpected near total obstruction of the airway from a carinal mass.  (+info)

Propofol versus sevoflurane for fiberoptic intubation under spontaneous breathing anesthesia in patients difficult to intubate. (6/98)

BACKGROUND: The most recommended technique for the management of patients with a difficult airway is fiberoptic intubation (FOI). The aim of this study was to compare propofol and sevoflurane for FOI performance in patients who were difficult to intubate. METHODS: Seventy-eight patients scheduled for maxillo-facial surgery were included in this prospective, randomized study. The airway was topically anesthetized with lidocaine 5% before performance of FOI with propofol TCI (group P) or sevoflurane (group S). The following parameters were recorded: rate of success, duration of the induction and of the FOI, BIS and PETCO2 values. A visual analogic scale (VAS) was used to monitor the technical difficulties as well as the recall of patients and their satisfaction. The respiratory and hemodynamic complications were also evaluated. RESULTS: Induction and procedure duration were significantly shorter in group S compared with group P. The rate of successful FOI was not different: 38 cases (97%) in group P and 35 cases (90%) in group S. No significant differences were observed between groups regarding BIS values and VAS values for technical difficulties and for patient recall and satisfaction. The incidence of hypertension or tachycardia was significantly higher in group S compared with group P. The incidence of respiratory complications was not significantly different between the groups, but three patients experienced obstructive dyspnea with hypoxemia. CONCLUSION: Propofol and sevoflurane provide a high success rate for the performance of FOI in patients who are difficult to intubate.  (+info)

Manual hyperinflation is associated with a low rate of adverse events when performed by experienced and trained nurses in stable critically ill patients--a prospective observational study. (7/98)

BACKGROUND: Manual hyperinflation (MH) can be performed as part of airway management in intubated and mechanically ventilated patients to mobilize airway secretions. Although previous studies demonstrated MH to be associated with hemodynamic and respiratory instability, we hypothesized MH to cause fewer adverse events (AEs) when performed by experienced and trained nurses in stable critically ill patients. METHODS: The incidence and type of AEs associated with MH were studied in a 28-bed mixed medical-surgical Intensive Care Unit. A difference in mean arterial pressure (MAP) or heart rate (HR) >15%, a decrease in peripheral oxygen saturation (SpO2) >5%, and a change in end-tidal (et)-CO2 >20% were considered AEs. A decrease of MAP to +info)

National census of airway management techniques used for anaesthesia in the UK: first phase of the Fourth National Audit Project at the Royal College of Anaesthetists. (8/98)


  • The agreement enables Medutech to market ETView's VivaSight(TM) airway management platform (previously known as TVT(TM)), combining an airway ventilation tube with integrated continuous high resolution airway imaging for patient airway control and lung isolation capability, in Mexico for a period of 2 years. (
  • VivaSight(TM)-DL1 is a proprietary, single-use disposable medical device, consisting of a dual lumen airway ventilation tube with an integrated continuous high resolution video airway imaging system permitting airway control and lung isolation during certain surgical procedures. (
  • They were listening to multiple speakers in conference sessions, and looking through dozens of exhibits of new products that relate to airway management and ventilation for the EMS provider. (
  • In adult patients, Continuous Positive Airway Pressure (CPAP) can be used to augment ventilation and oxygenation in a patient who is breathing on his own, and has an intact face to strap the mask to. (
  • Any dentist performing sedation or providing care to a sedated patient should be able to provide airway management and ventilation for a patient encountering respiratory distress. (
  • Together with a team of experts, Dr. John A. Pacey - inventor of GlideScope Video Laryngoscope - will be on hand at the Verathon booth to discuss the various benefits video laryngoscopy technology has brought to airway management. (
  • The symposium, entitled "Video Laryngoscopy: The Past, Present and Future", will explore how video laryngoscopy has transformed airway management over the last decade. (
  • This guideline was launched at the Difficult Airway Society Annual Scientific Meeting at the Mermaid Centre, London in November and at the Intensive Care Society State of the Art Scientific meeting in December and will be published in February 2018. (
  • Kosova Airway Management Society (KAMS) is established in 2018. (
  • Seit 2002 führen wir das St. Galler Airway Management Symposium durch, an dem wir bestrebt sind, alle Seiten der Atemwegssicherung zu beleuchten. (
  • St.Galler Airway Management Symposium vom 20. (
  • A joint collaboration of the annual scientific meetings of The Difficult Airway Society (DAS) and The Society for Airway Management (SAM), WAMM 2015 will take place in Dublin, Ireland from November 12th-14th. (
  • Clinicians charged with caring for trauma patients must be able to quickly recognize a trauma patient in need of an airway intervention as well as develop and sustain the skills necessary required to perform the vast array of life-saving maneuvers designed to establish and maintain a patent airway in trauma patients. (
  • The emergent nature of the procedure does not allow time for a detailed and thorough airway evaluation, so every trauma patient can be considered to have difficult airway to ensure appropriate preparation. (
  • If the trauma patient is conscious and able to cooperate, a brief history may elicit additional risk factors for a difficult airway including obstructive sleep apnea, arthritis, head and neck cancer or radiation, or any difficulty with previous airway interventions. (
  • While traditional difficult airway scoring systems such as the Mallampati and LEMON scores are not applicable in trauma patients due to the emergent nature of the airway intervention, several physical examination findings may be useful to determine increasing difficulty with airway management. (
  • Keeping in mind that the vast majority of trauma patients will have limited neck mobility due to cervical spine immobilization and cervical collar, additional physical examination findings that portend a difficult airway include presence of a beard or facial hair, obesity, and evidence of direct injuries to the head, face, and neck. (
  • Trauma patients may present with blunt or penetrating injuries to the head, neck, or face, which ultimately may result in airway obstruction. (
  • Common causes of direct airway trauma include blunt or penetrating maxillofacial or neck injuries, burns, and smoke inhalation. (
  • Shrimpton, AJ & Gill, H 2020, ' Airway management for dental clearance in a preschool child: A UK survey ', Paediatric Anaesthesia . (
  • Findings from multiple sources revealed the infrequent utility of advanced airway management techniques and limited pedagogy has affected both confidence and success rates. (