Extraglottic Airway Device Misplacement: A Novel Classification System and Findings in Postmortem Computed Tomography

Norii, Tatsuya; Makino, Yohsuke; Unuma, Kana; Hatch, Gary M.; Adolphi, Natalie L.; Dallo, Sarah; Albright, Danielle; Sklar, David P.; Braude, Darren

doi:10.1016/j.annemergmed.2020.10.005

Cited by 6 publications

(7 citation statements)

References 34 publications

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“…Until recently, the placement of an SAD was a blind procedure and contrary to the belief that its placement led to proper positioning, the literature suggests that despite the clinical tests to verify proper placement, in 50 to 80% of cases its placement is deficient [ 38 , 39 ]. Blind insertion of a SAD can lead to errors.…”

Section: We Should No Longer Use Sads Without Vision-guided Systemsmentioning

confidence: 99%

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Supraglottic Airway Devices with Vision Guided Systems: Third Generation of Supraglottic Airway Devices

Castillo-Monzón,

Gaszyński,

Marroquín-Valz

et al. 2023

JCM

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Supraglottic airway devices are currently widely used for airway management both for anaesthesia and emergency medicine. First-generation SADs only had a ventilation channel and did not provide protection from possible aspiration of gastric content if regurgitation occurred. Second-generation SADs are equipped with a gastric channel to allow the insertion of a gastric catheter and suctioning of gastric content. Additionally, the seal was improved by a change in the shape of the cuff. Some second-generation SADs were also designed to allow for intubation through the lumen using fiberscopes. Although the safety and efficacy of use of SADs are very high, there are still some issues in terms of providing an adequate seal and protection from possible complications related to misplacement of SAD. New SADs which allow users to choose the insertion scope and control the position of SAD can overcome those problems. Additionally, the Video Laryngeal Mask Airway may serve as an endotracheal intubation device, offering a good alternative to fibre-optic intubation through second-generation SADs. In this narrative review, we provide knowledge of the use of video laryngeal mask airways and the possible advantages of introducing them into daily clinical practice.

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Section: We Should No Longer Use Sads Without Vision-guided Systemsmentioning

confidence: 99%

“…The inadequate placement of SADs has been corroborated by clinical, radiological [ 17 , 18 ], magnetic resonance imaging (MRI), computed tomography (CT) [ 38 ] and lateral neck X-ray, fibre-optic [ 28 , 36 , 44 ] and ultrasound evaluations [ 45 , 46 , 47 ].…”

Section: Assessment Of Sadsmentioning

confidence: 99%

Supraglottic Airway Devices with Vision Guided Systems: Third Generation of Supraglottic Airway Devices

Castillo-Monzón,

Gaszyński,

Marroquín-Valz

et al. 2023

JCM

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“…Minor-3 errors are particularly notable among minor errors. For example, pointing out mispositioned medical devices might be valuable feedback to emergency medicine workers [24]. Coronary artery calcifications in the young might indicate the presence of heritable risk factors for atherosclerosis and the information might benefit next of kin [25].…”

Section: Ta B L E 1 Modified Goldman Classification Used In This Studymentioning

confidence: 99%

Accuracy of forensic pathologists in incorporating post‐mortem CT (PMCT) in forensic death investigation

Makino

Unuma

Nolte

et al. 2022

Journal of Forensic Sciences

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Post‐mortem computed tomography (PMCT) is now performed routinely in some medical examiner's offices, and the images are typically interpreted by forensic pathologists. In this study, the question of whether pathologists appropriately identify significant PMCT findings and incorporate them into the death investigation report and the cause and manner of death (COD and MOD) statements was addressed. We retrospectively reviewed 200 cases where PMCT was performed. The cases were divided into four categories: (1) full autopsy without radiology consultation (n = 77), (2) external exam without radiology consultation (n = 79), (3) full autopsy with radiology consultation (n = 26), (4) external exam with radiology consultation (n = 18). A radiologist (not the consult radiologist) read the PMCT images, and a pathologist (not the case pathologist) reviewed the case pathologist's post‐mortem examination report in tandem to determine any PMCT findings omitted from the report. Omitted findings were classified into error types according to a modified Goldman classification including Major 1: Unrecognized fatal injury or pathology that would change COD and/or MOD, and Major 2: Unrecognized fatal injury or pathology that would not change COD and/or MOD. A total of 13 Major errors were identified (6.5%), and none definitively changed the MOD. All four Major‐1 errors which could change the COD were found in Category 2. Of 9 Major‐2 errors, 2 occurred in Category 1, 6 occurred in Category 2, and 1 occurred in Category 4. In conclusion, forensic pathologists who routinely utilize computed tomography (CT) interpret CT images well enough to reliably certify the COD and MOD.

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“…However, the readers were not provided with these results. As misplacements of the LMA are common causes affecting the performance of the LMA and the occurrence of postoperative airway complications including PST, 5 we are very interested in knowing whether the two groups were comparable in term of the fiberscopic scores for positioning of the LMA.…”

Section: In Reference To Effects Of Nitrous Oxide On Intracuff Pressure Of Laryngeal Mask Airway and Occurrence Of Postoperative Sore Thrmentioning

confidence: 99%

In Reference to Effects of Nitrous Oxide on Intracuff Pressure of Laryngeal Mask Airway and Occurrence of Postoperative Sore Throat

Xiao

Xue

et al. 2022

Journal of PeriAnesthesia Nursing

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Three years ago, I published an article called "Pregnancy Loss, Bereavement, and Conscientious Objection in Perioperative Services" in the Journal of PeriAnesthesia Nursing (Catlin, 2018, 33(4), 553-559). The paper topic was termination of pregnancy and the ethical role of perioperative nurses. Although I focused upon controversies in conscientious objection and bereavement support, there was never a thought in my mind that a mere three years later I would be lamenting over the lack of termination services at all.In my writing, I took for granted the following: perioperative services, sterile conditions, timely lifesaving interventions, well-trained physicians, pain medication, and the option of ending gestation of the fetus with serious genetic anomaly or a threat to a woman's physical or mental health. Now, as I write, these services are disappearing, and not a day goes by without another group of elected officials, most often men, closing the doors on these services. Now, in many places, if that pregnancy termination is desired, a woman may need to travel long distances, pay large sums for necessary medical care, or carry that pregnancy to term and simply live with the consequences.Three years ago, in this same paper, I wrote about the Codes of Ethics from the American Nurses Association, the Association of DOI of original article: http://dx.doi

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Extraglottic Airway Device Misplacement: A Novel Classification System and Findings in Postmortem Computed Tomography

Cited by 6 publications

References 34 publications

Supraglottic Airway Devices with Vision Guided Systems: Third Generation of Supraglottic Airway Devices

Supraglottic Airway Devices with Vision Guided Systems: Third Generation of Supraglottic Airway Devices

Accuracy of forensic pathologists in incorporating post‐mortem CT (PMCT) in forensic death investigation

In Reference to Effects of Nitrous Oxide on Intracuff Pressure of Laryngeal Mask Airway and Occurrence of Postoperative Sore Throat

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