Airway, Breathing or Consequences: Medical-Legal Consequences of Airway Mismanagement

In the first part of this two-part article, we reviewed the tools and technology available to help ensure proper endotracheal tube placement through the detection and evaluation of end-tidal carbon dioxide (EtCO2). The key takeaway from part one is that we need to understand, use and trust the equipment available and the information we are given. Each time; every time; all the time. When we lose track of that key principle, bad things happen. As healthcare professionals, whether we work outside of hospitals, inside hospitals or between hospitals, our experience often leads us beyond direct patient care. For some, that means focusing on management responsibilities. For others, it leads to rewarding career paths in education and training. And for a few, opportunities arise to bridge professional interests and engage in the challenging work of providing expertise in medical-legal situations. Among the more common medical-legal situations for which expert witnesses are needed are cases where airway management (or the lack thereof) has led to significant negative outcomes. As expert witnesses, we may work for the plaintiff team (representing the person harmed) or the defense team (representing the medical professionals and organizations being sued). Avoidable or Correctable? When dealing with airway-related medical malpractice suits, one of the first questions that must be asked is simply, was the situation avoidable or correctable? We all know that mistakes happen. (After all, we...
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Airway & Respiratory Exclusive Articles Source Type: news

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Purpose of review The prevalence of obesity continues to rise in developed countries. Increasingly, anaesthesiologists are faced with management of this cohort of patient in the ambulatory setting. This review summarizes the factors involved with such management of the obese patient as well as provision of guidance on recently accrued evidence. Recent findings A number of reviews have emphasized the value of preoperative assessment in ambulatory management for the obese, with emphasis on diagnosis, management and outcomes of patients with obstructive sleep apnoea. Drug delivery particularly with appropriate dose sched...
Source: Current Opinion in Anaesthesiology - Category: Anesthesiology Tags: AMBULATORY ANESTHESIA: Edited by Claude Meistelman Source Type: research
Authors: Solidoro P, Corbetta L, Patrucco F, Sorbello M, Piccioni F, D'amato L, Renda T, Petrini F Abstract In the last decades, the use of flexible bronchoscopy (FB) has greatly increased in intensive care, anesthesia and thoracic surgery for diagnostic purpose, management of critical patients and to facilitate airway management for tracheal intubation, one lung ventilation and lung transplant management. The huge availability of endoscopic instruments and devices for airway management has amplified indications and possibilities for bronchoscopic procedures performed by intensive care physicians, anesthesiologist,...
Source: Panminerva Medica - Category: General Medicine Tags: Panminerva Med Source Type: research
We thank Mr. Wood and Mr. Podsialdo for their insightful comments regarding the Pragmatic Airway Resuscitation Trial (PART) results.  With regards to their comment of prior studies finding better outcomes with intubation than supraglottic airways, one must bear in mind that these prior studies were biased by their retrospective designs; the airway was selected by paramedic choice and may have been influenced by a range of factors such as the patient’s condition, anatomy, the physical environment or the practitioner’s level of comfort. Meta-analysis or systematic reviews of these retrospective studies ...
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Airway & Respiratory Exclusive Articles Source Type: news
In this study, for all-comers, that was an abysmal 6%. This is an important number because it tells us that overall, successful resuscitation from cardiac arrest is rare and that a number of our efforts may have some statistically significant differences but the absolute effect on the gold standard outcome is rather small. But that’s a story for another time. The focus here is on airway management in cardiac arrest, and the suggestion that the “verdict is out” on whether or not paramedics should be using an endotracheal tube or a supraglottic device.
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Airway & Respiratory Exclusive Articles Source Type: news
Authors: Sorbello M Abstract PMID: 30394073 [PubMed - as supplied by publisher]
Source: Minerva Anestesiologica - Category: Anesthesiology Tags: Minerva Anestesiol Source Type: research
This article reviews the current and emerging methods of fetal evaluation, indications for ex utero intrapartum treatment, and provides a detailed description of the procedure and necessary personnel.
Source: Clinics in Perinatology - Category: Perinatology & Neonatology Authors: Source Type: research
Purpose of review Historically, most evidence supporting emergency airway management strategies have been limited to small series, retrospective analyses and extrapolation from other settings (i.e. the operating room). Over the past year, several large, randomized clinical trials have offered new findings to inform emergency airway management techniques. Recent findings One large, randomized clinical trial, found improved first attempt success rates with bougie facilitated intubation compared with traditional intubation. Two randomized clinical trials suggested better outcomes in adult out-of-hospital cardiac arrest (...
Source: Current Opinion in Critical Care - Category: Nursing Tags: EMERGENCIES IN CRITICAL CARE: Edited by Wesley H. Self Source Type: research
Purpose of review The volume of bariatric and nonbariatric surgical procedures on obese patients is dramatically increasing worldwide over the past years. In this review, we discuss the physiopathlogy of respiratory function during anesthesia in obese patients, the stratification of perioperative risk to develop intraoperative and postoperative pulmonary complications, the optimization of airway management, and perioperative ventilation, including postoperative respiratory assistance. Recent findings Scores have been proposed to stratify the risk of surgical patients, some of which were specifically developed for obes...
Source: Current Opinion in Critical Care - Category: Nursing Tags: THE SURGICAL PATIENT: Edited by Karim Asehnoune Source Type: research
Conditions:   Adverse Effect;   Anesthesia;   Airway Complication of Anesthesia Intervention:   Procedure: Induction of anesthesia Sponsor:   Umeå University Recruiting
Source: - Category: Research Source Type: clinical trials
Conclusions: Both devices can be safely applied to geriatric patients with similar success rates and oropharyngeal leak pressures. However, inserting the i-gel™ was faster and easier compared to the LMA-S in paralyzed elderly patients. PMID: 30343563 [PubMed - as supplied by publisher]
Source: Korean Journal of Anesthesiology - Category: Anesthesiology Tags: Korean J Anesthesiol Source Type: research
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