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.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.Laryngoscopy: Examination, therapy or surgery of the interior of the larynx performed with a specially designed endoscope.Laryngoscopes: Endoscopes for examining the interior of the larynx.Intubation, Gastrointestinal: The insertion of a tube into the stomach, intestines, or other portion of the gastrointestinal tract to allow for the passage of food products, etc.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.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.Disposable Equipment: Apparatus, devices, or supplies intended for one-time or temporary use.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.Androstanols: Androstanes and androstane derivatives which are substituted in any position with one or more hydroxyl groups.ManikinsAnesthesiology: A specialty concerned with the study of anesthetics and anesthesia.Cricoid Cartilage: The small thick cartilage that forms the lower and posterior parts of the laryngeal wall.Anesthetics, Intravenous: Ultrashort-acting anesthetics that are used for induction. Loss of consciousness is rapid and induction is pleasant, but there is no muscle relaxation and reflexes frequently are not reduced adequately. Repeated administration results in accumulation and prolongs the recovery time. Since these agents have little if any analgesic activity, they are seldom used alone except in brief minor procedures. (From AMA Drug Evaluations Annual, 1994, p174)Neuromuscular Nondepolarizing Agents: Drugs that interrupt transmission at the skeletal neuromuscular junction without causing depolarization of the motor end plate. They prevent acetylcholine from triggering muscle contraction and are used as muscle relaxants during electroshock treatments, in convulsive states, and as anesthesia adjuvants.Airway Obstruction: Any hindrance to the passage of air into and out of the lungs.Anesthesia, IntratrachealLaryngeal Edema: Abnormal accumulation of fluid in tissues of any part of the LARYNX, commonly associated with laryngeal injuries and allergic reactions.Thiopental: A barbiturate that is administered intravenously for the induction of general anesthesia or for the production of complete anesthesia of short duration.Equipment Design: Methods of creating machines and devices.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.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).Anesthesia, Inhalation: Anesthesia caused by the breathing of anesthetic gases or vapors or by insufflating anesthetic gases or vapors into the respiratory tract.Tracheostomy: Surgical formation of an opening into the trachea through the neck, or the opening so created.Propofol: An intravenous anesthetic agent which has the advantage of a very rapid onset after infusion or bolus injection plus a very short recovery period of a couple of minutes. (From Smith and Reynard, Textbook of Pharmacology, 1992, 1st ed, p206). Propofol has been used as ANTICONVULSANTS and ANTIEMETICS.Respiratory Insufficiency: Failure to adequately provide oxygen to cells of the body and to remove excess carbon dioxide from them. (Stedman, 25th ed)Nasolacrimal Duct: A tubular duct that conveys TEARS from the LACRIMAL GLAND to the nose.Tracheal StenosisNeuromuscular Depolarizing Agents: Drugs that interrupt transmission at the skeletal neuromuscular junction by causing sustained depolarization of the motor end plate. These agents are primarily used as adjuvants in surgical anesthesia to cause skeletal muscle relaxation.Preanesthetic Medication: Drugs administered before an anesthetic to decrease a patient's anxiety and control the effects of that anesthetic.Anesthetics, Combined: The use of two or more chemicals simultaneously or sequentially to induce anesthesia. The drugs need not be in the same dosage form.Lacrimal Duct Obstruction: Interference with the secretion of tears by the lacrimal glands. Obstruction of the LACRIMAL SAC or NASOLACRIMAL DUCT causing acute or chronic inflammation of the lacrimal sac (DACRYOCYSTITIS). It is caused also in infants by failure of the nasolacrimal duct to open into the inferior meatus and occurs about the third week of life. In adults occlusion may occur spontaneously or after injury or nasal disease. (Newell, Ophthalmology: Principles and Concepts, 7th ed, p250)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).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.Methyl Ethers: A group of compounds that contain the general formula R-OCH3.Colonoscopes: Specially designed endoscopes for visualizing the interior surface of the colon.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.Neuromuscular Blockade: The intentional interruption of transmission at the NEUROMUSCULAR JUNCTION by external agents, usually neuromuscular blocking agents. It is distinguished from NERVE BLOCK in which nerve conduction (NEURAL CONDUCTION) is interrupted rather than neuromuscular transmission. Neuromuscular blockade is commonly used to produce MUSCLE RELAXATION as an adjunct to anesthesia during surgery and other medical procedures. It is also often used as an experimental manipulation in basic research. It is not strictly speaking anesthesia but is grouped here with anesthetic techniques. The failure of neuromuscular transmission as a result of pathological processes is not included here.Fentanyl: A potent narcotic analgesic, abuse of which leads to habituation or addiction. It is primarily a mu-opioid agonist. Fentanyl is also used as an adjunct to general anesthetics, and as an anesthetic for induction and maintenance. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1078)Delivery Rooms: Hospital units equipped for childbirth.Alfentanil: A short-acting opioid anesthetic and analgesic derivative of FENTANYL. It produces an early peak analgesic effect and fast recovery of consciousness. Alfentanil is effective as an anesthetic during surgery, for supplementation of analgesia during surgical procedures, and as an analgesic for critically ill patients.Emergency Medical Services: Services specifically designed, staffed, and equipped for the emergency care of patients.Bronchoscopes: Endoscopes for the visualization of the interior of the bronchi.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.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.Tracheal DiseasesProspective 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.Anesthesia, Intravenous: Process of administering an anesthetic through injection directly into the bloodstream.Hoarseness: An unnaturally deep or rough quality of voice.Video-Assisted Surgery: Endoscopic surgical procedures performed with visualization via video transmission. When real-time video is combined interactively with prior CT scans or MRI images, this is called image-guided surgery (see SURGERY, COMPUTER-ASSISTED).Bronchoscopy: Endoscopic examination, therapy or surgery of the bronchi.Epistaxis: Bleeding from the nose.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.Premedication: Preliminary administration of a drug preceding a diagnostic, therapeutic, or surgical procedure. The commonest types of premedication are antibiotics (ANTIBIOTIC PROPHYLAXIS) and anti-anxiety agents. It does not include PREANESTHETIC MEDICATION.Anesthetics, Inhalation: Gases or volatile liquids that vary in the rate at which they induce anesthesia; potency; the degree of circulation, respiratory, or neuromuscular depression they produce; and analgesic effects. Inhalation anesthetics have advantages over intravenous agents in that the depth of anesthesia can be changed rapidly by altering the inhaled concentration. Because of their rapid elimination, any postoperative respiratory depression is of relatively short duration. (From AMA Drug Evaluations Annual, 1994, p173)Neuromuscular Blocking Agents: Drugs that interrupt transmission of nerve impulses at the skeletal neuromuscular junction. They can be of two types, competitive, stabilizing blockers (NEUROMUSCULAR NONDEPOLARIZING AGENTS) or noncompetitive, depolarizing agents (NEUROMUSCULAR DEPOLARIZING AGENTS). Both prevent acetylcholine from triggering the muscle contraction and they are used as anesthesia adjuvants, as relaxants during electroshock, in convulsive states, etc.Monitoring, Intraoperative: The constant checking on the state or condition of a patient during the course of a surgical operation (e.g., checking of vital signs).Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi.Clinical Competence: The capability to perform acceptably those duties directly related to patient care.Pneumonia, Aspiration: A type of lung inflammation resulting from the aspiration of food, liquid, or gastric contents into the upper RESPIRATORY TRACT.Arytenoid Cartilage: One of a pair of small pyramidal cartilages that articulate with the lamina of the CRICOID CARTILAGE. The corresponding VOCAL LIGAMENT and several muscles are attached to it.Adjuvants, Anesthesia: Agents that are administered in association with anesthetics to increase effectiveness, improve delivery, or decrease required dosage.Lidocaine: A local anesthetic and cardiac depressant used as an antiarrhythmia agent. Its actions are more intense and its effects more prolonged than those of PROCAINE but its duration of action is shorter than that of BUPIVACAINE or PRILOCAINE.Tracheotomy: Surgical incision of the trachea.Conscious Sedation: A drug-induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. No interventions are required to maintain a patent airway. (From: American Society of Anesthesiologists Practice Guidelines)Hypnotics and Sedatives: Drugs used to induce drowsiness or sleep or to reduce psychological excitement or anxiety.Capnography: Continuous recording of the carbon dioxide content of expired air.Etomidate: Imidazole derivative anesthetic and hypnotic with little effect on blood gases, ventilation, or the cardiovascular system. It has been proposed as an induction anesthetic.Piperidines: A family of hexahydropyridines.Chin: The anatomical frontal portion of the mandible, also known as the mentum, that contains the line of fusion of the two separate halves of the mandible (symphysis menti). This line of fusion divides inferiorly to enclose a triangular area called the mental protuberance. On each side, inferior to the second premolar tooth, is the mental foramen for the passage of blood vessels and a nerve.Bronchial Spasm: Spasmodic contraction of the smooth muscle of the bronchi.Emergency Medical Technicians: Paramedical personnel trained to provide basic emergency care and life support under the supervision of physicians and/or nurses. These services may be carried out at the site of the emergency, in the ambulance, or in a health care institution.Heart Rate: The number of times the HEART VENTRICLES contract per unit of time, usually per minute.Manubrium: The upper or most anterior segment of the STERNUM which articulates with the CLAVICLE and first two pairs of RIBS.Positive-Pressure Respiration: A method of mechanical ventilation in which pressure is maintained to increase the volume of gas remaining in the lungs at the end of expiration, thus reducing the shunting of blood through the lungs and improving gas exchange.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.Masks: Devices that cover the nose and mouth to maintain aseptic conditions or to administer inhaled anesthetics or other gases. (UMDNS, 1999)Nasal Cavity: The proximal portion of the respiratory passages on either side of the NASAL SEPTUM. Nasal cavities, extending from the nares to the NASOPHARYNX, are lined with ciliated NASAL MUCOSA.Anesthesia, Obstetrical: A variety of anesthetic methods such as EPIDURAL ANESTHESIA used to control the pain of childbirth.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Lacrimal Apparatus Diseases: Diseases of the lacrimal apparatus.Cervical Vertebrae: The first seven VERTEBRAE of the SPINAL COLUMN, which correspond to the VERTEBRAE of the NECK.Respiratory Care Units: The hospital unit in which patients with respiratory conditions requiring special attention receive intensive medical care and surveillance.Dacryocystorhinostomy: Surgical fistulization of the LACRIMAL SAC for external drainage of an obstructed nasolacrimal duct.Vecuronium Bromide: Monoquaternary homolog of PANCURONIUM. A non-depolarizing neuromuscular blocking agent with shorter duration of action than pancuronium. Its lack of significant cardiovascular effects and lack of dependence on good kidney function for elimination as well as its short duration of action and easy reversibility provide advantages over, or alternatives to, other established neuromuscular blocking agents.Laryngeal Diseases: Pathological processes involving any part of the LARYNX which coordinates many functions such as voice production, breathing, swallowing, and coughing.Atracurium: A non-depolarizing neuromuscular blocking agent with short duration of action. Its lack of significant cardiovascular effects and its lack of dependence on good kidney function for elimination provide clinical advantage over alternate non-depolarizing neuromuscular blocking agents.Air Ambulances: Fixed-wing aircraft or helicopters equipped for air transport of patients.Laryngostenosis: Developmental or acquired stricture or narrowing of the LARYNX. Symptoms of respiratory difficulty depend on the degree of laryngeal narrowing.Nitrous Oxide: Nitrogen oxide (N2O). A colorless, odorless gas that is used as an anesthetic and analgesic. High concentrations cause a narcotic effect and may replace oxygen, causing death by asphyxia. It is also used as a food aerosol in the preparation of whipping cream.Dexmedetomidine: A imidazole derivative that is an agonist of ADRENERGIC ALPHA-2 RECEPTORS. It is closely-related to MEDETOMIDINE, which is the racemic form of this compound.Anesthesia, Dental: A range of methods used to reduce pain and anxiety during dental procedures.Hemodynamics: The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM.Esophagus: The muscular membranous segment between the PHARYNX and the STOMACH in the UPPER GASTROINTESTINAL TRACT.Neck: The part of a human or animal body connecting the HEAD to the rest of the body.Status Asthmaticus: A sudden intense and continuous aggravation of a state of asthma, marked by dyspnea to the point of exhaustion and collapse and not responding to the usual therapeutic efforts.Anesthesia Recovery Period: The period of emergence from general anesthesia, where different elements of consciousness return at different rates.Vocal Cords: A pair of cone-shaped elastic mucous membrane projecting from the laryngeal wall and forming a narrow slit between them. Each contains a thickened free edge (vocal ligament) extending from the THYROID CARTILAGE to the ARYTENOID CARTILAGE, and a VOCAL MUSCLE that shortens or relaxes the vocal cord to control sound production.Double-Blind Method: A method of studying a drug or procedure in which both the subjects and investigators are kept unaware of who is actually getting which specific treatment.Blood Pressure: PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS.Single-Blind Method: A method in which either the observer(s) or the subject(s) is kept ignorant of the group to which the subjects are assigned.Emergencies: Situations or conditions requiring immediate intervention to avoid serious adverse results.Surgery, Oral: A dental specialty concerned with the diagnosis and surgical treatment of disease, injuries, and defects of the human oral and maxillofacial region.Pneumothorax: An accumulation of air or gas in the PLEURAL CAVITY, which may occur spontaneously or as a result of trauma or a pathological process. The gas may also be introduced deliberately during PNEUMOTHORAX, ARTIFICIAL.Vocal Cord Paralysis: Congenital or acquired paralysis of one or both VOCAL CORDS. This condition is caused by defects in the CENTRAL NERVOUS SYSTEM, the VAGUS NERVE and branches of LARYNGEAL NERVES. Common symptoms are VOICE DISORDERS including HOARSENESS or APHONIA.Pharyngitis: Inflammation of the throat (PHARYNX).Colonoscopy: Endoscopic examination, therapy or surgery of the luminal surface of the colon.Lacerations: Torn, ragged, mangled wounds.Critical Care: Health care provided to a critically ill patient during a medical emergency or crisis.Analgesics, Opioid: Compounds with activity like OPIATE ALKALOIDS, acting at OPIOID RECEPTORS. Properties include induction of ANALGESIA or NARCOSIS.Intensive Care Units: Hospital units providing continuous surveillance and care to acutely ill patients.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.Oral Surgical Procedures: Surgical procedures used to treat disease, injuries, and defects of the oral and maxillofacial region.Infant, Newborn: An infant during the first month after birth.Thyroid Cartilage: The largest cartilage of the larynx consisting of two laminae fusing anteriorly at an acute angle in the midline of the neck. The point of fusion forms a subcutaneous projection known as the Adam's apple.Anesthetics, Local: Drugs that block nerve conduction when applied locally to nerve tissue in appropriate concentrations. They act on any part of the nervous system and on every type of nerve fiber. In contact with a nerve trunk, these anesthetics can cause both sensory and motor paralysis in the innervated area. Their action is completely reversible. (From Gilman AG, et. al., Goodman and Gilman's The Pharmacological Basis of Therapeutics, 8th ed) Nearly all local anesthetics act by reducing the tendency of voltage-dependent sodium channels to activate.Numismatics: Study of coins, tokens, medals, etc. However, it usually refers to medals pertaining to the history of medicine.Maxillofacial Injuries: General or unspecified injuries involving the face and jaw (either upper, lower, or both).gamma-Cyclodextrins: Cyclic GLUCANS consisting of eight (8) glucopyranose units linked by 1,4-glycosidic bonds.Mouth: The oval-shaped oral cavity located at the apex of the digestive tract and consisting of two parts: the vestibule and the oral cavity proper.Airway Extubation: Removal of an endotracheal tube from the patient.Anesthesia, Local: A blocking of nerve conduction to a specific area by an injection of an anesthetic agent.Isoflurane: A stable, non-explosive inhalation anesthetic, relatively free from significant side effects.Resuscitation: The restoration to life or consciousness of one apparently dead. (Dorland, 27th ed)Retrospective Studies: Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.