Lingual traction to facilitate fiber-optic intubation of difficult airways: a single-anesthesiologist randomized trial

Ching, Yiu‐Hei; Karlnoski, Rachel; Chen, Henian; Camporesi, Enrico M.; Shah, Vimal V.; Padhya, Tapan; Mangar, Devanand

doi:10.1007/s00540-014-1920-9

Cited by 8 publications

(6 citation statements)

References 12 publications

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“…Lingual traction is also a frequently used airway clearance method for FOI 18 . Pulling and holding the tip of the tongue with gauze or Duval forceps showed a significant airway clearance effect at the soft palate level; however, it did not show proper airway clearance at the epiglottis level 6 , 18 , 19 . Therefore, it is recommended to use a combination of jaw-thrust and lingual traction to secure airway clearance at both the soft palate and epiglottis 6 .…”

Section: Discussionmentioning

confidence: 88%

Tongue retraction using a McIvor blade improves airway condition during fiberoptic intubation: a randomized controlled trial

Lee,

Han,

Kim

et al. 2023

Sci Rep

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Airway clearance is crucial for successful fiberoptic intubation. We hypothesized that tongue retraction using a McIvor blade could facilitate fiberoptic intubation. This randomized clinical trial aimed to compare intubation time and airway condition between the jaw thrust maneuver and tongue retraction with the McIvor blade during fiberoptic intubation. Ninety-four adult patients scheduled for elective surgery were randomly assigned to one of two groups. During fiberoptic intubation, airway clearance was secured by applying the jaw-thrust maneuver (J group) or by tongue retraction using the McIvor blade (M group). We assessed the total intubation time, number of attempts for tube advancement, and airway clearance at the soft palate and epiglottis levels. The total intubation time was significantly shorter in the M group than in the J group (p = 0.035). The number of attempts to advance the tube was significantly lower in the M group (p = 0.033). Airway clearance at the soft palate level was significantly better in the M group than in the J group (p = 0.027). Retracting the tongue with the McIvor blade demonstrated a better condition for fiberoptic intubation and shortened total intubation time compared with the jaw-thrust maneuver.Clinicalregistiration: CRIS; http://cris.nih.go.kr (KCT0002392) registered 28/07/2017.

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Section: Discussionmentioning

confidence: 88%

Tongue retraction using a McIvor blade improves airway condition during fiberoptic intubation: a randomized controlled trial

Lee,

Han,

Kim

et al. 2023

Sci Rep

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“…Actually, the otolaryngologist did oppose verbally to anaesthesia with curare and suggested the anaesthesiologist to perform an optical fibre bronchoscope guided endotracheal intubation. Such a technique would have facilitated intubation, in accordance with the anaesthesiology guidelines 23 . The anaesthesiologist refused because the optical fiber bronchoscope tube was too short.…”

Section: Case Report (The Case Judged By the Criminal Appealmentioning

confidence: 99%

Is the team leading surgeon criminally liable for his collaborators’ errors? Judges confirm responsibility and condemn an otorhinolaryngologist

Gulino

Ralli

Luca

et al. 2018

Acta Otorhinolaryngol Ital

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In current healthcare, delivery of medical and surgical treatment takes place in a multidisciplinary manner. This raises the problem of distinguishing the conditions under which the person who has properly carried out his duties, respecting the related leges artis, can be held responsible for damages materially caused by another member of the medical team. Jurisprudence has developed the so-called "principle of trust" for which every member of the team can rely on the fact that other members are acting in compliance with the leges artis of their specialisation. The Supreme Court has limited the application of this principle. The authors examine the jurisprudence on responsibility of the team in otolaryngology and conclude that individual liability should be limited to the specific expertise of the individual specialist. KEY WORDS: Team leader responsibility • Principle of trust • Équipe responsibility • Legal medicine RIASSUNTONella realtà sanitaria contemporanea, la prestazione terapeutica si svolge in forma multidisciplinare. Si pone, quindi, il problema di distinguere a quali condizioni colui che ha espletato correttamente le proprie mansioni rispettando le leges artis a lui richieste, può essere chiamato a rispondere del danno materialmente causato da altro membro dell'équipe medica. La dottrina ha elaborato il "principio di affidamento", approssimativamente traducibile in "principle of trust", ossia ogni membro dell'equipe può fare affidamento sul fatto che gli altri soggetti agiscano nell'osservanza delle leges artis della loro specializzazione. La Suprema Corte ha limitato l'applicazione di tale principio al fine di aumentare la possibilità di evitare eventuali errori dei colleghi. Gli autori esaminano la giurisprudenza che si è formata sulla responsabilità in équipe in casi di interesse otorinolarigoiatrico e concludono che l'ambito della responsabilità dovrebbe essere circoscritto alle specifiche competenze dei singoli.

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“…As the use of a fiberoptic bronchoscope for tracheal intubation has been reduced (due partly to use of alternative devices such as videolaryngoscopes), training using this kind of a simulator may be necessary. A simple procedure (traction of the tongue) may facilitate fiberoptic intubation [48].…”

Section: Trainingmentioning

confidence: 99%

Progress in difficult airway management

Asai

2017

J Anesth

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Lingual traction to facilitate fiber-optic intubation of difficult airways: a single-anesthesiologist randomized trial

Abstract: In this study, lingual traction was shown to be a valuable maneuver for facilitating fiber-optic bronchoscope-guided intubation in the management of patients with anticipated difficult airways.

Cited by 8 publications

References 12 publications

Tongue retraction using a McIvor blade improves airway condition during fiberoptic intubation: a randomized controlled trial

Tongue retraction using a McIvor blade improves airway condition during fiberoptic intubation: a randomized controlled trial

Is the team leading surgeon criminally liable for his collaborators’ errors? Judges confirm responsibility and condemn an otorhinolaryngologist

Progress in difficult airway management

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