• Title/Summary/Keyword: airway management

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Effect of MAD Snoring Design on Pharyngeal Airway Dimension (하악전방이동 코골이 장치의 수직 교합량이 상기도에 미치는 영향)

  • Ra, In-Sil;Lee, Jang-Hoon
    • Journal of Digital Convergence
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    • v.15 no.10
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    • pp.307-314
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    • 2017
  • In this study, a minimum amount of the vertical occlusion was secured differently in each type of mandibular advance devices snoring and Class I malocclusion patients wore these devices. This study analyzes, after the use of devices, a different amount of the vertical occlusion results in a change of the area of upper airway by additional changes such as mandibular position, muscle changes, tongue position. The higher the vertical amount, the area of the upper airway was shown smaller, And if the patient's tongues was prevented from the distal movement, the area of the upper airway had increased, To reduce snoring, doctors should accurately diagnose patients' occlusal relationships and select a MAD snoring that is appropriate for the occlusion. The dental technician who builds the selected device should also consider design settings such as the amount of vertical occlusion, the finish lines, and the thickness of the device to increase the effectiveness of the device.

Acute Airway Obstruction Secondary to Lingual Hematoma after Lower Third Molar Extraction: A Case Report

  • Yi, Sangmin;Oh, Je-Seok;Youn, Gap-Hee;Chung, Kwang;Jung, Seunggon;Park, Hong-Ju;Oh, Hee-Kyun;Kook, Min-Suk
    • Journal of Korean Dental Science
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    • v.7 no.1
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    • pp.43-47
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    • 2014
  • Few dental procedures are potentially life-threatening. Note, however, that a dental extraction can result in preventable death. Severe post-extraction bleeding can occur, which may give rise to an alarming situation if there is any delay in detecting and managing the problem. The most immediate danger for a healthy patient with severe post-extraction hemorrhage is airway compromise. Acute airway obstruction from post-extraction hematoma is relatively uncommon, but it may occur with fatal consequences if there is any reluctance to maintain the airway clearance. Therefore, dentists and oral and maxillofacial surgeons should have clear understanding of the problem and measures to control it. Active bleeding that is not controlled by local measures in a dental office should be referred to the nearest hospital emergency department as soon as possible for appropriate management.

Airway Obstruction and Respiratory Distress Owing to Sedation by use of Chloral Hydrate & Ketamine Before Extraction of the Mesiodens in Patient with Bronchial Asthma & Tonsillar Hyperplasia -A Case Report- (기관지 천식과 편도 증식증 환자에서 상악 정중부 과잉치 발치 전 포크랄과 케타민 투여 진정요법 시 발생된 기도폐쇄와 호흡장애 -증례 보고-)

  • Choi, Young-Su;Kang, Sang-Hoon;Kim, Moon-Key;Lee, Chun-Ui;Yoo, Jae-Ha
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.10 no.1
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    • pp.34-44
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    • 2010
  • The causes for airway obstruction include foreign body aspiration, congenital structural abnormalities of the airway, infection, etc. And the potential causes of acute respiratory distress contain many situations, like hyperventilation, vasodepressor syncope, asthma, etc. A major factor that leads to the exacerbation of respiratory disorders is undue stress, either physiologic or psychologic. Psychologic stress in dentistry is the primary factor in the exacerbation of preexisting medical problems. Adequate pretreatment medical and dental evaluation of the prospective patient can often prevent respiratory problems from developing. The dentist can modify patient management to minimize the risk of exacerbating these conditions. When dental anxiety is a major factor, the use of psychosedative procedures and other stress-reduction techniques should also be considered. This is the report of a children case of airway obstruction and respiratory distress owing to sedation complication by use of Chloral hydrate and Ketamine before extraction of the mesiodens in a patient with bronchial asthma and tonsillar hyperplasia. After these situations, the patient was consulted & referred to the department of Pediatrics and Otorhinolaryngology.

Airway Evaluation for Endotracheal Intubation of Mandibular Prognathic Patient (하악전돌증 환자에서 기관내 삽관을 위한 기도평가에 관한 연구)

  • Lee, Sung-Ju;Kim, Hyun-Jeong;Yum, Kwang-Won
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.3 no.1 s.4
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    • pp.28-33
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    • 2003
  • Background: The fundamental responsibility of an anesthesiologist is to maintain adequate gas exchange. Failure to maintain a patent airway can result in brain damage or death. Generally, in patients with mandibular prognathism, who have the protruded mandible, the mask ventilation was thought to be not easy. The purpose of this study was to observe the degree of the difficulty of airway management in mandibular prognathism using some anatomic criteria for defining and grading difficulty of airway and difficulty of endotracheal intubation with direct laryngoscope. Methods: The observations and measurements are done to the 54 patients with mandibular prognathism, who were scheduled for corrective esthetic surgery. The case study is done to the 30 patients with normal mandible for control group. In all patients, mouth opening distance (MOD), mouse opening angle (MOA), mandibular length (ML), mandibular depth (MD), thyromental distance (TMD), thyromental area (TMA), Mallampati grades, and Cormack and Lehane grades are measured. T-test and Chi-square test are done (P < 0.05). Results: In the mandibular prognathism cases, the measurements of MD, TMD and TMA are more greater than those of controls (P < 0.05). Mallampati grades with tongue thrust are higher in the female mandibular prognathism cases than those of female controls. Most of the grades of the mandibular prognathism cases with Cormack and Lehane grading system are I or II being easy intubation cases (P < 0.05) Conclusions: In the patients of mandibular prognathism, the intubation with laryngoscope will be easer than that of normal mandible in general. It is for that their laryngeal aperture can be easily visible when the laryngoscope are used.

