• Title/Summary/Keyword: airway management

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DENTAL TRAUMA FROM OROPHARYNGEAL AIRWAY IN CHILDREN WITH THE HYPOXIC ISCHEMIC ENCEPHALOPATHY : CASE REPORTS (저산소성 허혈성 뇌병변 환아에서 구인두 기도유지기에 의한 치아 손상 : 증례보고)

  • Lee, Mi-Yeon;Shin, Teo-Jeon;Hyun, Hong-Keun;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taeg;Kim, Chong-Chul;Lee, Sang-Hoon
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.9 no.2
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    • pp.127-130
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    • 2013
  • Hypoxic ischemic encephalopathy (HIE) is an important cause of permanent damage to central nervous system cells, most cases with oxygen deprivation in the nenonate due to birth asphyxia. Survival children with HIE develop problems such as cerebral palsy, mental retardation, learning difficulties, and other permanent neuro-developmental disabilities. This article report two cases of the children with HIE who had be traumatized on their teeth from oropharyngeal airway (OPA) in the emergency situation. The patients with the disease accompanying seizure or convulsion, needs special consideration for the prevention from dental trauma in emergency airway management.

Effect of adenotonsillar hypertrophy on right ventricle function in children

  • Lee, Jin Hwan;Yoon, Jung Min;Lim, Jae Woo;Ko, Kyung Og;Choi, Seong Jun;Kim, Jong-Yeup;Cheon, Eun Jung
    • Clinical and Experimental Pediatrics
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    • v.57 no.11
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    • pp.484-488
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    • 2014
  • Purpose: Chronic upper airway obstruction causes hypoxemic pulmonary vasoconstriction, which may lead to right ventricle (RV) dysfunction. Adenotonsillar hypertrophy (ATH) is the most common cause of upper airway obstruction in children. Therefore, we aimed to evaluate RV function in children with ATH. Methods: Twenty-one children (male/female, 15/6; mean age, $92.3{\pm}39.0$ months; age range, 4-15 years) with ATH and 21 healthy age- and gender-matched controls were included in this study. Tricuspid annular plane systolic excursion and RV myocardial performance index were measured by transthoracic echocardiography. Further, the plasma level of N-terminal of probrain natriuretic peptide (NT-proBNP), an indicator of RV function, was determined. Results: The snoring-tiredness during daytime-observed apnea-high blood pressure (STOP) questionnaire was completed by the patients' parents, and loud snoring was noted in the ATH group. The plasma NT-proBNP level was significantly higher in the ATH group than that in the controls ($66.44{\pm}37.63pg/mL$ vs. $27.85{\pm}8.89pg/mL$, P=0.001). The echocardiographic parameters were not significantly different between the groups. Conclusion: We were unable to confirm the significance of echocardiographic evidence of RV dysfunction in the management of children with ATH. However, the plasma NT-proBNP level was significantly higher in the ATH group than that in the control, suggesting that chronic airway obstruction in children may carry a risk for cardiac dysfunction. Therefore, more patients should be examined using transthoracic echocardiography. In addition, pediatricians and otolaryngologists should consider cardiologic aspects during the management of children with severe ATH.

Design and Implementation of RFID-based Airway Logistics System for Ubiquitous Environments (유비쿼터스 환경을 위한 RFID 기반의 항공 물류 시스템의 설계 및 구현)

  • Jang, Sung-Ho;Ma, Yong-Beom;Noh, Chang-Hyeon;Park, Yang-Jae;Kim, Kyo-Hyeon;Cha, Heung-Suk;Lee, Jong-Sik;Kim, Jea-Moung
    • Journal of the Korea Society of Computer and Information
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    • v.12 no.6
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    • pp.297-306
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    • 2007
  • Bar-code based airway logistics systems have many problems like freight loss and data management error due to semiskilled air-cargo process and individual information system. To solve these problems, this paper analyzed how to process an air-cargo practically and designed and implemented the RFID-based airway logistics system. This system has an information service system which manages data from RFID systems in realtime and provides a communication interface for data sharing. And, this system precesses data queries from capture applications and access applications to provide various services to users such as the freight track and trace service. Also, this system includes a H/H reader agent to integrate existing bar-cord systems. It allows us to realize automation and information-oriented air-cargo process and achieve improvement of air-cargo services with reduction of freight loss and management error.

