• Title/Summary/Keyword: Airway Management

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The evaluation of a scoring system in airway management after oral cancer surgery

  • Lee, Ho-Jin;Kim, Jin-Wook;Choi, So-Young;Kim, Chin-Soo;Kwon, Tae-Geon;Paeng, Jun-Youg
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.37
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    • pp.19.1-19.7
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    • 2015
  • Background: The purpose of this retrospective study was to investigate the usefulness of tracheostomy scoring system in the decision of postoperative airway management in oral cancer patients. Materials and methods: A total of 104 patients were reviewed in this retrospective study, who underwent radical resection with or without neck dissection and free flap reconstruction due to oral cancer. The patients were classified into three groups according to the timing of the extubation; extubated groups (n = 51), overnight intubation group (n = 45), and tracheostomy group (n = 8). Cameron's score was used to evaluate the relation between the state of the patient's airway and the type of the operation. Results: Tracheostomy was performed in eight patients (8/104, 7.7 %). A total of 22 patients (21.2 %) had more than 5 points of which 17 patients (77.3 %) did not have a tracheostomy and any postoperative emergency airway problems. The tracheostomy scores were significantly different among the three groups. Hospital stay showed a significant correlation with the tracheostomy score. Conclusions: The scoring system did not quite agree with the airway management of the authors' clinic; however, it can be one of the clinical factors predicting the degree of the postoperative airway obstruction and surgical aggressiveness for recovery. The further studies are needed for clinically more reliable scoring systems.

Difficult Intubation in Patients Undergone Oromaxillary Surgery: Retrospective Study (전신마취를 시행한 구강외과 환자에서 어려운 기관내삽관: 후향적 연구)

  • Kwon, O-Seon;Kim, Cheul-Hong
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.8 no.2
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    • pp.118-121
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    • 2008
  • Background: This retrospective study aims to describe the airway management and to search predictive parameter for difficult intubation in 700 patients undergoing oromaxillary surgery. Methods: The medical records of 700 patients undergone oromaxillary surgery were reviewed for airway management during perioperative period. The cases of difficult intubation were selected and those radiologic findings were reviewed. The mandibular depth (MD), mandibular length (ML), thyromental distance (TMD) were measured. Results: In 41 cases difficult intubation were recorded in anesthetic record. The grade of Cormack and Lehane was III in 36 patients and IV in 5 cases. The MD of difficult intubation cases was $4.2{\pm}3.2\;cm$. The ML of difficult intubation cases was $10.1{\pm}3.8\;cm$. The TMD of difficult intubation cases was $5.9{\pm}4.3\;cm$. Under the fiberoptic guided awake intubation was undertaken in 75 patient. In none of the cases was failed nasotracheal intubation. Conclusions: The patients undergoing oromaxillar surgery have a potentially difficult airway but, if managed properly during perioperative preiod, morbidity and mortality can be reduced or avoided. The radiologic findings were poor predict for difficult intubation. The fiberoptic guided awake intubation is a safe alternative to direct laryngoscopic intubation.

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Clinical Aanalysis of Airway Trauma (외상성 기도 손상의 임상적 고찰)

  • Cho, Hyun-Min;Kim, Young-Jin;Ryu, Han-Young;Hwang, Jung-Joo
    • Journal of Trauma and Injury
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    • v.24 no.1
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    • pp.7-11
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    • 2011
  • Purpose: Traumatic airway injuries have high rates of mortality and morbidity. Thus, we evaluated the clinical results of trauma-related airway-injury patients. Methods: A clinical analysis was performed for patients with airway trauma who were admitted and treated at the Department of Thoracic and Cardiovascular Surgery, Konyang University Hospital from Dec. 2002 to Dec. 2009. Results: Sixteen patients were admitted and treated. Fourteen patients were male, and the ages of the patients ranged from 16 to 75 years. Six cases were penetrating injuries, 4 were traffic-accident injuries. 3 were fall injuries, and. 3 were other blunt trauma injuries. Anato- mic injuries included 14 trachea cases (87.5%), 1 Rt. main bronchus (6.25%), and 1 Lt. main bronchus cases (6.25%). Diagnosis was made by using computed tomography and bronchoscopy. Five patients were treated with an explothoracotomy, and 7 underwent neck exploration with primary repair. Three patients simply needed conservative management, and 1 patient was treated with a closed thoracostomy. The post-operative mortality rate was 6.25 % (1 patient). Conclusion: Airway trauma is dangerous and should be treated as an emergency, so a high index of suspicion is essential for rapid diagnosis and successful surgical intervention in patients with airway injuries.

