The difficult airway involves the complex interaction between patient factors, the clinical setting and the practitioner's skills (Apfelbaum in Anesthesiology 118(2):251-70, 2013 and Mark et al. in Anesth Analg 121(1):127-139, 2015). It can also be a result of preparedness and system failures. Our institution developed a protocol to enhance emergency airway management in settings outside of the operating theatre-the difficult airway (DA) team. The aims of this report are to perform a retrospective review to describe the patient profiles as well as our difficult airway code workflow, and to identify preliminary patterns within DAC activations over an 18-month period (September 2013 to November 2015) in a tertiary university hospital. We believe that these findings may aid institutions in establishing a difficult airway protocol or refining existing airway code workflows. Institutional board approval was granted for medical record review.
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http://dx.doi.org/10.1007/s11845-020-02471-5 | DOI Listing |
CJEM
January 2025
School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada.
Background: Management of the adult airway is one of the most stressful and time-critical procedures in emergency medicine. In the Cowichan District Hospital, a rural hospital in British Columbia, Emergency Department (ED) staff were uncomfortable with acquiring the equipment needed for adult advanced airway management and the mean length of time to acquire the equipment was 319 s. The aim of this quality improvement (QI) project was to decrease the time to obtain the equipment needed for adult advanced airway management by nurses and physicians in the Cowichan District Hospital ED to less than 90 s by May 2023.
View Article and Find Full Text PDFCJEM
January 2025
Department of Emergency Medicine, Dalhousie University, Halifax, NS, Canada.
Despite awake tracheal intubation being considered the safest method of intubation for patients with predicted difficult airways, there is limited evidence and poor availability of training interventions to assist emergency medicine physicians achieve competency in this technique. Here, we describe a novel, cadaver-based course for emergency medicine physicians to acquire skills in awake tracheal intubation. A convenience sample of 15 emergency medicine physicians from across Canada participated in the pilot course.
View Article and Find Full Text PDFJ Neurosurg Anesthesiol
January 2025
Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Republic of Korea.
Background: Predictors of difficult fiberscopic intubation have not been fully elucidated. This study focused on identifying radiographic predictors of difficult fiberscopic intubation during general anesthesia in patients with a cervical collar.
Methods: This retrospective study included unconscious patients who underwent orotracheal intubation using a flexible fiberscope while wearing a cervical collar to simulate a difficult airway.
Front Oncol
December 2024
Department of Anesthesiology, Peking Union Medical College Hospital, Beijing, China.
Background: The anesthetic management of patients with glucagonoma is complicated by a number of factors including glucose fluctuation, characterized necrolytic migratory erythema in oral and pharyngeal, which may lead to an unexpected difficult airway.
Case Presentation: Herein we describe the anesthetic considerations and management of a 47-year-old adult with glucagonoma, who presented for a laparoscopic splenectomy and distal pancreatectomy procedure.
Conclusion: This report details fiberoptic intubation in an adult with glucagonoma and necrolytic migratory erythema.
Tuberk Toraks
December 2024
Division of Pediatric Pulmonology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Türkiye.
Allergic bronchopulmonary aspergillosis (ABPA) is a complex hypersensitivity reaction observed in asthma as well as cystic fibrosis (CF) patients due to the colonization of the airways by Aspergillus fumigatus. While ABPA is most commonly observed in CF patients (2-9%), it is seen at a rate of 1-2% in patients diagnosed with asthma. ABPA is mostly seen in steroid dependent adult asthma patients and has rarely been reported in pediatric asthma patients.
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