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.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.Laboratory Animal Science: The science and technology dealing with the procurement, breeding, care, health, and selection of animals used in biomedical research and testing.Silicones: A broad family of synthetic organosiloxane polymers containing a repeating silicon-oxygen backbone with organic side groups attached via carbon-silicon bonds. Depending on their structure, they are classified as liquids, gels, and elastomers. (From Merck Index, 12th ed)Pulmonary Atelectasis: Absence of air in the entire or part of a lung, such as an incompletely inflated neonate lung or a collapsed adult lung. Pulmonary atelectasis can be caused by airway obstruction, lung compression, fibrotic contraction, or other factors.Foreign Bodies: Inanimate objects that become enclosed in the body.Methohexital: An intravenous anesthetic with a short duration of action that may be used for induction of anesthesia.Intensive Care: Advanced and highly specialized care provided to medical or surgical patients whose conditions are life-threatening and require comprehensive care and constant monitoring. It is usually administered in specially equipped units of a health care facility.Adrenergic beta-1 Receptor Antagonists: Drugs that bind to and block the activation of ADRENERGIC BETA-1 RECEPTORS.Dilatation: The act of dilating.Midazolam: A short-acting hypnotic-sedative drug with anxiolytic and amnestic properties. It is used in dentistry, cardiac surgery, endoscopic procedures, as preanesthetic medication, and as an adjunct to local anesthesia. The short duration and cardiorespiratory stability makes it useful in poor-risk, elderly, and cardiac patients. It is water-soluble at pH less than 4 and lipid-soluble at physiological pH.Glycopyrrolate: A muscarinic antagonist used as an antispasmodic, in some disorders of the gastrointestinal tract, and to reduce salivation with some anesthetics.Emergency Treatment: First aid or other immediate intervention for accidents or medical conditions requiring immediate care and treatment before definitive medical and surgical management can be procured.Treatment Failure: A measure of the quality of health care by assessment of unsuccessful results of management and procedures used in combating disease, in individual cases or series.Consciousness Monitors: Devices used to assess the level of consciousness especially during anesthesia. They measure brain activity level based on the EEG.Sufentanil: An opioid analgesic that is used as an adjunct in anesthesia, in balanced anesthesia, and as a primary anesthetic agent.Ventilator Weaning: Techniques for effecting the transition of the respiratory-failure patient from mechanical ventilation to spontaneous ventilation, while meeting the criteria that tidal volume be above a given threshold (greater than 5 ml/kg), respiratory frequency be below a given count (less than 30 breaths/min), and oxygen partial pressure be above a given threshold (PaO2 greater than 50mm Hg). Weaning studies focus on finding methods to monitor and predict the outcome of mechanical ventilator weaning as well as finding ventilatory support techniques which will facilitate successful weaning. Present methods include intermittent mandatory ventilation, intermittent positive pressure ventilation, and mandatory minute volume ventilation.Apnea: A transient absence of spontaneous respiration.Postoperative Complications: Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.Device Removal: Removal of an implanted therapeutic or prosthetic device.Granuloma, Laryngeal: A tumor-like nodule or mass of inflammatory granulation tissue projecting into the lumen of the LARYNX.EthersOxygen: An element with atomic symbol O, atomic number 8, and atomic weight [15.99903; 15.99977]. It is the most abundant element on earth and essential for respiration.Deglutition Disorders: Difficulty in SWALLOWING which may result from neuromuscular disorder or mechanical obstruction. Dysphagia is classified into two distinct types: oropharyngeal dysphagia due to malfunction of the PHARYNX and UPPER ESOPHAGEAL SPHINCTER; and esophageal dysphagia due to malfunction of the ESOPHAGUS.Noninvasive Ventilation: Techniques for administering artificial respiration without the need for INTRATRACHEAL INTUBATION.Respiratory Aspiration: Inhaling liquid or solids, such as stomach contents, into the RESPIRATORY TRACT. When this causes severe lung damage, it is called ASPIRATION PNEUMONIA.Operating Rooms: Facilities equipped for performing surgery.Tooth Injuries: Traumatic or other damage to teeth including fractures (TOOTH FRACTURES) or displacements (TOOTH LUXATION).Ventilators, Mechanical: Mechanical devices used to produce or assist pulmonary ventilation.Nose: A part of the upper respiratory tract. It contains the organ of SMELL. The term includes the external nose, the nasal cavity, and the PARANASAL SINUSES.Oligohydramnios: A condition of abnormally low AMNIOTIC FLUID volume. Principal causes include malformations of fetal URINARY TRACT; FETAL GROWTH RETARDATION; GESTATIONAL HYPERTENSION; nicotine poisoning; and PROLONGED PREGNANCY.Organization and Administration: The planning and managing of programs, services, and resources.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.Apgar Score: A method, developed by Dr. Virginia Apgar, to evaluate a newborn's adjustment to extrauterine life. Five items - heart rate, respiratory effort, muscle tone, reflex irritability, and color - are evaluated 60 seconds after birth and again five minutes later on a scale from 0-2, 0 being the lowest, 2 being normal. The five numbers are added for the Apgar score. A score of 0-3 represents severe distress, 4-7 indicates moderate distress, and a score of 7-10 predicts an absence of difficulty in adjusting to extrauterine life.Oxygen Inhalation Therapy: Inhalation of oxygen aimed at restoring toward normal any pathophysiologic alterations of gas exchange in the cardiopulmonary system, as by the use of a respirator, nasal catheter, tent, chamber, or mask. (From Dorland, 27th ed & Stedman, 25th ed)Pulmonary Edema: Excessive accumulation of extravascular fluid in the lung, an indication of a serious underlying disease or disorder. Pulmonary edema prevents efficient PULMONARY GAS EXCHANGE in the PULMONARY ALVEOLI, and can be life-threatening.Neuroleptanalgesia: A form of analgesia accompanied by general quiescence and psychic indifference to environmental stimuli, without loss of consciousness, and produced by the combined administration of a major tranquilizer (neuroleptic) and a narcotic.Contracture: Prolonged shortening of the muscle or other soft tissue around a joint, preventing movement of the joint.Emergency Service, Hospital: Hospital department responsible for the administration and provision of immediate medical or surgical care to the emergency patient.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.Pressure: A type of stress exerted uniformly in all directions. Its measure is the force exerted per unit area. (McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed)Pharynx: A funnel-shaped fibromuscular tube that conducts food to the ESOPHAGUS, and air to the LARYNX and LUNGS. It is located posterior to the NASAL CAVITY; ORAL CAVITY; and LARYNX, and extends from the SKULL BASE to the inferior border of the CRICOID CARTILAGE anteriorly and to the inferior border of the C6 vertebra posteriorly. It is divided into the NASOPHARYNX; OROPHARYNX; and HYPOPHARYNX (laryngopharynx).Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals.Tidal Volume: The volume of air inspired or expired during each normal, quiet respiratory cycle. Common abbreviations are TV or V with subscript T.Endoscopy: Procedures of applying ENDOSCOPES for disease diagnosis and treatment. Endoscopy involves passing an optical instrument through a small incision in the skin i.e., percutaneous; or through a natural orifice and along natural body pathways such as the digestive tract; and/or through an incision in the wall of a tubular structure or organ, i.e. transluminal, to examine or perform surgery on the interior parts of the body.Advanced Cardiac Life Support: The use of sophisticated methods and equipment to treat cardiopulmonary arrest. Advanced Cardiac Life Support (ACLS) includes the use of specialized equipment to maintain the airway, early defibrillation and pharmacological therapy.Intermittent Positive-Pressure Ventilation: Application of positive pressure to the inspiratory phase when the patient has an artificial airway in place and is connected to a ventilator.Blood Gas Analysis: Measurement of oxygen and carbon dioxide in the blood.Burns, Inhalation: Burns of the respiratory tract caused by heat or inhaled chemicals.Thoracic Surgical Procedures: Surgery performed on the thoracic organs, most commonly the lungs and the heart.Surgical Procedures, Elective: Surgery which could be postponed or not done at all without danger to the patient. Elective surgery includes procedures to correct non-life-threatening medical problems as well as to alleviate conditions causing psychological stress or other potential risk to patients, e.g., cosmetic or contraceptive surgery.

