Emergency medicine clinics of North America
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Airway management in the emergency department is a critical skill that must be mastered by emergency physicians. When rapid-sequence induction with oral-tracheal intubation performed by way of direct laryngoscopy is difficult or impossible due to a variety of circumstances, an alternative method or device must be used for a rescue airway. ⋯ Familiarity with this technique is a valuable addition to the airway-management armamentarium of emergency physicians caring for ill or injured patients. Variations of the technique have been described, and their use depends on the individual circumstances.
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Emerg. Med. Clin. North Am. · Nov 2008
The laryngeal mask airway: prehospital and emergency department use.
The LMA now has a well-established role in airway management. There are several different types of LMAs to accommodate many different patient needs. The LMA has become one of the most important and versatile tools in the management of patients with difficult airways.
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Emerg. Med. Clin. North Am. · Nov 2008
Challenges and advances in intubation: airway evaluation and controversies with intubation.
Management of the airway is the first priority in any patient. Dealing with a difficult airway can be a challenge, whether or not it involves facemask ventilation, an intermediate airway device, laryngoscopy and intubation, or a surgical airway. ⋯ The goal of rapid sequence intubation (RSI) is to eliminate or mitigate untoward reflex responses to intubation. Although controversy has arisen regarding the various steps in RSI, it remains an essential component of emergency medicine practice.
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Emerg. Med. Clin. North Am. · Aug 2008
ReviewMonitoring the critically ill emergency department patient.
Many critically ill patients are remaining in the emergency department for extended periods of time, and delays in diagnosis and/or therapy may increase patient morbidity and mortality. All emergency physicians use monitoring modalities in critically ill patients to detect early cardiovascular compromise and impaired oxygen delivery before disastrous collapse occurs. The authors hope the discussion in this article regarding the monitoring of oxygenation, ventilation, arterial perfusion pressure, intravascular volume, markers of tissue hypoxia, and cardiac output will help the EP provide optimal care for this complicated patient population.
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Emergency physicians are regularly called on to care for critically poisoned patients. This article reviews the general approach and management of the critically poisoned patient. ⋯ Appropriate testing in the poisoned patient is reviewed. Complications of poisoning that may bring a rapid demise of the critically ill poisoned patient are highlighted and the management of those complications is discussed.