Managing and securing the bleeding upper airway: a narrative review

AbstractFailure to manage bleeding in the airway is an important cause of airway-related death. The purpose of this narrative review is to identify techniques and strategies that can be employed when severe bleeding in the upper airway may render traditional airway management (e.g., facemask ventilation, intubation via direct/video laryngoscopy, flexible  bronchoscopy) impossible because of impeded vision. An extensive literature search was conducted of bibliographic databases, guidelines, and textbooks using search terms related to airway management and bleeding. We identified techniques that establish a definitive airway, even in cases of impeded visibility resulting from severe bleeding in the airway. These include flexible video-/optical- scope-guided intubation via a supraglottic airway device; cricothyroidotomy or tracheotomy; and retrograde-, blind nasal-, oral-digital-, light-, and ultrasound-guided intubation. We provide a structured approach to managing bleeding in the airway that accounts for the source of bleeding and the estimated risk of failure to intubate using direct laryngoscopy or to achieve a front-of-neck access for surgical airway rescue. In situations where these techniques are predicted to be successful, the reco mmended approach is to identify the cricothyroid membrane (in preparation for rescue cricothyroidotomy), followed by rapid sequence induction. In situations where traditional management of the airway is likely to fail, we recommend an awa...
Source: Canadian Journal of Anesthesia - Category: Anesthesiology Source Type: research

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Abstract Dietary supplements (DS) pose many side effects and multiple interactions with perioperative medications, which may increase surgical morbidity and mortality. Descriptive empirical data are essentially nonexistent related to DS consumption and patient knowledge of DS. The aims of this study were to investigate the prevalence of use, type of supplements used, and the knowledge base among military beneficiaries and veterans consuming DS during the preoperative period. This descriptive cross-sectional study solicited data from 2,623 volunteer, preoperative patients at 6 different military medical centers thr...
Source: AANA Journal - Category: Anesthesiology Authors: Tags: AANA J Source Type: research
ConclusionAfter great improvements in rectal cancer treatment, late gastrointestinal toxicity after radiotherapy is experienced less frequent and less severe; however, it remains a great concern associated with worse quality of life.
Source: International Journal of Colorectal Disease - Category: Gastroenterology Source Type: research
ConclusionIt is safe to continue the use of anti-platelet therapy throughout the peri-operative phase in patients with hip fracture surgery. The continuation of such therapy is not associated with increased risk of bleeding or blood transfusion or other complications in patients who had surgical treatment for femoral neck fracture.
Source: International Orthopaedics - Category: Orthopaedics Source Type: research
Authors: Wheeler AP, Hemingway C, Gailani D Abstract INTRODUCTION: Factor XI (FXI) deficiency is associated with highly variable bleeding, including excessive gynecologic and obstetrical bleeding. Since approximately 20% of FXI-deficient women will experience pregnancy-related bleeding, careful planning and knowledge of appropriate hemostatic management is pivotal for their care. AREAS COVERED: In this manuscript, authors present our current understanding of the role of FXI in hemostasis, the nature of the bleeding phenotype caused by its deficiency, and the impact of deficiency on obstetrical care. The authors...
Source: Expert Review of Hematology - Category: Hematology Tags: Expert Rev Hematol Source Type: research
Authors: Merideth MA, Introne WJ, Wang JA, O'Brien KJ, Huizing M, Gochuico BR Abstract Hermansky-Pudlak syndrome (HPS) is a rare autosomal recessive disorder characterized by defective biogenesis of lysosome-related organelles. Clinical manifestations include a bleeding diathesis due to a platelet delta storage pool deficiency, oculocutaneous albinism, inflammatory bowel disease, neutropenia, and pulmonary fibrosis. Ten genes associated with HPS are identified to date, and each gene encodes a protein subunit of either Biogenesis of Lysosome-related Organelles Complex (BLOC)-1, BLOC-2, BLOC-3, or the Adaptor Protein...
Source: Platelets - Category: Hematology Tags: Platelets Source Type: research
Publication date: Available online 22 May 2020Source: Journal of Pediatric Surgery Case ReportsAuthor(s): Ryo Tamura, Corina Moldovan, Milan Gopal
Source: Journal of Pediatric Surgery Case Reports - Category: Surgery Source Type: research
Conclusion Complete removal of the axillary scar tissue after breast cancer treatment and re-augmentation of the axilla with a turnover flap results in a reduction in ipsilateral lymphedema and an improvement in pain and quality of life. We interpret these findings as a result of the physiological re-alignment of the lymphatic vessels combined with a lymph node-containing local transposition flap. Therefore, re-augmentation with a turnover flap could be an effective non-microsurgical alternative to lymph node transplantation. PMID: 32435069 [PubMed]
Source: Geburtshilfe und Frauenheilkunde - Category: OBGYN Tags: Geburtshilfe Frauenheilkd Source Type: research
AbstractPurposeWe aimed to investigate the association between sleep disturbance and menstrual problems in female Chinese university students.MethodsA convenience sample of 1006 female university students participated in this study. Sleep duration, sleep quality, and insomnia symptoms were assessed by the Pittsburgh Sleep Quality Index and the Insomnia Severity Index. A structured questionnaire was used to assess participants ’ demographics and menstrual characteristics.ResultsThe prevalence rates of irregular menstrual cycle, heavy menstrual bleeding, menstrual flow length ≥ 7 days, period pain, and p...
Source: Sleep and Breathing - Category: Respiratory Medicine Source Type: research
CONCLUSIONS: Results from this PMS increase the clinical experience of a FVIII-poor pdVWF in patients of all ages and VWD types including those with thrombotic risk factors and emphasize that giving FVIII is not always mandatory to effectively treat patients with severe VWD. PMID: 32445594 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - Category: Hematology Authors: Tags: J Thromb Haemost Source Type: research
Iliacus hematoma syndrome (IHS) is characterized as a retroperitoneal compartment neuropathy caused by bleeding within the iliacus muscle leading to hematoma formation and compression upon the femoral nerve [1]. Subsequently, it shows symptoms such as weakness of the iliopsoas muscle, numbness, loss of knee-jerk, and sensory loss of anteromedial thigh [2]. IHS may be precipitated by trauma alone but have characteristically been described in patients with hemophilia and those on anticoagulation therapy [3, 4].
Source: Injury - Category: Orthopaedics Authors: Source Type: research
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