Pharyngeal mucosal pressures, airway sealing pressures, and fiberoptic position with the intubating versus the standard laryngeal mask airway. (1/190)

BACKGROUND: The tube of the intubating laryngeal mask (ILM) is more rigid than the standard laryngeal mask airway (LMA), and the authors have tested the hypothesis that pharyngeal mucosal pressures, airway sealing pressures, and fiberoptic position are different when the two devices are compared. METHODS: Twenty anesthetized, paralyzed adults were randomly allocated to receive either the LMA or ILM for airway management. Microchip sensors were attached to the size 5 LMA or ILM at locations corresponding to the pyriform fossa, hypopharynx, base of tongue, posterior pharynx, and distal and proximal oropharynx. Mucosal pressures, airway sealing pressures, and fiberoptic positioning were recorded during inflation of the cuff from 0 to 40 ml in 10-ml increments. RESULTS: Airway sealing pressures were higher for the ILM (30 vs. 23 cm H2O), but epiglottic downfolding was more common (56% vs. 26%). Pharyngeal mucosal pressures were much higher for the ILM at five of six locations. Mean mucosal pressures in the distal oropharynx for the ILM were always greater than 157 cm H2O, regardless of cuff volume. There was no correlation between mucosal pressures and airway sealing pressures at any location for the LMA, but there was a correlation at three of six locations for the ILM. CONCLUSIONS: The ILM provides a more effective seal than the LMA, but pharyngeal mucosal pressures are higher and always exceed capillary perfusion pressure. The ILM is unsuitable for use as a routine airway and should be removed after its use as an airway intubator.  (+info)