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The Response of Parenchymal Mass and Airway Obstruction from Lung Cancer to Radiation Therapy (단순 흉부 X-선 사진상 폐암 소견에 대한 방사선 치료의 효과 -단기 추적 조사를 중심으로-)

  • Kang, Cheol-Hoon;Shin, Sei-One;Kim, Myung-Se
    • Radiation Oncology Journal
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    • v.7 no.2
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    • pp.227-233
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    • 1989
  • From April 1986 to Dec 1988, fifty one patients with carcinoma of lung were treated by radiation therapy in Department of Therapeutic Radiology, Yeungnam University Hospital Of the 51 patients, $31(61\%)$ were squamous cell ca, $8(15.7\%)$ were small cell ca, and remained $4(7.9\%)$ were other cell types. Total radiation dose was average $64Gy (60\~75 Gy)$ for group A and 45Gy $(40\~59Gy)$ for group B. The mass regression and the response of airway obstruction to radiation therapy was established on the basis of follow up chest X-ray. The mass regression above $50\%$ of total volume was noted in 23 patients $(74.2\%)$ among 31 patients and the difference between two groups was not seen. In squamous cell ca, however, the mass regression rate (above $50\%$ of total volume) was $83.3\%$ (10/12) in group A compared to $50\%$ (3/6) in group B(p<0.05). The alleviation of airway obstruction was noted as follows. In group A, CR $42.9\%$, PR $35.7\%$, no response $21.4\%$ and in group B, CR $55.6\%,\;PR\;33.3\%$, no response $11.1\%$. But, in squamous cell ca, responsiveness is higher than group B. The study indicates that the importance of higher radiation dose in the management of primary tumor mass and airway obstruction caused by lung cancer especially squamous cell ca. So, meticulous treatment planning and multimodality combination therapy without increasing si.do elect or complication is recommended in management of inoperable bronchogenic carcinoma.

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Laryngeal Inhalation Injury (흡인성 화상에 의한 후두 손상)

  • 조정일;김영모;임정혁;김용재;이철우;이명택
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.12 no.1
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    • pp.11-16
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    • 2001
  • Background and Objectives : A burn injury to the glottis differs from a burn injury to the trachea, bronchi, and lung parenchyma, in that thermal injury does not occur to any significant degree below the level of the larynx, due to the effective cooling of air by the upper airway and to reflex closure of the vocal cords from a blast of hot air. Therefore, the laryngeal inhalation injury give rise to airway problem and voice change. The objectives of this study is to assess management of laryngeal inhalation injury and voice change after management. Materials and Methods : Voice choses and laryngeal injuries of eight laryngeal inhalation patients were analyzed through questionnaire, voice dynamic laboratory, and laryngeal stroboscopy. Operative management was performed to five patients for airway patiency and vocal cord movement on laryngeal pathology ind voice therapy was performed to all patients. One-year after, voice changes and laryngeal injuries were reanalyzed with same methods. Results : Vocal breathiness, decreased voice intensity, reduced voice range, and easy fatigability were major complaints of laryngeal inhalation patients. Glottic stenosis were developed to five of eight patients, and vocal cord atrophy, bowing were developed to others. Vocal cord mucosal waves were significantly decreased in all patients. Jitter(%), Shimmer(dB) were increased and Maximal phonation time(MPT) was decreased. One-year after, subjective voice changes and objective voice parameters were improved. And vocal cord mucosal waves were recovered in all patients. Conclusions : Subjective voice quality and objective voice parameters were improved after operative management for laryngeal pathology and voice therapy. And we observed recovery of vocal fold mucosal waves by laryngeal stroboscopy. We think that early preventable tracheotomy is necessary to reduce the laryngeal contact injury in laryngeal inhalation patients.

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A Study on Nursing Diagnoses, Interventions, Outcomes Frequently Used and Linkage to NANDA-NOC-NIC in Major Nursing Departments (간호 대상자별 다빈도 간호진단, 간호중재, 간호결과 및 연계 체계조사)

  • Kim, Jong-Kyung
    • Journal of Korean Academy of Nursing Administration
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    • v.16 no.2
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    • pp.121-142
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    • 2010
  • Purpose: The purpose of this study was to identify NANDA, NIC, and NOC frequently used and their linkages in major nursing departments for development of the nursing process and nursing management system. Methods: This study was a descriptive study. Data were collected from 123 nurses who worked in medical, surgical, pediatric, gynecologic, and psychiatric department. The questionnaire was based on the NANDA, NOC, NIC, and NANDA-NOC-NIC linkage system. This research was analyzed by an EXCEL program and SPSS $Pc^{+}15.0$. Results: Nursing diagnoses frequently used were 'anxiety', 'disturbed sleep pattern', 'activity intolerance', 'social isolation', 'nausea', 'ineffective airway clearance', 'chronic pain', nursing outcomes frequently used were 'thermoregulation', 'bowel elimination', 'pain control', 'vital sign status', 'pain level', and nursing interventions frequently used were 'nausea management', 'airway suctioning', 'bowel elimination management', 'diarrhea management', 'medication management'. NANDA-NOC-NIC linkages in major nursing departments were recognized, and these results were similar to the results of other researches. Conclusion: The results of this study will be provided as a guideline to apply to the nursing process and development of the nursing process system with the NANDA-NOC-NIC linkage in major nursing department.

