The Difficult Airway. The Difficult Airway. Difficult Airway Algorithms: ASA. Ectopic Anesthesia. Cancel Case. Awaken. airway. Defining ng the problem
|
|
- Clara Mitchell
- 8 years ago
- Views:
Transcription
1 The Difficult Airway The Difficult Airway Robert J. Vissers, MD FACEP Department of Emergency Medicine Legacy, Emanuel Hospital Defining ng the problem Defining ng the difficult d airway a Identifying ng the difficult d airway a Managing ng the difficult d airway a Difficult Airway Algorithms: ASA Cancel Case Fig 1 ASA DIFFICULT A AIRWAY ALGORITHM Anesthesiology 1996;84:686 Awaken Ectopic Anesthesia Problem: Urgency Cost of failure Formula for error 1
2 Emergency Airway Management Solution: Preparation Anticipate difficulties Simple, consistent, reproducible approach Difficult Airway Algorithms Common principles Assessment of ventilation difficulty Assessment of intubation difficulty Awake vs. induction and paralysis Calling for help Surgical airway is a potential endpoint Decision to intubate Approach to the Emergency Airway Decision to intubate Decision to Intubate Near death? Unresponsive? Difficult Airway? Rapid Sequence Intubation Crash Airway Difficult Airway Techniques Failed Airway Airway maintenance Oxygenation Ventilation Facilitate therapy Expected course Adapted from: Walls RM, Ed. The Manual of Emergency Airway Management Philadelphia, Lippincott,
3 Decision to Intubate: Modifiers Operator experience Setting Potential for a difficult airway Never take away what you cannot replace National Emergency Airway Registry (NEAR) Prospective airway registry n = 12,000 <1% fail rate with RSI Cricothyrotomy rate 0.6% No cases of cannot intubate, cannot ventilate with death The Difficult Airway DIFFICULT BAG AND MASK VENTILATION DIFFICULT LARYNGOSCOPY AND INTUBATION DIFFICULT CRICOTHYROTOMY SAKLES TRIANGLE 3
4 The Difficult Airway Assessment of Difficult BVM DIFFICULT BAG AND MASK VENTILATION DIFFICULT LARYNGOSCOPY AND INTUBATION DIFFICULT CRICOTHYROTOMY SAKLES TRIANGLE Assessment of Difficult BVM Consider potential difficulty of BVM ventilation before RSI Beware the full stomach Equipment out and ready Five predictors of difficult BVM: facial hair, obesity, adentulous,, elderly, snoring * *Langeron O, et al. Anesthesiology, Assessment of Difficult BVM: Bones M ask seal O besity/obstruction A ge > 55 N o teeth S tiff lungs 4
5 The Difficult Airway DIFFICULT BAG AND MASK VENTILATION DIFFICULT LARYNGOSCOPY AND INTUBATION DIFFICULT CRICOTHYROTOMY SAKLES TRIANGLE Assessment of Difficult Intubation Laryngoscopic view (Cormack-Lehane) too late Systems too complex, impractical Need simple, fast approach 5
6 Difficult Airway? LEMON Law L ook externally E xamine (3-3-2) M allampati grade O bstruction N eck mobility Adapted from: Walls RM, Ed. The Manual of Emergency Airway Management Philadelphia, Lippincott, Cognitive forcing strategies in clinical decisionmaking. P Croskerry. Ann Emerg Med Jan, LEMON: Look Simple visual inspection often reveals obvious potential difficulties 6
7 LEMON: Examine Assess oral opening - 3 fingers Measure the mandible - 3 fingers Position of larynx - 2 fingers LEMON: Examine Assess oral opening should be able to accommodate 3 fingers LEMON: Examine Measure the mandible - should be able to fit 3 fingers between the mentum and the hyoid bone 7
8 LEMON: Examine Assess position of larynx should get 2 fingers between the thyroid cartilage and the mandible 8
9 LEMON: Mallampati Class I Class II Class III Class IV LEMON: Obstruction? 1) Location? 2) Fixed or mobile? 3) Speed of progression? 9
