Surgical approach in difficult airway management

Helm, Matthias; Gries, A.; Mutzbauer, Till S.

doi:10.1016/j.bpa.2005.06.002

Cited by 45 publications

(23 citation statements)

References 31 publications

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“…Technical aspects of EPA procedures, however, are only one half of the training needed [112,121]. During CICO, the situation must be recognised and the decision made to proceed to EPA [122].…”

Section: Trainingmentioning

confidence: 99%

Equipment and strategies for emergency tracheal access in the adult patient

Hamaekers

Henderson

2011

Anaesthesia

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SummaryThe inability to maintain oxygenation by non‐invasive means is one of the most pressing emergencies in anaesthesia and emergency care. To prevent hypoxic brain damage and death in a ‘cannot intubate, cannot oxygenate’ situation, emergency percutaneous airway access must be performed immediately. Even though this emergency is rare, every anaesthetist should be capable of performing an emergency percutaneous airway as the situation may arise unexpectedly. Clear knowledge of the anatomy and the insertion technique, and repeated skill training are essential to ensure completion of this procedure rapidly and successfully. Various techniques have been described for emergency oxygenation and several commercial emergency cricothyroidotomy sets are available. There is, however, no consensus on the best technique or device. As each has its limitations, it is recommended that all anaesthetists are skilled in more than one technique of emergency percutaneous airway. Avoiding delay in initiating rescue techniques is at least as important as choice of device in determining outcome.

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Section: Trainingmentioning

confidence: 99%

Equipment and strategies for emergency tracheal access in the adult patient

Hamaekers

Henderson

2011

Anaesthesia

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“…We believe that the detailed didactic instruction of surgical airway steps and neck anatomy, familiarity with the surgical airway instruments, and supervision by an expert faculty member may have been responsible for the 96% success rate of our participants. We hope that such knowledge and hands-on experience reduces complication rates during future procedures when it comes to performance on patients [23,24].…”

Section: Discussionmentioning

confidence: 97%

Teaching the surgical airway using fresh cadavers and confirming placement nonsurgically

Latif

Chhabra

Ziegler

et al. 2010

Journal of Clinical Anesthesia

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“…33,34 The method of conventional cricothyroidotomy is as follows: 1) the operator stands on the patient's right side (if the operator is right-handed) and makes a 4-cm-long midline vertical incision on the skin; 2) the cricothyroid membrane is identified by blunt dissection; 3) the larynx is immobilized using the left hand; 4) the cricothyroid membrane is incised transversely using a no 11 scalpel blade; 5) the larynx is stabilized with a tracheal hook at the inferior aspect of the thyroid cartilage; and 6) the patient is intubated with an endotracheal tube. 31,35 Brofeldt et al 32 introduced the RFST for establishing an emergency airway in 1996. The steps of this method are as follows: 1) the operator stands on the patient's left side (if the operator is right-handed) and identifies the cricothyroid 337 338 339 340 341 342 343 344 345 346 347 348 349 350 351 352 353 354 355 356 357 358 359 360 361 362 363 364 365 366 367 368 369 370 371 372 373 374 375 376 377 378 379 380 381 382 383 384 385 386 387 388 389 390 391 392 393 membrane; 2) a horizontal stab incision is made through the skin and membrane using a no 20 scalpel blade; 3) the larynx is stabilized with a tracheal hook at the inferior aspect of the ostomy (on the cricoid cartilage), providing caudal traction; and 4) the patient is intubated with an endotracheal tube.…”

Section: Discussionmentioning

confidence: 99%