Palliation of dysphagia from inoperable oesophageal carcinoma using Atkinson tubes or self-expanding metal stents. (2/190)

Until recently, intubation for the palliation of malignant dysphagia has relied upon the insertion of a variety of plastic tubes. Self-expanding metal stents are reported to have a lower complication rate. We have compared the results of Atkinson tube insertion with self-expanding metal stents in patients with inoperable oesophageal carcinoma. From 1990 to 1994 Atkinson tubes were inserted for the palliation of dysphagia from oesophageal cancer, from 1994 onwards self-expanding metal stents were used. Complications, mortality and hospital stay were compared in both groups of patients. In all, 87 patients with inoperable oesophageal carcinoma were treated, 46 with an Atkinson tube and 41 with metal stents. Complications occurred at similar rates in both groups (56% Atkinson tubes, 44% metal stents). There was a significantly higher perforation rate associated with Atkinson tube insertion (8 patients, 17%) compared with metal stents (1 patient, 2.4%, P = 0.02, chi 2). The length of stay was also significantly higher in the Atkinson tube group (median 10 days) compared with the metal stent group (3 days, P < 0.01, Mann-Whitney U test). Mortality rates were similar in both groups. The use of metal stents for the palliation of dysphagia in inoperable oesophageal carcinoma results in a lower perforation rate and a reduced length of stay and they represent a significant advantage over Atkinson tubes.  (+info)