10 LEMON: Neck Mobility Can the patient flex and extend the neck? Actively assess in the non-trauma obtunded patient. Cervical spine immobilization - remove anterior collar while c-spine c is immobilized. 10
11 LEMON Law L ook externally E xamine (3-3-2) M allampati grade O bstruction N eck mobility LEMON: Predictive? 156 ED patients requiring intubation Scored using LEMON Simple point system used (0 to 10) Compared to laryngoscopic view (Cormack Lehane) Felt to be predictive, P<0.05 Reed MJ et al. Can an airway assessment score predict difficulty at intubation in the emergency department? Emerg Med J 2005 Feb; 22:
12 LEMON: Predictive? Reed MJ et al. Can an airway assessment score predict difficulty at intubation in the emergency department? Emerg Med J 2005 Feb; 22: Airway alternatives Nasal Supraglottic: Infraglottic: ZIST BNTI Fiberoptics BVM Intubating LMA Lightwand Glidescope Fiberoptics Bougie Combitube King-LT TTJV Cricothyrotomy Zone of Increasing Sphincter Tone 12
13 Rescue Devices Combitube Most require oral access Most are designed to deal with high anterior cords I-LMA, King-LT, Combitube Intubating stylet (bougie, frova,, etc.) Video - glidescope King-LT I-LMA 13
14 Video Laryngoscopy LMA CTrach Glidescope 14
15 Pediatric Asthmatic Preoxygenation: Desaturation Beginning to fatigue Sats dropping Needs to be intubated 6 ml/kg/min 3.4 ml/kg/min From: Benumof JL: Anesthesiology 87: , Preoxygenation: Desaturation 15
16 Awake look/scopes Antisyalogogue atropine or glycopyrrolate Anesthesia lidocaine (2-4%), benzocaine Decongestant oxymetazoline (afrin) Nebulize,, atomize (MADgic ), viscous Sedation ketamine,, versed Agitated Burn Case 42-year-old woman set herself on fire in her car. Uncooperative, yelling let me die % burns, mostly 3, 3, to face, trunk, anterior arms and thighs. Unable to get a BP or O2 sat. 16
17 Intubating Stylet/Bougie Clinical Issues: Agitated Patient Assessment of the difficult airway beware ego, fear, urgency The agitated or violent trauma patient Haldol, Droperidol, Midazolam, Ketamine 5 yo girl, choked on peanuts last night Unable to sleep, trouble breathing Looks tired, resp distress, tripod Oh, nuts 17
18 Airway alternatives Nasal Supraglottic: Infraglottic: ZIST BNTI Fiberoptics BVM Intubating LMA Lightwand Glidescope Fiberoptics Bougie Combitube King-LT TTJV Cricothyrotomy Zone of Increasing Sphincter Tone 18
19 No landmarks? Cricothyroid membrane under the 4 th finger The tongue is your friend find it and follow it to the glottis Suction,, suction, suction 4-finger rule for the cricothyroid membrane 19
20 Consider surgical airway early Summary Organized, rapid, simple approach Assess for difficult ventilation BONES Assess for difficult intubation LEMON 20
21 Obese asthmatic 21
AIRWAY MANAGEMENT. Angkana Lurngnateetape, MD. Department of Anesthesiology Siriraj Hospital
AIRWAY MANAGEMENT Angkana Lurngnateetape, MD. Department of Anesthesiology Siriraj Hospital Perhaps the most important responsibility of the anesthesiologist is management of the patient s airway Miller
More informationAIRWAY MANAGEMENT IN THE CRITICALLY ILL. Robert J. Vissers MD High Risk Emergency Medicine Hawaii, 2012
AIRWAY MANAGEMENT IN THE CRITICALLY ILL Robert J. Vissers MD High Risk Emergency Medicine Hawaii, 2012 Objectives Review the optimal airway management for the crashing patient in the ED Prevent the complications
More informationContinued on next page
Resident Journal Review An Update on Airway Management in Emergency Medicine Authors: Michael Allison, MD; Michael Scott, MD; Kami Hu, MD; David Bostick, MD; Daniel Boutsikaris, MD Edited by: Michael C.