Pre-hospitalization Advanced Airway Management Using The KING LTS-DTM and the LMA ProSealTM (LTS와 LMA를 이용한 병원 전 전문 기도 관리 연구)

  • Choi, Uk-Jin;Shim, Gyu-Sik
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.12
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    • pp.5893-5900
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    • 2012
  • It is very critical to promptly maintain airway of cardiac arrest cases or serious traumatic cases. The purpose of this study is to compare intubation rate, successful rate and pre-/post-education self-confidence between laryngeal tube (LTS) and proseal laryngeal mask (PLMA), so that it may contribute to improving the ability of 119 emergency team - a pivotal role in pre-hospitalization process - to carry out advanced airway management. In order to achieve the purpose, total 60 paramedics (Class I) who worked for incumbent 119 emergency team were asked to join a practical experiment and were also divided into two groups (LTS group: 30 people, PLMA group: 30 people). In details, they were all asked to take 3 sessions of practice (5 minutes per session) using dummy model to quantitatively measure the time and success/failure of intubation and the change of their self-confidence. As a result, it was found that there were statistically significant differences in the time of intubation between LTS and PLMA group (p=.000), but there was no significant difference in the rate of successful intubation between these two groups, and self-confidence of two groups tended to significantly increase after experiment (p=.000). Conclusively, if it is necessary to promptly apply intubation to traumatic cases with immobilized cervical vertebral and lingual edema, LTS can be useful as an effective means of intubation. And it is expected that continuing intubation training using LTS will improve the ability of emergency team to perform advanced airway management for traumatic cases.

Clinical Experience of Silicone Airway Stent in the Management of Benign Tracheobronchial Stenosis (양성 기도협착질환에서 실리콘 기도스텐트의 임상경험 - Dumon 스텐트와 Natural 스텐트의 비교 -)

  • Ryu, Yon Ju;Yu, Chang-Min;Choi, Jae Chul;Kwon, Yong Soo;Kim, Hojoong;Kim, Jhingook;Suh, Soo Won
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.1
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    • pp.62-68
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    • 2005
  • Background : The clinical results of a Natural stent in patients with a benign tracheobronchial stenosis were examined by comparing the clinical outcomes and complications of those patients who underwent Dumon and Natural stenting in the management of benign airway stenosis. Methods : The medical records of 94 patients (39 Dumon and 55 Natural stent) with a benign tracheobronchial stenosis were reviewed and analyzed. Results : Post-tuberculous stenosis was the leading indication for airway stenting (74%), which was followed by post-intubation stenosis (21%). After intervention, the dyspnea had improved among those patients who underwent Dumon (90%) and Natural (86%) stenting. After stabilizing the dyspnea, the stent could be successfully removed in half of the patients who underwent both Dumon (54%) and Natural (49%) stenting. During the 42 month follow-up period, the complication rate was similar in those patients who underwent Dumon and Natural stenting: migration (46% vs 53%), granulation tissue formation (36% vs 49%), mucostasis (21% vs 16%) and restenosis (51% vs 36%). Conclusion : The clinical results of Natural airway stent was similar to those of Dumon stent in the management of benign tracheobronchial stenosis.

Non-Surgical Management of Critically Compromised Airway Due to Dilatation of Interposed Colon

  • Min, Jinsoo;Cho, Young-Jae
    • Tuberculosis and Respiratory Diseases
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    • v.79 no.2
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    • pp.98-100
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    • 2016
  • We present a rare case of critically compromised airway secondary to a massively dilated sequestered colon conduit after several revision surgeries. A 71-year-old male patient had several operations after the diagnosis of gastric cancer. After initial treatment of pneumonia in the pulmonology department, he was transferred to the surgery department for feeding jejunostomy because of recurrent aspiration. However, he had respiratory failure requiring mechanical ventilation. The chest computed tomography (CT) scan showed pneumonic consolidation at both lower lungs and massive dilatation of the substernal interposed colon compressing the trachea. The dilated interposed colon was originated from the right colon, which was sequestered after the recent esophageal reconstruction with left colon interposition resulting blind pouch at both ends. It was treated with CT-guided pigtail catheter drainage via right supraclavicular route, which was left in place for 2 weeks, and then removed. The patient remained well clinically, and was discharged home.

Airway management in a displaced comminuted fracture of the mandible and atlas with a vertebral artery injury: A case report

  • Paramaswamy, Rathna
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.18 no.3
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    • pp.183-187
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    • 2018
  • Complex cervical spine fractures are a serious complications of maxillofacial trauma and associated with high mortality and neurological morbidity. Strict vigilance in preventing further insult to the cervical spine is a crucial step in managing patients who are at risk for neurologic compromise. We report a rare case of a right transverse process of atlas fracture with right-sided vertebral artery injury that was associated with a comminuted fracture of the body and angle of the mandible, which restricted mouth opening. Airway management was performed by an awake fiber-optic nasotracheal intubation, where neck movement was avoided with a cervical collar. Vertebral artery injuries may have disastrous consequences, such as basilar territory infarction and death, and should be suspected in patients with head and neck trauma. After mandibular plating, the patient was on cervical collar immobilization for 12 weeks and anti-coagulant therapy.