Emergency Endotracheal Intubation With a Rigid Stylet of an Infant With Severe Subglottic Stenosis

Strutt, Jonathan; Thompson, Nicole R.; Stotesbery, Jennifer; Horváth, Balázs

doi:10.1016/j.jemermed.2020.01.013

Cited by 4 publications

(4 citation statements)

References 9 publications

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“…477 Case reports observed intubation successes with bougies, introducers, and stylets for patients with unanticipated or emergency difficult airways (Category B4-B evidence). 114,[478][479][480][481][482][483][484][485] Nonrandomized studies comparing videolaryngoscopes with direct laryngoscopy reported equivocal findings for intubation success with difficult airways in emergency departments (Category B1-E evidence). 6,486,487 Observational studies indicated successful videolaryngoscope-guided intubation rates after failed intubation ranging from 92 to 100% for unanticipated and emergency difficult airways (Category B4-B evidence).…”

Section: Recommendations For Anticipated Difficult Airway Managementmentioning

confidence: 99%

See 1 more Smart Citation

2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway

Apfelbaum¹,

Hagberg²,

Connis³

et al. 2021

Anesthesiology

593

547

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The American Society of Anesthesiologists; All India Difficult Airway Association; European Airway Management Society; European Society of Anaesthesiology and Intensive Care; Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care, Learning, Teaching and Investigation Difficult Airway Group; Society for Airway Management; Society for Ambulatory Anesthesia; Society for Head and Neck Anesthesia; Society for Pediatric Anesthesia; Society of Critical Care Anesthesiologists; and the Trauma Anesthesiology Society present an updated report of the Practice Guidelines for Management of the Difficult Airway.

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Section: Recommendations For Anticipated Difficult Airway Managementmentioning

confidence: 99%

Section: Unanticipated and Emergency Difficult Airway Managementmentioning

confidence: 99%

2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway

Apfelbaum¹,

Hagberg²,

Connis³

et al. 2021

Anesthesiology

593

547

View full text Add to dashboard Cite

show abstract

“…A retrospective analysis of >5000 neonatal intubations, one RCT, and two meta-analyses (with low quality of evidence) did not identify benefits for first time success rate or complications if a stylet was used or not 55,58,87,88 . Nevertheless, a stylet or bougie might be essential if reinforcement or stronger angulation of the tracheal tube is needed or when the larynx is anatomically anterior and angulation of the tracheal tube is essential to facilitate intubation 85,89 …”

Section: Methodsmentioning

confidence: 99%

“…55,58,87,88 Nevertheless, a stylet or bougie might be essential if reinforcement or stronger angulation of the tracheal tube is needed or when the larynx is anatomically anterior and angulation of the tracheal tube is essential to facilitate intubation. 85,89 Recommendation: We recommend flexible bronchoscopy by the nasal route in case of restricted mouth opening (1C).…”

Section: Pico 4 Difficult Airway Managementmentioning

confidence: 99%

Airway management in neonates and infants

Disma,

Asai,

Cools

et al. 2023

European Journal of Anaesthesiology

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Airway management is required during general anaesthesia and is essential for life-threatening conditions such as cardiopulmonary resuscitation. Evidence from recent trials indicates a high incidence of critical events during airway management, especially in neonates or infants. It is important to define the optimal techniques and strategies for airway management in these groups. In this joint European Society of Anaesthesiology and Intensive Care (ESAIC) and British Journal of Anaesthesia (BJA) guideline on airway management in neonates and infants, we present aggregated and evidence-based recommendations to assist clinicians in providing safe and effective medical care. We identified seven main areas of interest for airway management: i) preoperative assessment and preparation; ii) medications; iii) techniques and algorithms; iv) identification and treatment of difficult airways; v) confirmation of tracheal intubation; vi) tracheal extubation, and vii) human factors. Based on these areas, Population, Intervention, Comparison, Outcomes (PICO) questions were derived that guided a structured literature search. GRADE (Grading of Recommendations, Assessment, Development and Evaluation) methodology was used to formulate the recommendations based on those studies included with consideration of their methodological quality (strong ‘1’ or weak ‘2’ recommendation with high ‘A’, medium ‘B’ or low ‘C’ quality of evidence). In summary, we recommend: 1. Use medical history and physical examination to predict difficult airway management (1С). 2. Ensure adequate level of sedation or general anaesthesia during airway management (1B). 3. Administer neuromuscular blocker before tracheal intubation when spontaneous breathing is not necessary (1С). 4. Use a videolaryngoscope with an age-adapted standard blade as first choice for tracheal intubation (1B). 5. Apply apnoeic oxygenation during tracheal intubation in neonates (1B). 6. Consider a supraglottic airway for rescue oxygenation and ventilation when tracheal intubation fails (1B). 7. Limit the number of tracheal intubation attempts (1C). 8. Use a stylet to reinforce and preshape tracheal tubes when hyperangulated videolaryngoscope blades are used and when the larynx is anatomically anterior (1C). 9. Verify intubation is successful with clinical assessment and end-tidal CO2 waveform (1C). 10. Apply high-flow nasal oxygenation, continuous positive airway pressure or nasal intermittent positive pressure ventilation for postextubation respiratory support, when appropriate (1B).

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Airway management in neonates and infants: European Society of Anaesthesiology and Intensive Care and British Journal of Anaesthesia joint guidelines

Disma,

Asai,

Cools

et al. 2024

British Journal of Anaesthesia

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Emergency Endotracheal Intubation With a Rigid Stylet of an Infant With Severe Subglottic Stenosis

Cited by 4 publications

References 9 publications

2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway

2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway

Airway management in neonates and infants

Airway management in neonates and infants: European Society of Anaesthesiology and Intensive Care and British Journal of Anaesthesia joint guidelines

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