Modified nasopharyngeal tube for upper airway obstruction. (3/190)

A modified nasopharyngeal tube is described that does not add airway dead space and resistance, is well tolerated, highly successful, and allows simultaneous use of oxygen prongs. This potentially reduces the need for surgical intervention to relieve high upper airway obstruction from Pierre-Robin syndrome and other causes.  (+info)

Sensorineural hearing loss and prematurity. (4/190)

OBJECTIVE: To elucidate clinical antecedents of sensorineural hearing loss (SNHL) in very preterm infants. DESIGN: Case-control study. SUBJECTS: Fifteen children < 33 weeks' gestation with significant SNHL born between 1 January 1990 and 31 December 1994, detected within 9 months of birth, and 30 matched control children. METHODOLOGY: Perinatal variables in the two groups were compared using non-parametric tests and conditional logistic regression (EGRET). RESULTS: Median birth weight for the index group was 960 g (range 600-2914 g) compared with 1026 g (range 410-2814 g) for controls. Children with SNHL had longer periods of intubation, ventilation, oxygen treatment, and acidosis, and more frequent treatment with dopamine or frusemide. Neither peak nor trough aminoglycoside levels, nor duration of jaundice or level of bilirubin varied between groups. However, SNHL was more likely if peak bilirubin levels coexisted with netilmicin use (odds ratio (95% confidence interval) 14.2 (1.8 to 113.6)) or if acidosis occurred when bilirubin levels were over 200 micromol/l (OR 8.0 (0.9 to 71.6). Frusemide use in the face of high serum creatinine levels (OR 8.9 (1.1 to 74.5)) or netilmicin treatment (OR 5.0 (0.99 to 24.8)) was also associated with SNHL. At 12 months of age, seven of 15 children with SNHL had evidence of cerebral palsy compared with two of 30 controls (OR 12.3 (2.1 to 71)). CONCLUSIONS: Preterm children with SNHL required more intensive care in the perinatal period and developed more neurological complications than controls. Among very preterm babies, the coexistence of risk factors for hearing loss may be more important than the individual factors themselves.  (+info)

Adhesion formation in intubated rabbits increases with high insufflation pressure during endoscopic surgery. (5/190)

The aim of the study was to test the hypothesis that the increase in adhesion formation by CO(2) pneumoperitoneum is caused by mesothelial hypoxaemia. Therefore the effect of the intra-abdominal pressure together with the flow rate upon adhesion formation was evaluated in rabbits following laser and bipolar lesions during endoscopic surgery using humidified CO(2) at 35 +/- 1 degrees C. The intra-abdominal pressure and flow rate were 5 mmHg and 1 l/min in group 1 (n = 5), 5 mmHg and 10 l/min in group 2 (n = 4), 20 mmHg and 1 l/min in group 3 (n = 5) and 20 mmHg and 10 l/min in group 4 (n = 4) respectively. A rapid and reliable intubation method for rabbits was developed to permit high insufflation pressure. By two-way analysis of variance, total adhesion scores following a laser lesion increased with flow rate (P = 0.0003) and insufflation pressure (P = 0.002). Total adhesion scores of bipolar lesions increased with pressure (P = 0.02) but not with flow rate (P = 0.1). The total adhesion scores of laser and bipolar lesions together increased with flow rate (P = 0.005) and with insufflation pressure (P = 0.004). There was no statistical interaction between flow rate and insufflation pressure. In conclusion, the insufflation pressure in endoscopic surgery with CO(2) pneumoperitoneum is a co-factor in adhesion formation, together with desiccation.  (+info)

