Middle East journal of anaesthesiology
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Middle East J Anaesthesiol · Jun 2006
Case ReportsPercutaneous tracheostomy in a patient with mandibulo-maxillary interfixation with modified approach for bronchoscopic guidance--case report.
Percutaneous tracheostomy has replaced the surgical approach in many intensive care unit patients. In this case report, we present the use of percutaneous tracheostomy on a patient with mandibulo-maxillary interfixation. A 19-year-old male with severe maxillofacial injuries underwent mandibulo-maxillary interfixation. ⋯ The bronchoscope was introduced from the other nostril and used to inspect the withdrawal of the ETT from outside. Our case demonstrates the feasibility of percutaneous tracheostomy in the setting of mandibulo-maxillary interfixation. To our knowledge this is the first report of percutaneous tracheostomy in this indication.
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ICU patients, mainly those who need prolonged ventilatory support, may require tracheostomy, which once was done in the operating room, nowadays is performed in the ICU, as percutaneous dilatational tracheostomy (PDT). Forty two patients 18-72 yrs of age (mean 44 yrs), with varying indications for tracheostomy, had undergone PDT in the ICU under the standard protocol for this procedure. ⋯ The difficulties encountered were mainly the anatomical landmarks (10%), difficulties in dilatation (5%) and peristomal oozing (1%). It is concluded that percutaneous dilatational tracheostomy is an easy, cost effective, practical when done at bedside in the ICU, and spares transferring the patient to the operating theater.
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Middle East J Anaesthesiol · Jun 2006
Editorial Historical ArticleMiddle East Journal of Anesthesiology--hand, head and heart.
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Middle East J Anaesthesiol · Jun 2006
ReviewMedico-legal aspects in anesthesia: how to lead a happy life.
This article discusses medico-legal aspects in anesthesia. It underlines the standards of care by which anesthesiologists should abide by, as well as define malpractice, its causes, and ways to avoid it. The role of the expert witness is explained and the ethical guidelines to follow are outlined.