Emergency medicine clinics of North America
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Pediatric airway problems are seen commonly in pediatric and general emergency departments, management of the pediatric airway is often stressful to providers. This article reviews the pediatric airway, highlighting the anatomic and physiologic differences between infant, pediatric and adult airways, and how these differences impact assessment and management of the pediatric airway.
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In this article, the physiology of surfactant is reviewed along with the research that lead to its current clinical uses. Acute lung injury (ALI) and Acute Respiratory Distress Syndrome (ARDS) will also be reviewed because they represent pulmonary disease processes in which secondary deficiency and surfactant inactivation occur, for which surfactant may prove to be an effective treatment. Finally, research using surfactant as a treatment for other pulmonary diseases, such as bronchiolitis and asthma, will be briefly highlighted. These studies may one day lead to new treatment opportunities in the realm of emergency medicine.
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This article describes the use of laryngoscopy for tracheal intubation. Maneuvers basic to successful orotracheal laryngoscopic intubation are described, which should be incorporated into the skill sets of individuals called on to manage the airway in an emergency.
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Airway management is an essential component of the emergency medicine skill set. Management of the difficult airway may include airway adjuncts, including variants of laryngoscopic blades, supraglottic devices, stylets, and video laryngoscopy. These various airway adjuncts have certain advantages and disadvantages, and factors to be considered include ease of use, cost, maintenance, storage, and portability. Selection of a subset of the numerous products available can aid the clinician in the development of expertise with airway adjunct devices that can be reliably used in urgent situations.