How to open the airway is an essential skill that every health provider should know. Of all the airway skills, it’s the easiest to master and the most likely to save lives in respiratory distress and failure. This article details recognizing airway obstruction, techniques to open the airway, and insertion of Read More …
Discussion of how to open an airway using lateral neck X-rays to demonstrate how positioning the head and neck can either open or obstruct the airway. Read More …
In many ways pediatric anatomy and physiology predisposes a child to respiratory distress and respiratory failure. Inefficient mechanics of breathing is one major risk factor for infants and young children. This article discusses the ways the anatomy of a child creates inefficient mechanics of breathing and predisposes to respiratory distress and failure. Read More …
An emergency department physician I met the other day shared with me an experience from her hospital that offers a good example of the fact that there are many different ways of managing an airway emergency in a child that don’t involve intubation. Medical management can sometimes avoid some of the risks of losing the airway that intubation might impose. Read More …
A case of “can’t intubate- can’t ventilate is discussed which illustrates the importance of always using good techniques of basic airway management. Read More …
Needle cricothyrotomy or percutaneous transtracheal jet ventilation (PCJV) can truly be a life saving procedure. It is a fast, effective way of providing oxygen to a patient with an obstructed airway who does not respond to more conventional means of opening the airway. The “can’t intubate-can’t ventilate” scenario is a good example. PCJV is faster to perform than a surgical airway. It will buy you time to establish a more permanent airway such as an intubation or surgical airway if the patient is hypoxic.
However, PCJV carries some rare though potentially serious risks of worsening airway obstruction and cardiovascular collapse if the catheter is not correctly positioned within the trachea. Fear may prevent us from using it. In addition, most of us have never had to use PCJV in an emergency or even seen it used. Lack of familiarity with the equipment and simple lack of comfort may make us hesitate to try. We may not even think about it in the moment of crisis. So let’s look at some of the ways we can use PCJV safely. Read More …
Airway obstruction, one of the most serious and potentially life-threatening problems a patient can have, can occur in any patient given the right combination of mental and physical conditions. Respiratory insufficiency and failure from both upper or lower airway obstruction share many of the same symptoms and signs. Being able to recognize the signs of airway obstruction may save your patient’s life. Read More …
One of the more frightening events in anesthesia is laryngospasm: the protective, reflex, spasmodic closure of the vocal cords that occurs when the vocal cords are stimulated. This article discusses the mechanism of laryngospasm, and how to treat it. Read More …