Combination therapy for chronic Pseudomonas aeruginosa respiratory infection associated with biofilm formation. (6/190)

There had been no reports of investigations into biofilms in chronic respiratory infection in vivo. Recently, we established a new murine model of chronic respiratory infection with Pseudomonas aeruginosa. In the present study, we examined the bacteriological effect of combined clarithromycin and levofloxacin against chronic respiratory infection with P. aeruginosa. Scanning electron micrograph of the surface of the catheter intubated in mouse bronchus for 7 days demonstrated in vivo formation of a biofilm containing blood cells, complex fibrous structures and bacteria. Treatment with either clarithromycin alone or levofloxacin alone had no statistical effect on the number of viable bacteria in lung. The combined use of both drugs resulted in a significant decrease in the number of viable bacteria. The present experiment demonstrates that the newly established murine model was useful to investigate the treatment of biofilm-associated chronic respiratory infection with P. aeruginosa, and combination therapy with clarithromycin and levofloxacin was effective in biofilm-associated chronic respiratory infection.  (+info)

Anesthesia in the Yom Kippur war. (7/190)

The role of the anesthetist in the treatment of battle casualties is discussed in the light of personal experience in a field hospital and in the rear during the Yom Kippur War of October 1973. Resuscitation and intensive care both before and after evacuation play an important part in reducing mortality, and the importance of providing adequate facilities for these functions in the battle area as well as at the base is emphasized.  (+info)

Endoscopic management of biliary leaks after T-tube removal in liver transplant recipients: nasobiliary drainage versus biliary stenting. (8/190)

This study presents the long-term sequelae of endoscopic retrograde cholangiopancreatography (ERCP)-managed biliary leakage in patients who underwent orthotopic liver transplantation (OLT) and compares the relative efficacy, safety, and charges of nasobiliary drainage (NBD) versus biliary stenting (BS). We identified all orthotopic liver transplant recipients from January 1, 1993, to December 31, 1997, who had undergone ERCP for biliary leakage. Clinical outcome and charges were calculated on an intention-to-treat basis according to initial endoscopic therapy. Of the 1,166 adult OLTs performed during the study period, 442 patients underwent elective T-tube removal. ERCP was attempted in 69 patients (16%) who developed biliary leakage after T-tube removal. Three patients (5%) in whom initial ERCP was unsuccessful underwent surgery. NBD and BS were used as primary therapy in 45 (68%) and 21 patients (32%), respectively. Three patients initially treated with NBD required reendoscopy or surgery compared with 6 patients initially treated with BS (P <.05). Although not statistically significant, there was a trend toward greater expense in the BS group compared with the NBD group. ERCP is a safe and effective method of managing biliary leakage after T-tube removal in orthotopic liver transplant recipients. However, our results suggest NBD is the preferred method because recurrent leaks were more common in patients treated initially with BS. With prompt use of ERCP, surgery is rarely needed for this complication of OLT.  (+info)