Tongue-lip adhesion in Pierre Robin sequence

  • Kumar, K.S. Krishna;Vylopilli, Suresh;Sivadasan, Anand;Pati, Ajit Kumar;Narayanan, Saju;Nair, Santhy Mohanachandran
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.42 no.1
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    • pp.47-50
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    • 2016
  • Patients with Pierre Robin sequence exhibit varying degrees of airway obstruction and feeding difficulty. In some patients, airway obstruction may be profound, warranting surgical intervention to maintain a patent airway. The purpose of this article is to highlight the advantages of the tongue-lip adhesion procedure for the management of airway obstruction in such patients compared to the currently available options.

The Relationship between Advanced Airway Management and Self-Efficacy by Level 1 Emergency Medical Technicians(EMT) in 119 Emergency Medical Service (119구급대 1급 응급구조사의 전문기도유지술과 자기효능감과의 관계)

  • Jeong, Beom-Jun;Choi, Sung-Soo;Yun, Seong-Woo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.4
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    • pp.1709-1717
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    • 2013
  • This study was to identify the frequency and related factors of advanced airway management for patients with cardiac arrest by the Level 1 emergency medical technicians in the 119 Emergency medical service. 95 level-1 medical technicians belonging to Gwangju Fire Service Headquarter were surveyed with structured questionnaire composed of general and job-related characteristics, self-efficacy, barrier factors to performing the advanced airway for patients with cardiac arrest. From January 1, 2010 to June 30, 2011, data obtained from the Gwangju Fire Service Headquarter by performance of advanced airway. Self-efficacy toward the necessity of advanced airway revealed positive correlation with self-confidence. The barrier factor to advanced airway performance had negative correlation with the frequency of performance. The most important factor of advanced airway performance was necessity and self-efficacy. In conclusion, it is necessary to develop the field-based practice education program and to improve self-efficacy.

Chronic Obstructive Pulmonary Disease: Respiratory Review of 2013

  • Kim, Yu-Il
    • Tuberculosis and Respiratory Diseases
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    • v.76 no.2
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    • pp.53-58
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    • 2014
  • Chronic obstructive pulmonary disease (COPD) is a common airway disease that has considerable impact on disease burdens and mortality rates. A large number of articles on COPD are published within the last few years. Many aspects on COPD ranging from risk factors to management have continued to be fertile fields of investigation. This review summarizes 6 clinical articles with regards to the risk factors, phenotype, assessment, exacerbation, management and prognosis of patients with COPD which were being published last year in major medical journals.

A Comparison of Endotracheal Intubation using the Macintosh Laryngoscope, the Gum Elastic Bougie and the Pentax AirWay Scope in Neck-Stabilized Manikin (경추 고정 마네킹에게 직접 후두경(Macintosh laryngoscope), 부지(Gum elastic bougie), 비디오 후두경(Pentax AirWay Scope)을 사용한 기관내삽관 비교)

  • Choi, Uk-Jin;Cho, Keun-Ja
    • The Korean Journal of Emergency Medical Services
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    • v.15 no.3
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    • pp.71-80
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    • 2011
  • Purpose : This research was designed to provide basic data for advanced pre-hospital airway management by comparing the ease of intubation, the success rate and the time for intubation performed with Macintosh Laryngoscope, Gum Elastic Bougie and Pentax AirWay Scope on the floor and table. Methods : Intubation was performed 30 times in total, including 5 times for each of intubation using Macintosh Laryngoscope, Gum Elastic Bougie and Pentax Airway Scope on the table and floor, only on subjects who passed the practice test of the national exam for paramedics. Data were collected by measuring the ease of intubation, the success rate and the time for intubation, and then analyzed by descriptive analysis, paired t-test, ANOVA using SPSS 18.0. Results : 1. There was a significant difference in the ease of intubation according to intubation devices. 2. There was a significant difference in the ease of intubation according to table height for intubation. 3. There was a significant difference in the success rate according to intubation devices. 4. There was no significant difference in the success rate according to table height for intubation. 5. There was a significant difference in the intubation time according to intubation devices. 6. There was a partially significant difference in the intubation time according to table height for intubation. Conclusion : Sufficient training not only with Macintosh Laryngoscope but also with Gum Elastic Bougie and Pentax Airway Scope could improve the survival rate by intubation in patients with difficult airway.

