Summary
Novel coronavirus 2019 is a single‐stranded, ribonucleic acid virus that has led to an international pandemic of coronavirus disease 2019. Clinical data from the Chinese outbreak have been reported, but experiences and recommendations from clinical practice during the Italian outbreak have not. We report the impact of the coronavirus disease 2019 outbreak on regional and national healthcare infrastructure. We also report on recommendations based on clinical experiences of managing patients throughout Italy. In particular, we describe key elements of clinical management, including: safe oxygen therapy; airway management; personal protective equipment; and non‐technical aspects of caring for patients diagnosed with coronavirus disease 2019. Only through planning, training and team working will clinicians and healthcare systems be best placed to deal with the many complex implications of this new pandemic.
The pericapsular nerve group (PENG) block is a novel regional anaesthesia technique that aims to provide hip analgesia with preservation of motor function, although evidence is currently lacking. In this single-centre, observer-masked, randomised controlled trial, patients undergoing total hip arthroplasty received pericapsular nerve group block or no block (control group). Primary outcome measure was maximum pain scores (0-10 numeric rating scale) measured in the first 48 h after surgery. Secondary outcomes included postoperative opioid consumption; patient mobilisation assessments; and length of hospital stay. Sixty patients were randomly allocated equally between groups. The maximum pain score of patients receiving the pericapsular nerve group block was significantly lower than in the control group at all time-points, with a median (IQR [range]) of 2.
The GlideScope allowed the participants to obtain a successful intubation applying a lower force. A flatter and more uniform pressure distribution, a higher successful rate, and a better glottic view were observed with the GlideScope.
Purpose: About 1% to 3% of laryngoscopic intubations can be difficult or impossible. Light-guided intubation has been proven to be an effective, safe, and simple technique. This article reviews current knowledge about the newer version lightwand: the Trachlight™ (TL).Source: To determine its clinical utility and limitations, we reviewed the current literature (book and journal articles) on the TL since its introduction in 1995.
SummaryThis study assesses the efficacy of the intubating laryngeal mask as a ventilation device and blind intubation guide. Following induction of anaesthesia with propofol, the device was successfully inserted at the first attempt in 110/110 (100%) patients. Placement took less than 10 s in all patients. Size selection was based on nose-chin distance. Adequate ventilation was achieved in 104/110 (95%) patients. Blind tracheal intubation using an 8-mm internal diameter straight silicone cuffed tracheal tube was attempted 3 min after the administration of vecuronium. Passage of a lighted stylet through the intubating laryngeal mask was used to determine the position of the intubating laryngeal mask cuff before blind intubation. If resistance was felt during intubation, a sequence of adjusting manoeuvres was used, based on the depth at which resistance occurred. Tracheal intubation was possible in 104/104 (100%) patients. In 42 (40%) patients, no resistance was encountered and the trachea was intubated at the first attempt. Sixty-two (60%) patients required one adjusting manoeuvre. The mean (range) time taken to successful intubation, i.e. the time from disconnection of the intubating laryngeal mask from the breathing system to successful tracheal intubation, was 79 (12-315) s. Six patients with potential or known intubation problems were included in the study. The tracheas of all six patients were successfully intubated. We conclude that the intubating laryngeal mask is an effective ventilation device and intubation guide with potential for use in patients who may present difficulty in tracheal intubation.
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