Critical care clinics
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Critical care clinics · Jul 2000
ReviewTeaching airway management skills. How and what to learn and teach.
It is important to instruct all individuals involved in patient care in airway management. The degree of skills actually taught depends on the student. Currently, there are many options for teaching. ⋯ There is room for improvement in instruction, even in anesthesiology programs. Various techniques must be taught and practiced. As more anesthesiologists become trained and then train other physicians, the number of cases in the Closed Claims Study involving the airway will continue to decrease.
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Critical care clinics · Jul 2000
ReviewThe role of fiberoptic bronchoscopy in airway management of the critically ill patient.
Fiberoptic bronchoscopes (FOB) play a pivotal role in airway management in the operating room and critical care environments. This article examines the role of FOBs in modern airway management based on a review of recent literature and personal experience.
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Despite having been a known surgical procedure for over 5000 years, the specifics of how, when, and why to perform a surgical airway are still debated. With new procedures, equipment, and techniques, operative airway management is becoming more complex. ⋯ Unlike Dr. Jackson in 1909, surgeons today have to evaluate these new procedures not only by their efficacy but also by their cost effectiveness.
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Tracheal insufflation of oxygen has at least three major uses for chronic oxygen supplementation through a percutaneous catheter, it is an adjunctive measure to enhance gas exchange during mechanical ventilation, and it provides an emergency therapy for oxygen delivery with upper airway obstruction. In this article the mechanisms of gas exchange and techniques of oxygen delivery are described for each of these major uses.
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Critical care clinics · Jul 2000
ReviewEmergent airway management. Indications and methods in the face of confounding conditions.
Optimal airway management requires an experienced caregiver, attention to detail, and knowledge of the patient's physiology. A variety of pharmacologic agents have proved useful in obtaining a secure airway and minimizing risk to the patient. Depending on the skills of the caregiver, oral intubation has become the preferred means of airway control in most patients. Advances in technique, equipment, and pharmacology have greatly improved the art of airway management; however, there is no substitute for an experienced clinician.