Use of Video Laryngoscopy and Camera Phones to Communicate Progression of Laryngeal Edema in Assessing for Extubation

Newmark, Jordan L.; Ahn, Young Keun; Adams, Mark C.; Bittner, Edward A.; Wilcox, Susan R.

doi:10.1177/0885066612437528

Cited by 18 publications

(19 citation statements)

References 12 publications

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“…The results of these serial examinations may be difficult to quantify and relay to other medical personnel. Some videolaryngoscopes have image‐capturing facilities, or the practitioner may choose the cheaper alternative of taking a photograph of the screen with a mobile phone .…”

Section: Resultsmentioning

confidence: 99%

Tracheal extubation of the adult intensive care patient with a predicted difficult airway – a narrative review

et al. 2016

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Management of the difficult airway is an important, but as yet poorly-studied, component of intensive care management. Although there has been a strong emphasis on prediction and intubation of the difficult airway, safe extubation of the patient with a potentially difficult airway has not received the same attention. Extubation is a particularly vulnerable time for the critically ill patient and, because of the risks involved and the consequences of failure, it warrants specific consideration. The Royal College of Anaesthetists 4th National Audit Project highlighted differences in the incidence and consequences of major complications during airway management between the operating room and the critical care environment. The findings in the section on Intensive Care and Emergency Medicine reinforce the importance of good airway management in the critical care environment and, in particular, the need for appropriate guidelines to improve patient safety. This narrative review focuses on strategies for safe extubation of the trachea for patients with potentially difficult upper airway problems in the intensive care unit.

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Section: Resultsmentioning

confidence: 99%

Tracheal extubation of the adult intensive care patient with a predicted difficult airway – a narrative review

et al. 2016

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“…Furthermore, this technology allows archiving of exams, which is especially useful for conditions that require serial exams, including airway edema. 6 This is important in the hospital setting where the practitioner performing the examination may differ day to day. Decreased continuity of care has been found to be associated with an increased incidence of repetitive procedures on patients.…”

Section: Discussionmentioning

confidence: 99%

Smartphone capture of flexible laryngoscopy: Optics, subsite visualization, and patient satisfaction

2019

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Objective To determine whether a smartphone adaptor can record laryngoscopic videos of adequate quality for clinical diagnosis and communication among otolaryngologists and assess the impact of recorded exams on patient satisfaction. Methods Twenty adult inpatients undergoing flexible laryngoscopy in a tertiary care medical center were prospectively enrolled. Each subject's larynx was visualized with the standard laryngoscope eyepiece and with an attached mobile phone adaptor with video recording capabilities. A 5‐point Likert scale was used by the resident performing the scope to grade the adaptor and eyepiece exams. The same scale was used by an offsite otolaryngology attending to grade the adaptor video. Patients were shown the video, and a satisfaction survey was administered. Results In all patients, the adaptor was easy to use and required minimal setup. Ninety percent of patients reported an increase in satisfaction after watching the video of their exam. The eyepiece was superior to the adaptor in resolution, focus, color fidelity, brightness, and optical fluidity (P < 0.05). The video recording was deemed sufficient for clinical assessment in 90% of cases. The offsite reviewer determined that there would be “little” (15%) or “no value” (65%) in repeating the scope exam in the majority of patients. The laryngeal subsites were equally visible with the eyepiece and the adaptor (“full view,” 85%–100%). Conclusion Laryngoscopy videos recorded by a portable smartphone adaptor are sufficient for clinical evaluation in the majority of cases. This technology may improve patient satisfaction and communication among clinicians. Level of Evidence 4 Laryngoscope, 129:2147–2152, 2019

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“…However, there is research to suggest that the cuffleak test demonstrates poor correlation in predicting successful or failed extubation. 15,16 Typically, once the patient has met sufficient subjective and objective extubation criteria 14 , a wire or tube exchange device is inserted into the ETT and the patient is extubated. In the event of persistent airway obstruction and respiratory compromise a new ETT can readily be reinserted over the in situ wire or tube exchanger.…”

Section: Discussionmentioning

confidence: 99%

Use of Glidescope in Trial Extubation of the Difficult Airway

Khurmi¹,

Cubillo²,

Desk³

2017

SDRP-JAS

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ABSTRACT:It is not uncommon for patients to arrive in the operating suites with potential airway issues. These patients include pregnant woman, patients with cervical spine arthritis, the morbidly obese and patients who have had multiple and prolonged intubations. An estimated 40% of the adult population is deemed to be obese based on Body Mass Index. 12 Many intubated patients experience a degree of laryngeal edema or swelling (see figure 1 and 2). However, symptoms typically remain subclinical. Frequent laryngoscopy can lead to laryngeal edema and trauma. The duration of endotracheal intubation is directly correlated to degree of edema. Intraoperative fluid management and fluid shifts can also aggravate laryngeal edema. Early reintubation (0-72 hours post-extubation) occurs about 12% of the time. 5 Safely managing a difficult airway (expected or unexpected) is critical to the overall well-being of the patient. Many evaluations and precautions are taken at the onset of an anesthetic. One should be just as vigilant at the conclusion of an anesthetic involving a challenging airway to avoid post-extubation complications. While guidelines to safely plan and perform extubation exist, the use of modern technology seems to be less prevalent. Using a video laryngoscope to evaluate the airway prior to extubation can be a valuable adjunct in the overall assessment of readiness to extubate a patient. In this report we describe a case of failed extubation and the ultimate use of video laryngoscopy to assist in the decision making process to extubate or perform a tracheostomy.KEY WORDS: difficult airway, extubation, video laryngoscope, obesity KEY MESSAGES: In the setting of a known or suspected difficult airway, a video laryngoscope should be on the short list of tools that can be used to successfully extubate the patient.

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Use of Video Laryngoscopy and Camera Phones to Communicate Progression of Laryngeal Edema in Assessing for Extubation

Cited by 18 publications

References 12 publications

Tracheal extubation of the adult intensive care patient with a predicted difficult airway – a narrative review

Tracheal extubation of the adult intensive care patient with a predicted difficult airway – a narrative review

Smartphone capture of flexible laryngoscopy: Optics, subsite visualization, and patient satisfaction

Use of Glidescope in Trial Extubation of the Difficult Airway

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