Ultrasound comparison of external and internal neck anatomy with the LMA Unique.

Introduction: Internal neck anatomy landmarks and their relation after placement of an extraglottic airway devices have not been studied extensively by the use of ultrasound. Based on our group experience with external landmarks as well as internal landmarks evaluation with other techniques, we aimed use ultrasound to analyze the internal neck anatomy landmarks and the related changes due to the placement of the Laryngeal Mask Airway Unique.

Methods: Observational pilot investigation.

Laryngo-tracheal ultrasonography to confirm correct endotracheal tube and laryngeal mask airway placement.

Waveform capnography was recommended as the most reliable method to confirm correct endotracheal tube or laryngeal mask airway placements. However, capnography may be unreliable during cardiopulmonary resuscitation and during low flow states. It may lead to an unnecessary removal of a well-placed endotracheal tube, re-intubation and interruption of chest compressions.

Models to teach lung sonopathology and ultrasound-guided thoracentesis.

Lung sonography allows rapid diagnosis of lung emergencies such as pulmonary edema, hemothorax or pneumothorax. The ability to timely diagnose an intraoperative pneumothorax is an important skill for the anesthesiologist. However, lung ultrasound exams require an interpretation of not only real images but also complex acoustic artifacts such as A-lines and B-lines.

Teaching ultrasound procedural skills-low cost phantoms and animal models.

Acquiring the necessary cognitive and psychomotor skills to perform ultrasound guided procedures may require initial training. Growing evidence shows that simulation can help in the acquisition of procedural skills. Commercially available phantoms are expensive, have non-tissue like haptics, are preformed with fixed targets and do not allow for additional targets to be imbedded.

Submandibular sonography: assessment of hyomental distances and ratio, tongue size, and floor of the mouth musculature using portable sonography.

Objectives: The aim of this study was to evaluate the feasibility of sonography as a tool to measure the hyomental distance ratio and tongue size in obese patients with a large neck circumference. The hyomental distance ratio is a predictor of difficult laryngoscopy that may result in difficult intubation.

Methods: Five obese and 7 morbidly obese adult patients with a history of either difficult or easy intubation had a submandibular sonographic examination performed in the supine position.