Intubation

Easy pediatric nasal intubation Abstract: Background: Pediatric anesthesiologists use Magill forceps commonly during nasotracheal intubation but often have difficultly during advancing the nasotracheal tube into the trachea, differences in pediatric airway structure relative to adults are thought to be the reason of this problem. The modified pediatric Magill forceps (modified by Farrukh and his colleagues) added anteroposterior firm grasping of the nasotracheal tube enables us for elevation and downward rotation of the nasotracheal tube which makes the tube in line with the axis of the trachea facilitating its passage into the trachea. Objectives: Evaluation of the value of modified pediatric Magill forceps in facilitating…

a bilevel positive pressure ventilation device. Ideally with the help of this literature review, it will be easier to determine when these modalities are most appropriate and useful as well as provide concrete evidence that will be useful when suggesting these ideas to a doctor. Clinical Application Studies There are a number of different reasons why a neonate would need some additional ventilatory support immediately after birth. One of the most common reasons would be in the…

In 1932 Wilson suggested its prophylactic and therapeutic use in poliomyelitis. Tracheostomy was then recommended for a large variety of indications apart from obstructive causes... Finally, the era starting in 1965 till the present period came as a period of rationalization. Complications, indications and interrelation with endotracheal intubation are clearly outlined(3). It started as just making an opening in the trachea to proper placement of metallic tube to plastic tubes.…

Anesthesiologists (ASA) advise that ‘multiple airway features should be assessed’3. EL-Ganzori simplified risk index (EGRI) combines and stratifies seven variables derived from parameters and observations individually associated with difficult intubation, a score more than 4 has been used as the definition of difficult intubation in different populations4. In spite of the development of numerous airway devices in the past two decades, a recent British survey concluded that difficulty with…

Direct laryngoscope and intubation would be difficult as the patient had limited mouth opening. The Supraglottic device such as laryngeal mask airway was considered as the most suitable option and patient was prepared for that. Preoperative management A routine proper preoperative assessment was done and the condition explained to the patient and an informed written consent was taken. The patient was kept fasting for six hours and premedicated. The preoperative investigations were done and…

Incidence of difficult intubation Difficult tracheal intubation contributes greatly to anaesthesia related morbidity and mortality. The principal adverse outcomes associated with the difficult airway include brain injury, cardiopulmonary arrest, unnecessary tracheostomy, airway trauma, damage to teeth and death8,9 The incidence of failed tracheal intubation ranges from 1 in 1000–2000 cases in the elective setting10,3. Failed and difficult tracheal intubations are associated with…

If severe gagging or coughing had been noted, the scope was removed and remifentanil titrated higher and a wait for 90 seconds before reattempting intubation. Tracheas have been intubated with Flex-Tip tracheal tubes (Parker Medical, Highlands Ranch CO, USA) size 7.0 for women and size 7.5 for men. The tube was placed over FOB in FOB group or over a 60º hockey stick stylet in GVL group. To minimize the effect of operator inexperience, intubation was done by one of the two investigators who…

RSI: Benefits vs. Risks Often patients presents in an emergency department (ED) or those treated in the field with a compromised airway and requires urgent airway control and protection to prevent hypoxaemia and secondary brain damage. Unlike in anaesthesia these patients are often none staved, unstable and critically ill. Although they present with a low Glasgow Coma Scale scores their airway protective reflexes might still be intact which increases the risk of aspiration on an intubation…

Keeping the patient spontaneous breathing is the main principle of an awake fiberoptic intubation. The sitting position has shown to aid fiberoptic intubations. Fiberoptic intubation is not without flaws. Since the patient is awake, they become uncooperative. The patient presented, in this case, was uncooperative. Suctioning her oral pharynx was used to test her gag reflex. She did not exhibit a gag during the test. Anesthesia professionals attempted to place an oral airway however it was…

The pathophysiological mechanisms involved with ventilator-associated pneumonia or VAP is correlated with bacteria flowing through the endotracheal tube, allowing a direct route to enter a person’s lungs. Studies suggest the principle risk-factor for the development VAP relies on the utilization of the endotracheal tube or ETT (Mietto MD et.al, 2013). Usually after 12 hours of intubation, bacteria that is specifically act as contaminated oropharyngeal secretions may often accumulate through the…