Difficult airway management and the novice physician
| Autor: | Rajpaul Ganesh, Kurt E Springmann, Jeffrey J Lunn, Noble L Aikins, Joanne Solis-Keus |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2010 |
| Předmět: |
medicine.medical_specialty
physician medicine.diagnostic_test business.industry medicine.medical_treatment Laryngoscopy Tracheal intubation law.invention Surgery Airway Randomized controlled trial law Anesthesia Emergency Medicine medicine Physician managing Intubation In patient Original Article business Difficult airway difficult |
| Zdroj: | Journal of Emergencies, Trauma and Shock |
| ISSN: | 0974-519X 0974-2700 |
| Popis: | Background: Selection of the ideal airway device in patients with difficult airways (DA) or potentially difficult airways remains controversial, especially, for a novice anesthesia physician (NP) who must deviate from conventional direct laryngoscopy with a rigid laryngoscope following a failed intubation and employ one of the several alternative devices. The author determines and compares tracheal intubation success rates, times to success and complications of a novice physician using four alternative airway devices in 20 obese (BMI more than 27.5) patients who may be more difficult to intubate than normal weight patients. Materials and Methods: In this prospective randomized experimental study the author investigates a novice physician's use of the Bullard™, Fiberoptic™, Fastrach™ and Trachlight™ comparing reliability, rapidity and safety of orotracheal intubations. Following induction of anesthesia the NP was allowed up to a maximum of two attempts per device at oral intubation. Mean intubation times plus/minus SD, per cent success rates and postoperative complications were evaluated for each device. Results: The Fastrach™ was successful 100% of the time on the first attempt requiring a mean time of 55 seconds plus/minus 6.6. All intubations were unsuccessful following two attempts with the Fiberoptic™. A success rate of 20% (one of five) was achieved with the Trachlight™ on first attempt after 95 seconds. The Bullard™ was successful in 40 % (two of five) of the patients after a mean time 60 seconds plus/minus five, but was the only device to result in mild oral discomfort one day post operatively. Conclusions: In the hands of a novice physician managing a difficult or potentially difficult airway, often encountered in obese patients, the Fastrach™ demonstrated the highest success rate. |
| Databáze: | OpenAIRE |
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