Emergency medicine clinics of North America
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This article focuses on the specific anatomic differences in the pediatric patient when contrasted with the adult patient. An emergency physician must be familiar with these differences to provide the best emergency care. Because maintaining an adequate airway is so crucial to these patients, recognition of these differences in the infant and child may be a life-saving step.
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Cricothyroidotomy is a technique used to gain emergency access to the airway through the cricothyroid membrane. Although its use should be reserved for specific circumstances, the procedure is safe and can be performed rapidly. Knowledge of the anatomy of the anterior neck and a specific sequence for performing the cricothyroidotomy generally will result in a good success rate and acceptable complications.
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The esophageal obturator airway has been in use for the past 20 years. It is promoted as being easy to use and can be rapidly inserted blindly; however, numerous complications have been noted. The device is reviewed in this article and compared to endotracheal intubation.
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Emerg. Med. Clin. North Am. · Nov 1988
ReviewPharmacologic aids to intubation and the rapid sequence induction.
Endotracheal intubation usually can be performed in the emergency setting without the use of pharmacologic adjuncts. However, local airway anesthesia lessens patient discomfort, and the use of sedation and muscle relaxants occasionally may be necessary. Rapid sequence induction of general anesthesia adds benefits as well as risks to airway management; used in the circumstance of a full stomach combined with open eye injury or closed head injury associated with raised intracranial pressure, it should be practiced only by physicians appropriately trained and skilled at the procedure.