International journal of obstetric anesthesia
-
It is recommended that a cricoid pressure (force) of 40 N should be applied to prevent regurgitation. The tolerance of incremental levels of cricoid pressure was assessed in 22 conscious volunteers. Each level of cricoid pressure was applied for 20 s using a cricoid yoke. ⋯ Nine subjects complained of breathing difficulties at cricoid forces of 35 N or above; 2 had complete airway obstruction. A, cricoid force of over 20 N is likely to be poorly tolerated by the awake patient. It is recommended that a force of 20 N should be maintained before loss of consciousness and the full force of 40 N be reserved for the onset of general anaesthesia; the assistant can practise these levels on a set of weighing scales.
-
Int J Obstet Anesth · Sep 1992
Successful cardiopulmonary resuscitation of a parturient with amniotic fluid embolism.
A case of presumed amniotic fluid embolism is presented. Diagnosis is based on clinical findings in a 21-year-old parturient, who was admitted to hospital at 39 weeks gestation. During labor the patient became dyspneic and cyanotic, had convulsions and finally suffered a cardiac arrest. ⋯ Following delivery of the baby the heart rhythm returned to normal. The prolonged resuscitation produced serious neurological sequelae in both mother and infant in the first few months following delivery, though with complete long-term recovery. This case report highlights the importance of displacing the uterus laterally and performing an emergency cesarean section during resuscitation.