  • Adequate equipment for RSI, i. e. standard airway equipment (with airway bougie) and other mandatory devices including endotracheal confirmation devices (CO2 detection devices and others), alternative intubation equipment, rescue oxygenation devices and surgical airway kits. (
  • Rarely, DSI will avert the need for intubation by alleviating agitation and improving oxygenation to an acceptable level. (
  • On Aug. 12, 2018, the 22-year-old plaintiff's decedent died in the operating room as a result of a botched intubation. (
  • Sometimes, even if you appear to be breathing normally and your blood oxygen levels look fine, you may need intubation. (
  • 2. Use Bag-Valve mask (BVM) to provide 100% supplemental oxygen to patient prior to intubation. (
  • This delirium, combined with the low oxygen desaturation on the monitor, often leads to precipitous attempts at intubation without adequate preoxygenation. (
  • It's a robotic intubation device that utilizes infrared light to identify the airway and guide the tube toward it. (
  • Other analysed parameters included airway obstruction, hemodynamic changes, treatment for hemodynamics response, consumption time for intubation, amnesia level, and postoperative adverse events. (
  • Pre-hospital RSI provides improved intubating conditions compared with intubation with deep sedation only, takes less time for intubation, and uses a safer combination and dosage of drugs. (
  • A report of an unexpected and novel anaesthetic complication in a rabbit, the presence of faecal matter in the oropharynx impeding attempts at intubation, was recently published in Veterinary Record Case Reports. (
  • Initial attempts at intubation by an experienced anaesthetist were unsuccessful, with intubation finally achieved after five minutes. (
  • However, it is imperative to realize that DSI should only be initiated with the end-goal being intubation and securing the airway. (
  • To the Editor: The article entitled "Serial Blood Gas Studies During Cardiopulmonary Resuscitation" by Fillmore, Shapiro, and Killip ( Ann Intern Med 72:465-469, 1970) demonstrates conclusively the efficacy of endotracheal intubation over mouth-to-mouth resuscitation in lowering arterial PCO 2 and raising oxyhemoglobin saturation. (
  • If you smoke, have a lung disease such as COPD , have a neck or spine injury, or you're overweight , it can make intubation and recovery harder. (
  • To make intubation a little easier, researchers at the Hebrew University of Jerusalem have developed a device they call GuidIN Tube. (
  • Typically, endobronchial intubation or bronchial blockers are utilized to achieve lung isolation during these procedures. (
  • Built on the company's existing, clinically validated LapSim[R] platform, EndoSim features basic endoscopic skills training modules and advanced lower and upper gastrointestinal intubation training simulations. (
  • Gastrointestinal intubation and special nutritional management. (
  • Intubation time in patients undergoing cardiac surgery may be associated with increased mortality and morbidity. (
  • The aim of this study was to determine the influence of intubation time on morbidity and mortality in patients undergoing cardiac surgery. (
  • In the emergency department setting, RSI is superior to intubation with deep sedation, a technique not incorporating pharmacological paralysis as part of the intubation sequence. (
  • Other methods of intubation involve surgery and include the cricothyrotomy (used almost exclusively in emergency circumstances) and the tracheotomy, used primarily in situations where a prolonged need for airway support is anticipated. (
  • Endotracheal intubation is-even in the presence of alternative methods like laryngeal mask or laryngeal tube-the standard in securing a patient's airway. (
  • An intubation set is disclosed which incorporates a special fastening means by which the tube can be fixed conveniently and effectively to the body of a patient at a point adjacent to the body opening into which the tube has been inserted. (
  • A blind intubation guide (10) includes a guide wall (42), which aims an orotracheal tube (120) into the laryngeal opening (230), the guide wall (42) being pivotally mounted to an aft member (16) of the guide (10) to accommodate throats (202) of variable shallowness. (
  • a side arm connected to the guide wall, the guide wall being pivotally mounted to the aft member through the side arm and in spaced relationship to the support member so as to define an intubation tube passageway between the guide wall and the support member. (
  • The first radiograph obtained after selective intubation showed the tip of the endotracheal tube (ETT) in the right bronchus intermedius, with loss of aeration in the right upper lobe. (
  • The present invention provides an intubation assembly for nasogastric intubation comprising a catheter and a plastic sheath tube for encasing the catheter along substantially the full length thereof, the sheath tube having a longitudinal tear-off line over the full length thereof and having elasticity and rigidity slightly greater than the catheter which is slidably inserted in the sheath tube. (
  • Normally, a catheter for nasogastric intubation to be used for nutritional purposes comprises a weighted portion in which a weight is sealed into a distal end of a soft small-diameter plastic tube. (
  • During NG intubation, your doctor or nurse will insert a thin plastic tube through your nostril, down your esophagus, and into your stomach. (
  • An apparatus for endotracheal intubation comprises a suction stylet (10) telescopically disposed within an endotracheal tube (30) such that the suction stylet (10) is operative to aspirate fluids from the vicinity of the distal end (16) of the endotracheal tube. (
  • The apparatus further comprises a connector for releasably axially fixing the suction stylet with respect to the endotracheal tube during intubation. (
  • A method for endotracheal intubation is also disclosed in which a suction stylet (10) is telescopically disposed within an endotracheal tube (30). (
  • The extendable lighted intubation stylet includes a handle, a switch, a sheath, an extension member, and a light source. (
  • The extension member can be extended or retracted relative to the sheath thereby increasing or decreasing the length of the extendable lighted intubation stylet. (
  • In its extended configuration, the extendable intubation stylet is immediately available in the case of an unanticipated difficult airway and can be used as a bougie. (
  • This application is based on and hereby claims the benefit under 35 U.S.C. 119 from U.S. Provisional Application No. 60/831,825, entitled "Extendable Lighted Intubation Stylet," filed on Jul. (
  • Now a new device being developed by a team led by a mechanical engineering professor with help from an anesthesiologist at Ohio State University may make intubations a lot easier and more successful in challenging cases. (
  • 8. The intubation guide of claim 1 , the guide wall being pivotally mounted to the distal end of the aft member. (
  • 18. The intubation guide of claim 13 , the guide wall being pivotally mounted to the distal end of the aft member. (
Examination of the Small Intestine by Means of Duodenal Intubation, Book by J. L. Sellink (Paperback) |
Examination of the Small Intestine by Means of Duodenal Intubation, Book by J. L. Sellink (Paperback) | (
Trachea - Wikipedia
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Guidelines for Perioperative Care in Elective Colonic Surgery: Enhanced Recovery After Surgery (ERAS®) Society Recommendations ...
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