Articles: intubation.
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Case Reports
Lethal complication from insertion of nasogastric tube after severe basilar skull fracture.
An unusual complication is presented arising from the use of a nasogastric tube in a patient with a massive basilar skull fracture. Intracranial passage of the NG tube resulted. Therefore, in the presence of a severe basilar fracture and/or significant maxillofacial trauma where the integrity of the base of the skull may be in question, one should be very hesitant to insert tubes into the nasopharynx.
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Potential or actual supraglottic airway obstruction becomes critical when general anesthesia is begun. Four cases illustrated such obstruction, and the anesthetic and surgical management of each condition was critical. ⋯ In epiglottitis and peritonsillar abscess, the nature of the impending airway obstruction was appreciated, and the selection of a safe technique to secure the airway was made. Anesthetic and surgical management of potential supraglottic obstruction includes five options: (1) oral tracheal intubation by laryngoscopy while the patient is awake; (2) awake nasotracheal intubation; (3) inhalation induction by general anesthesia with intubation; (4) rapid induction with barbiturates and muscle relaxants with intubation; and (5) tracheostomy with local anesthesia.