Articles: intubation.
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Establishment of airway patency is a crucial procedure necessary for every emergency physician. Because no one method of airway management is appropriate for every emergency, emergency physicians must be skilled in several different types and familiar with the various equipment needed for each.
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An unconscious victim of an overdose was intubated with an endotracheal tube to prevent aspiration. The respiratory therapist deflated the cuff of the endotracheal tube to allow for a retrograde oral air leak and then tightly attached the oxygen tube directly to the endotracheal tube. ⋯ The patient sustained both a hemodynamic and a neurologic decompensation as the result of marked pulmonary overinflation, with bilateral pneumothoraces and probable cerebral and coronary artery air emboli. We present the case in the hope that it will help avoid any such future occurrences.
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Following amniotic embolism a severe ARDS developed in a 21 year-old women. After two months of respirator therapy a giant tracheoesophageal fistula arose. ⋯ Our two step surgical management consisted of esophageal diversion and reconstruction of the intestinal passage by retrosternal gastric tube. The advantages and disadvantages of esophageal diversion in giant tracheoesophageal fistulas are discussed.
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Acta Anaesthesiol Scand · Jul 1986
Comparative StudyAirway lesions caused by prolonged intubation with standard and with anatomically shaped tracheal tubes. A post-mortem study.
Two groups of patients intubated for long periods were examined post mortem. In Group A (22 patients) the mean duration of intubation was 4.0 days and in Group B (19 patients) 5.7 days. The mean for the two groups was 4.8 days. ⋯ The photographs were magnified and from these the size and estimated depth of any lesions were recorded. In the arytenoid and tracheal regions no significant difference was found between the two groups. In the cricoid region, on the other hand, the outcome was significantly more favourable following use of the anatomically shaped tube.