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Endotracheal Intubation of Paramedics in a Moving Ambulance (이동 중 구급차에서 1급 응급구조사의 기관내 삽관)

  • Shim, Gyu-Sik
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.11
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    • pp.5292-5298
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    • 2012
  • The purpose of this study is to perform the effectively advanced airway management in an emergency patient with cardiac arrest and trauma by comparing the appearance of influence in a change of visual-field height upon endotracheal intubation according to a change in position with intubation of paramedics in a moving ambulance and by analyzing the appearance of the influence in a patient's change in position with intubation upon speed in endotracheal intubation. Research subjects were randomly extracted 60(30 people for control group, 30 people for experimental group) people as the paramedics who are working at 13 fire stations in C Province. Data analysis was carried out ${\chi}^2$-test, independent t-test, paired t-test by using SPSS WIN 14.0 Version. As a result of research, to improve speed of the advanced airway management, it is considered to be likely effective in a patient's sniffing position and in the endotracheal intubation in the upper space of the main stretcher. The self-confidence in intubation after experiment increased significantly. Thus, the continuous education(training) on the intubation position and method within ambulance is considered to be likely needed for improving efficiency of the advanced airway management.

Evaluation of safety and usefulness of submental intubation in panfacial trauma surgery

  • Singaram, Mohanavalli;Ganesan, Ilango;Kannan, Radhika;Kumar, Rajesh
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.42 no.2
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    • pp.99-104
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    • 2016
  • Objectives: Submental intubation has been advocated as an alternative to classical tracheostomy for certain indicated panfacial trauma surgeries. Surgeons should have various options for airway management in maxillofacial trauma patients. Most maxillofacial injuries involve occlusal derangements, which might require intraoperative occlusal corrections; hence, orotracheal intubation is not ideal. Maxillofacial surgeons generally prefer nasotracheal intubation; however, in cases with concomitant skull base fracture or nasal bone fracture, nasotracheal intubation might not be suitable; in these situations, tracheostomy is typically performed. However, the possible complications of tracheostomy are well known. Due to trauma situations and to avoid the complications of tracheostomy, submental intubation would be an ideal alternative procedure in selected maxillofacial trauma surgery patients. This study aimed to evaluate the safety and usefulness of a submental intubation technique for panfacial trauma surgery. Moreover, we intended to share our experience of submental intubation and to recommend this simple, safe procedure for certain panfacial trauma surgeries. Materials and Methods: In five panfacial trauma patients, we performed submental intubation for airway management; the mean time required for the procedure was only eight minutes. Results: We were able to execute this procedure safely in a short time without any intraoperative or postoperative complications. Conclusion: Submental intubation is a safe and simple technique for airway management in indicated panfacial trauma surgery patients.

Study on the Development of Home Care Nursing Intervention Protocol for Stroke Patients (뇌졸중 환자의 가정간호중재 프로토콜 개발)

  • Yoo Ji-Soo
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.7 no.1
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    • pp.122-136
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    • 2000
  • Stroke patient needs rehabilitation after receiving an acute treatment in a hospital. When stroke patient gets involved in an early discharge program, home care nurse plays a pivotal role to make them to gain a full strength and to come back to his/her prior life before he/she is sick. In spite of the importance of home care nursing intervention protocol for home care nurses to perform home care nursing autonomously, home care nursing intervention protocol for stroke patient is rarely developed. Therefore this study was conducted to develop home care nursing protocol that is applicable for stroke patients in home care nursing area. 41 home care nursing charts for stroke patients registered in home care nursing agencies from December 1st 1994 to August 31st 1999 at Y hospitals in Seoul and Won-Ju city were analyzed. 44 home care nurses who were having over three years' experience on stroke patients were participated in this study as a user validity validation group. The results of this study are as follows. 1. 28 nursing diagnoses were selected on the basis of evaluation of nursing diagnoses of stroke patients presented in a previous literature and case studies on home care nursing. 2. 17 nursing diagnoses were classified through the frequency analysis of home care nursing charts for 41 stroke patients who had received home care nursing. The order of sequence was like these: impaired skin integrity, risk for infection, nutritional deficit, impaired physical mobility, constipation, knowledge deficit, ineffective airway clearance, anxiety in family members, risk for aspiration, self care deficit, altered urinary elimination, ineffective individual coping, social isolation, risk for injury, self-esteem disturbance, impaired verbal communication, fatigue of family caregiver. 3. Based on validation on expert and user validities, 44 nursing interventions which were above ICV=.80 were chosen. 4. Nursing intervention protocols which showed above ICV=.90 were developed and were like these; pressure ulcer care, position change, preventive care for circulatory dysfunction, tube care : catheter, vital sign monitor, constipation/impaction management, artificial airway management, suction of airway secretion, environmental management : safety, and fall prevention.

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Awareness level of basic emergency treatment by airline cabin crew (항공기 승무원의 기본응급처치 의식 조사)

  • Rho, Sang-Gyun;Lee, Jae-Gook;Lee, Jung-Hyun;Kim, Jee-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.9
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    • pp.4075-4082
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    • 2011
  • In the event of the emergency patient care, cabin crew must take the charge of the first responder quickly. The basic emergency treatment knowledge of the cabin crew consisted of 80.5%~97.8% when the emergency scene showed up in the passenger and the types of emergency care with that the cabin crew could cope were bleeding control, fever, seizures, myocardial infarction, airway management, and partial airway obstruction management. Considering these cares, the improper emergency types revealed approximately 3.2%~20.0%. In airway obstruction there was followed by loss of consciousness and this led to cardiac arrest. In case of cardiac arrest, the cabin crew must know how to check breathing and to use the automated external defibrillator(AED). The life-threatening cardiac arrest can happen to any passenger in any time, so the cabin crew should meet with the emergency accident and apply the AED to the cardiac arrest victim.