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High-Risk Airway Management in the Emergency Department. Part I: Diseases and Approaches
BACKGROUND: Successful airway management is critical to the practice of emergency medicine. Emergency physicians must be ready to optimize and prepare for airway management in critically ill patients with a wide range of physiologic challenges. Challenges in airway management commonly encountered in...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7214321/ https://www.ncbi.nlm.nih.gov/pubmed/32563613 http://dx.doi.org/10.1016/j.jemermed.2020.05.008 |
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author | Lentz, Skyler Grossman, Alexandra Koyfman, Alex Long, Brit |
author_facet | Lentz, Skyler Grossman, Alexandra Koyfman, Alex Long, Brit |
author_sort | Lentz, Skyler |
collection | PubMed |
description | BACKGROUND: Successful airway management is critical to the practice of emergency medicine. Emergency physicians must be ready to optimize and prepare for airway management in critically ill patients with a wide range of physiologic challenges. Challenges in airway management commonly encountered in the emergency department are discussed using a pearl and pitfall discussion in this first part of a 2-part series. OBJECTIVE: This narrative review presents an evidence-based approach to airway and patient management during endotracheal intubation in challenging cases that are commonly encountered in the emergency department. DISCUSSION: Adverse events during emergent airway management are common, with postintubation cardiac arrest reported in as many as 1 in 25 intubations. Many of these adverse events can be avoided with the proper identification and understanding of the underlying physiology, preparation, and postintubation management. Patients with high-risk features including severe metabolic acidosis; shock and hypotension; obstructive lung disease; pulmonary hypertension, right ventricle failure, and pulmonary embolism; and severe hypoxemia must be managed with airway expertise. CONCLUSIONS: This narrative review discusses the pearls and pitfalls of commonly encountered physiologic high-risk intubations with a focus on the emergency clinician. |
format | Online Article Text |
id | pubmed-7214321 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-72143212020-05-12 High-Risk Airway Management in the Emergency Department. Part I: Diseases and Approaches Lentz, Skyler Grossman, Alexandra Koyfman, Alex Long, Brit J Emerg Med Article BACKGROUND: Successful airway management is critical to the practice of emergency medicine. Emergency physicians must be ready to optimize and prepare for airway management in critically ill patients with a wide range of physiologic challenges. Challenges in airway management commonly encountered in the emergency department are discussed using a pearl and pitfall discussion in this first part of a 2-part series. OBJECTIVE: This narrative review presents an evidence-based approach to airway and patient management during endotracheal intubation in challenging cases that are commonly encountered in the emergency department. DISCUSSION: Adverse events during emergent airway management are common, with postintubation cardiac arrest reported in as many as 1 in 25 intubations. Many of these adverse events can be avoided with the proper identification and understanding of the underlying physiology, preparation, and postintubation management. Patients with high-risk features including severe metabolic acidosis; shock and hypotension; obstructive lung disease; pulmonary hypertension, right ventricle failure, and pulmonary embolism; and severe hypoxemia must be managed with airway expertise. CONCLUSIONS: This narrative review discusses the pearls and pitfalls of commonly encountered physiologic high-risk intubations with a focus on the emergency clinician. Elsevier 2020-07 2020-05-12 /pmc/articles/PMC7214321/ /pubmed/32563613 http://dx.doi.org/10.1016/j.jemermed.2020.05.008 Text en Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Article Lentz, Skyler Grossman, Alexandra Koyfman, Alex Long, Brit High-Risk Airway Management in the Emergency Department. Part I: Diseases and Approaches |
title | High-Risk Airway Management in the Emergency Department. Part I: Diseases and Approaches |
title_full | High-Risk Airway Management in the Emergency Department. Part I: Diseases and Approaches |
title_fullStr | High-Risk Airway Management in the Emergency Department. Part I: Diseases and Approaches |
title_full_unstemmed | High-Risk Airway Management in the Emergency Department. Part I: Diseases and Approaches |
title_short | High-Risk Airway Management in the Emergency Department. Part I: Diseases and Approaches |
title_sort | high-risk airway management in the emergency department. part i: diseases and approaches |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7214321/ https://www.ncbi.nlm.nih.gov/pubmed/32563613 http://dx.doi.org/10.1016/j.jemermed.2020.05.008 |
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