Ketamine – the solution for emergent tracheostomy in airway obstruction

Publication date: February 2020Source: Trends in Anaesthesia and Critical Care, Volume 30Author(s): Joana Filipa Veiga, Carla Hipólito, Petra Andresa, Adriana Rodrigues, Sara Arantes
Source: Trends in Anaesthesia and Critical Care - Category: Anesthesiology Source Type: research

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Abstract A "cannot ventilate, cannot intubate" scenario is a rare, high-risk anesthesia event. Cricothyrotomy is the final step, but anesthesia training and maintenance of surgical airway skills is variable. The ability to "cut to air" when one performs a cricothyrotomy may be all that prevents a patient from experiencing anoxic brain injury or death. Forty-three Certified Registered Nurse Anesthetists (CRNAs) performed emergency cricothyrotomies on a simulation manikin. Three techniques were available: (1) cricothyrotomy kit, (2) scalpel and tracheostomy, and (3) scalpel/bougie/endotracheal tu...
Source: AANA Journal - Category: Anesthesiology Authors: Tags: AANA J Source Type: research
CONCLUSIONS: This paper discusses the findings of a comprehensive, multispecialty audit of tracheostomy experience in a large health board, with over 150 tracheostomies performed annually. Elective cases form the majority although there is a significant case series of emergency tracheostomies performed for a range of pathologies. Around a quarter of those requiring tracheostomy ultimately died, mostly as a result of advanced cancer. PMID: 32233651 [PubMed - as supplied by publisher]
Source: Annals of the Royal College of Surgeons of England - Category: Surgery Authors: Tags: Ann R Coll Surg Engl Source Type: research
Abstract In order to clear airways and lungs defensive reflexes are provoked rather by the dynamic phase of mechanical stimulus. It is speculated that provocation of defensive response depends not only on stimulus duration but also on stimulus velocity. Fourteen adult rabbits were anaesthetized and tracheotomized. Mechanical stimulus was provoked by a mechanical probe introduced through the tracheotomy and rotated by a small electrical motor using a rotational velocity of 40 rpm/s and 20 rpm/s. Threshold, incidence and intensity of cough reflex (CR) were analyzed for each animal. Statistical comparisons between tw...
Source: Physiological Research - Category: Physiology Authors: Tags: Physiol Res Source Type: research
In this study, changes in the position of the endotracheal tube tip during extension of the head and neck for a tracheotomy were investigated. Twelve patients underwent placement of a tracheotomy during surgical procedures for oral cancer. After nasal intubation, the distance between the tube tip and the carina was measuring using a fiberoptic scope with the patient's head placed at an angle of 110°. Patients were repositioned for tracheotomy by placing a pillow under the shoulders and extending the head and neck at an angle of 140°. The distance measurements were subsequently repeated. The difference between the f...
Source: Anesthesia Progress - Category: Anesthesiology Tags: Anesth Prog Source Type: research
Abstract Smoke inhalation injury (SII) affects more than 50,000 people annually causing carbon monoxide (CO) poisoning. Although the increased blood level of carboxyhemoglobin (CO-Hb) is frequently used to confirm the diagnosis of SII, knowledge of its elimination in the acute phase is still limited. The aim of this study is to determine CO-Hb elimination rates and their differences in arterial (aCO-Hb) and mixed-venous (vCO-Hb) blood following severe SII in a clinically relevant ovine model. Forty-three chronically instrumented female sheep were subjected to SII (12 breaths, 4 sets) through tracheostomy tube unde...
Source: Biochemical and Biophysical Research communications - Category: Biochemistry Authors: Tags: Biochem Biophys Res Commun Source Type: research
Publication date: Available online 5 March 2020Source: Anaesthesia &Intensive Care MedicineAuthor(s): Nicola Doody, Neil Smart
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research
Publication date: February 2020Source: Trends in Anaesthesia and Critical Care, Volume 30Author(s): Fung Kei Ng, Ms Sarah Wallace, Ms Barbara Bonvento, James Lynch, Barry Coe, Mike Firn, Ms Anna Owen, Brendan A. McGrath
Source: Trends in Anaesthesia and Critical Care - Category: Anesthesiology Source Type: research
Publication date: February 2020Source: Trends in Anaesthesia and Critical Care, Volume 30Author(s): Fung Kei Ng, Ms Marie-Claire Healey, Johnathan Goves, Ms Elizabeth Edwards, James Lynch, Ms Sarah Wallace, Ms Barbara Bonvento, Brendan A. McGrath
Source: Trends in Anaesthesia and Critical Care - Category: Anesthesiology Source Type: research
Vikas Marwah, Shalendra Singh, Navdeep Sethi, Ankur KhandelwalJournal of Anaesthesiology Clinical Pharmacology 2020 36(1):128-130
Source: Journal of Anaesthesiology Clinical Pharmacology - Category: Anesthesiology Authors: Source Type: research
Publication date: Available online 15 February 2020Source: Trends in Anaesthesia and Critical CareAuthor(s): Ulrich Braun, Karl Günther Wiese, Hans-Albert Merten, Arnd TimmermannAbstractNoma (Cancrum oris) is an infectious acute disease that is prevalent in Africa, Asia and the American continent. This condition develops as a consequence of deficient nutrition. It is acquired by children between the ages of 1 and 7, and the children who contract it can die from sepsis within 2 weeks. The estimated mortality rate is in the range of 85%. The survivors have disfigurements of the face, massive scarring, open access to the...
Source: Trends in Anaesthesia and Critical Care - Category: Anesthesiology Source Type: research
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