Airway Management with Reinforced Laryngeal in Mask Airway in a Child with Hypoplastic Left Heart Syndrome (좌심실형성부전증후군 환아의 치과치료를 위한 전신마취 시 강화 후두마스크를 이용한 기도 유지)

  • Kim, Kyung Jin;Shin, Teo-Jeon;Hyun, Hong-Keun;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Kim, Chong-Chul;Seo, Kwang-Suk
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.13 no.4
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    • pp.221-224
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    • 2013
  • Despite the laryngeal mask airway (LMA) has been widely used in anesthesia, its use is rare in the field of dentistry. Placing LMA in the oral cavity may interrupt dental treatment. However, there are some circumstances in which LMA is more advantageous than tracheal intubation for managing the airway. Especially, the reinforced LMA has a flexible tube shaft, rendering it more accessible for dental treatment. We report a case of dental treatment of a 3-year-old patient with hypoplastic left heart syndrome combined with pulmonary hypertension using reinforced LMA for airway management under general anesthesia. We also discuss the considerations of utilizing the reinforced LMA for dental treatment.

Comparison of Endotracheal Intubation in Difficult Postures by Using the SALT(Supraglottic Airway Laryngopharyneal Tube)

  • Yun, Seong-Woo
    • Journal of the Korea Society of Computer and Information
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    • v.25 no.12
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    • pp.227-233
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    • 2020
  • The purpose of this study is to compare the speed, confidence, and ease of endotracheal intubation in a difficult posture by using the SALT(Supraglottic Airway Laryngopharyngeal Tube), and a direct laryngoscope to improve the ability to implement professional airway management. The subject of the study was an experimental study by a randomized crossover design, targeting 30 first-class emergency medical technicians working in J-do fire station, and the SPSS 20.0 version was used for data analysis. The endotracheal intubation by using SALT showed a significant difference in speed compared to endotracheal intubation by using a direct laryngoscope(p<.001), and also showed a significant difference in confidence and ease(p<.001). If it is difficult to endotracheal intubation by direct laryngoscope, or in the case of trauma patients, if SALT is used, safe and rapid intubation will be possible. In addition, to improve the efficiency of professional airway management, it is believed that the introduction of SALT in domestic sites is necessary.

Comparison between laryngeal tube suction II and laryngeal mask airway in novice users - A manikin study - (초보자에서 후두튜브기도기와 후두마스크기도기의 삽관 비교 - 마네킨 연구 -)

  • Hwang, Ji-Young;Cho, Keun-Ja
    • The Korean Journal of Emergency Medical Services
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    • v.16 no.3
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    • pp.19-28
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    • 2012
  • Purpose : The present study was designed to provide basic data for advanced pre-hospital airway management by comparing the insertion time and success rate between laryngeal tube suction II (LTS II) and laryngeal mask airway (LMA) in a manikin. Methods : A total of 32 participants were novice users to both of devices among paramedic students. After taking the introductory lecture and demonstrations, the participants made an attempt to insert the LTS II and LMA to compare the insertion time and success rate. They marked the easiness of insertion of the score ranged from 1 to 10 score scale and preference of the two devices. Results : The insertion time of the LTS II was significantly shorter than that of the LMA (p =.000). There was no significant difference between LTS II and LMA in the success rate. In the easiness of insertion, the score of LTS II $(8.47{\pm}1.41score)$ was significantly higher than that of LMA $(7.19{\pm}1.98score)$(p =.001). The preference of LTS II (75%) was much higher than that of LMA (25%). Conclusion : The manikin study data showed that the LTS II may be a good alternative airway device for providing and maintaining a patent airway.