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Difficult Airway Management Algorithm in Emergency Medicine: Do Not Struggle against the Patient, Just Skip to Next Step
We report a case of prehospital “cannot intubate” and “cannot ventilate” scenarios successfully managed by strictly following a difficult airway management algorithm. Five airway devices were used: the Macintosh laryngoscope, the gum elastic Eschmann bougie, the LMA Fastrach, the Melker cricothyroto...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi Publishing Corporation
2010
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3200218/ https://www.ncbi.nlm.nih.gov/pubmed/22046533 http://dx.doi.org/10.1155/2010/826231 |
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author | Sudrial, Jérôme Birlouez, Caroline Guillerm, Anne-Laurette Sebbah, Jean-Luc Amathieu, Roland Dhonneur, Gilles |
author_facet | Sudrial, Jérôme Birlouez, Caroline Guillerm, Anne-Laurette Sebbah, Jean-Luc Amathieu, Roland Dhonneur, Gilles |
author_sort | Sudrial, Jérôme |
collection | PubMed |
description | We report a case of prehospital “cannot intubate” and “cannot ventilate” scenarios successfully managed by strictly following a difficult airway management algorithm. Five airway devices were used: the Macintosh laryngoscope, the gum elastic Eschmann bougie, the LMA Fastrach, the Melker cricothyrotomy cannula, and the flexible fiberscope. Although several airway devices were used, overall airway management duration was relatively short, at 20 min, because for each scenario, failed primary and secondary backup devices were quickly abandoned after 2 failed attempts, each attempt of no more than 2 min in duration, in favor of the tertiary rescue device. Equally, all three of these rescue devices failed, an uncuffed cricothyroidotomy cannula was inserted to restore optimal arterial oxygenation until a definitive airway was secured in the ICU using a flexible fiberscope. Our case reinforces the need to strictly follow a difficult airway management algorithm that employs a limited number of effective devices and techniques, and highlights the imperative for early activation of successive preplanned steps of the algorithm. |
format | Online Article Text |
id | pubmed-3200218 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2010 |
publisher | Hindawi Publishing Corporation |
record_format | MEDLINE/PubMed |
spelling | pubmed-32002182011-11-01 Difficult Airway Management Algorithm in Emergency Medicine: Do Not Struggle against the Patient, Just Skip to Next Step Sudrial, Jérôme Birlouez, Caroline Guillerm, Anne-Laurette Sebbah, Jean-Luc Amathieu, Roland Dhonneur, Gilles Emerg Med Int Case Report We report a case of prehospital “cannot intubate” and “cannot ventilate” scenarios successfully managed by strictly following a difficult airway management algorithm. Five airway devices were used: the Macintosh laryngoscope, the gum elastic Eschmann bougie, the LMA Fastrach, the Melker cricothyrotomy cannula, and the flexible fiberscope. Although several airway devices were used, overall airway management duration was relatively short, at 20 min, because for each scenario, failed primary and secondary backup devices were quickly abandoned after 2 failed attempts, each attempt of no more than 2 min in duration, in favor of the tertiary rescue device. Equally, all three of these rescue devices failed, an uncuffed cricothyroidotomy cannula was inserted to restore optimal arterial oxygenation until a definitive airway was secured in the ICU using a flexible fiberscope. Our case reinforces the need to strictly follow a difficult airway management algorithm that employs a limited number of effective devices and techniques, and highlights the imperative for early activation of successive preplanned steps of the algorithm. Hindawi Publishing Corporation 2010 2010-07-27 /pmc/articles/PMC3200218/ /pubmed/22046533 http://dx.doi.org/10.1155/2010/826231 Text en Copyright © 2010 Jérôme Sudrial et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Sudrial, Jérôme Birlouez, Caroline Guillerm, Anne-Laurette Sebbah, Jean-Luc Amathieu, Roland Dhonneur, Gilles Difficult Airway Management Algorithm in Emergency Medicine: Do Not Struggle against the Patient, Just Skip to Next Step |
title | Difficult Airway Management Algorithm in Emergency Medicine: Do Not Struggle against the Patient, Just Skip to Next Step |
title_full | Difficult Airway Management Algorithm in Emergency Medicine: Do Not Struggle against the Patient, Just Skip to Next Step |
title_fullStr | Difficult Airway Management Algorithm in Emergency Medicine: Do Not Struggle against the Patient, Just Skip to Next Step |
title_full_unstemmed | Difficult Airway Management Algorithm in Emergency Medicine: Do Not Struggle against the Patient, Just Skip to Next Step |
title_short | Difficult Airway Management Algorithm in Emergency Medicine: Do Not Struggle against the Patient, Just Skip to Next Step |
title_sort | difficult airway management algorithm in emergency medicine: do not struggle against the patient, just skip to next step |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3200218/ https://www.ncbi.nlm.nih.gov/pubmed/22046533 http://dx.doi.org/10.1155/2010/826231 |
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