Articles: intubation.
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Numerous anaesthetic techniques exist for a patient who presents with a difficult endotracheal intubation. They all require an anaesthetic protocol which cannot be improvised. ⋯ When a fiberoptic bronchoscope is not available, several alternatives can be suggested: local anaesthesia of the glottis, retro-molar and retrograde intubation, or the use of a guide threaded over a lighted stylet; these techniques can be used in an anaesthetized patient breathing spontaneously. In the paralyzed patient impossible to intubate, various trans-laryngeal techniques of ventilation can be used in emergency: jet ventilation via the trans-crico-thyroid route, the use of a cricotomy cannula, or a minitracheotomy set.
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Review Randomized Controlled Trial Comparative Study Clinical Trial
Simulation technique for difficult intubation: teaching tool or new hazard?
This investigation evaluated the risks of a simulation drill designed to improve the skill of anesthesia personnel in dealing with an unexpected difficult intubation. In a controlled prospective study, 40 patients with normal airways scheduled to undergo noncardiothoracic surgery were randomized into two groups of 20 patients. In the control group, intubation was performed by standard techniques. ⋯ There were five uncomplicated esophageal intubations in the simulation group compared with none in the control group (p = 0.001). No other adverse events were recorded. The potential hazards of esophageal intubation should be considered before this simulation drill is performed.
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Case Reports
Acute pulmonary edema, an unusual complication following arthroscopy: a report of three cases.
Acute pulmonary edema in the young athlete is a rare complication following arthroscopic surgery. It is not related to fluid absorption during arthroscopy, but rather to a brief period of upper airway obstruction. ⋯ Young athletes may be at increased risk for laryngospasm-induced pulmonary edema because they have the ability to generate large negative intrathoracic pressures. This condition must be recognized promptly to minimize morbidity and mortality.