Revue médicale de la Suisse romande
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Rev Med Suisse Romande · Nov 1999
Review[Role of the ORL anesthetist in foreseen or unforseen difficult intubations].
Difficult intubation (DI) is a daily problem in a ENT unit. The place of the ENT anesthesiologist in the management of a DI is both in his own unit and in the hospital as an expert in DI. An anesthesiologist working in a ENT unit should be an expert in techniques allowing to manage intubation and oxygenation in every situations: i.e. fiberscopic intubation, LMA and intubating LMA and transtracheal ventilation. The ENT anesthesiologist may also play a role in the management of a DI in the hospital as an expert, both helping to cope with a difficult airway and teaching airway skills and the value of having a plan before managing any airway.
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Rev Med Suisse Romande · Nov 1999
Review[Algorithms for oxygenation and difficult intubations in obstetrics].
The obstetrical population is prone to difficult or failed intubation. Control of the airway is complicated by several factors specific to obstetric anesthesia; time of apnea is short due to a reduced functional residual capacity, pregnancy-induced hypertension and obesity are relatively frequent; anesthetist's skill can also be mentioned. ⋯ Each anesthetist must keep an algorithm in mind, should a difficult or failed intubation in obstetrical patient. Whichever method is used (ventilation through a facial mask or laryngeal mask, transtracheal oxygenation), the anesthetist must never forget that the first priority is always the safety of the mother.
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The place of the Head and Neck Surgeon in the management of the difficult airway. The Head and Neck Surgeon may help the anesthetist to secure the airway, in elective or emergency situations. This paper presents his endoscopic (rigid bronchoscopy, flexible bronchoscopy, endoscopically controlled transtracheal puncture) and surgical intubation techniques, and when to use them within a standard algorithm for difficult airway management.