Airway Management of Tetanus After the Haitian Earthquake
| Autor: | Paul G. Firth, Laura L. Roberts, James B. Solomon, Todd D. Gleeson |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Adult
Male Emergency Medical Services Palliative care medicine.medical_treatment Anesthetics General Intercostal Muscles medicine.disease_cause Disasters Positive-Pressure Respiration Fatal Outcome medicine Earthquakes Intubation Intratracheal Intubation Humans Airway Management Ships Mechanical ventilation Aged 80 and over Tetanus business.industry Tracheal intubation Palliative Care medicine.disease Haiti Anesthesiology and Pain Medicine Treatment Outcome Debridement Anesthesia Tetanospasmin Airway management Trismus Neuromuscular Blocking Agents Airway business |
| Zdroj: | Survey of Anesthesiology. 55:313 |
| ISSN: | 0039-6206 |
| Popis: | Two men developed severe tetanus after the 2010 Haitian earthquake. They were admitted to the United States Naval Ship Comfort, a hospital ship sent to provide humanitarian relief. Severe masseter and intercostal muscle spasm impaired airway access and ventilation. Propofol and sevoflurane relieved the tetany, allowing airway control and ventilation without intubation or neuromuscular blocking drugs during wound debridement. Presynaptic impairment of inhibitory neurotransmitter release by tetanospasmin toxin is countered by enhancement of spinal cord postsynaptic inhibitory receptor activity by general anesthetics. Avoidance of tracheal intubation and mechanical ventilation during anesthesia may be desirable in the settings of limited resources in which tetanus usually presents. |
| Databáze: | OpenAIRE |
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