More informationAirway assessment. Bran Retnasingham Andy McKechnie
Airway assessment Bran Retnasingham Andy McKechnie The average Camberwell patient? Airway assessment There is one skill above all else that an anaesthetist is expected to exhibit and that is to
More informationAcute Respiratory Failure
Acute Respiratory Failure Family Medicine Update Big Sky, Montana January, 2014 Mark Tieszen, MD, FCCM, FCCP Sanford Medical Center Fargo Critical Care Medicine mark.tieszen@sanfordhealth.org Acute Respiratory
More informationRapid Sequence Intubation in Pre-Hospital Care
Rapid Sequence Intubation in Pre-Hospital Care Dr Adam Chesters Specialist Registrar in Emergency Medicine and Pre-Hospital Care London s Air Ambulance CV University of Leicester Medical School Emergency
More informationAEROSPACE MEDICAL SERVICE SPECIALTY INDEPENDENT DUTY MEDICAL TECHNICIAN EMERGENCY MEDICINE PROCEDURES
QTP4N0X1C-9 02 July 2015 AEROSPACE MEDICAL SERVICE SPECIALTY INDEPENDENT DUTY MEDICAL TECHNICIAN EMERGENCY MEDICINE PROCEDURES Volume 9 TOTAL FORCE, TOTAL CARE EVERYTIME, ANYWHERE 383d TRAINING SQUADRON/XUFB
More informationLaryngeal Mask Airways (LMA), Indications and Use for the Pre-Hospital Provider. www.umke.org
Laryngeal Mask Airways (LMA), Indications and Use for the Pre-Hospital Provider Objectives: Identify the indications, contraindications and side effects of LMA use. Identify the equipment necessary for
More informationPHSW Procedural Sedation Post-Test Answer Key. For the following questions, circle the letter of the correct answer(s) or the word true or false.
PHSW Procedural Sedation Post-Test Answer Key 1 1. Define Procedural (Conscious) Sedation: A medically controlled state of depressed consciousness where the patient retains the ability to continuously
More informationDepartment of Anesthesiology and Pain Medicine and Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea
Clinical Research Article Korean J Anesthesiol 2010 November 59(5): 314-318 DOI: 10.4097/kjae.2010.59.5.314 Comparison of the laryngeal view during intubation using Airtraq and Macintosh laryngoscopes
More informationNeonatal Intubation. Purpose. Scope. Indications. Equipment Cardiorespiratory monitor SaO 2 monitor. Anatomic Considerations.
Page 1 of 5 Purpose Scope Indications Neonatal Intubation To assure proper placement of endotracheal tubes for maximum ventilation using proper intubation procedures. The policy applies to all Respiratory
More informationPRACTICE Guidelines are systematically developed
Copyright by the American Society of Anesthesiologists. Unauthorized reproduction of this article is prohibited. Special Articles Practice Guidelines for Management
More informationEMS Course Requirements
EMS Course Requirements The following outlines should be followed when creating your course syllabi. The minimum course hours must be met, but they can be exceeded depending on the needs of your class.
More informationGWAS Competency Mapping Levels of Medical Support Within GWAS
GWAS Competency Mapping Levels of Medical Support Within GWAS Great Western Ambulance Service NHS Trust is pleased to be able to work with a range of doctors in delivering effective pre-hospital care.
More informationAirway Management. J. D Urbano. For the Respiratory Therapist. Because at the Head of Every Team is a Respiratory Therapist
Airway Management For the Respiratory Therapist J. D Urbano Respiratory Therapists are highly trained and specialized members of the allied healthcare arsenal. They deal directly with patients who suffer
More informationENT Emergencies. Injuries of the Neck. Registrar Dept Trauma and emergency Medicine Tygerberg Hospital
ENT Emergencies Injuries of the Neck Registrar Dept Trauma and emergency Medicine Tygerberg Hospital Neck Injuries Blunt and Penetrating Trauma Blunt Injuries Blunt trauma direct/indirect Trauma to larynx
More informationFirst Responder: The National EMS Scope of Practice changes the name to Emergency Medical Responder.
APPROVED SCOPE 2/8/08 BOARD MTG First Responder: The National EMS Scope of Practice changes the name to Emergency Medical Responder. Emergency Medical Responder (EMR) Description of the Profession The
More informationAirway Management. J. D Urbano. For the Respiratory Therapist. Because at the Head of Every Team is a Respiratory Therapist
Airway Management For the Respiratory Therapist J. D Urbano Respiratory Therapists are highly trained and specialized members of the allied healthcare arsenal. They deal directly with patients who suffer
More informationUC Davis Medical Center Emergency Medicine Airway Equipment: Contents, Cleaning and Stocking
UC Davis Medical Center Emergency Medicine Airway Equipment: Contents, Cleaning and Stocking Introduction: Due to the large volume of critically ill patients who present for care at the U.C. Davis Emergency
More informationCoventry Airway Management course
Airway workshops The workshops are based on DAS Guidelines for managing un-anticipated difficult intubation. In addition lung isolation techniques workshop is recently introduced to this course. The aim
More informationRapid Sequence Intubation A Guide for Assistants
Rapid Sequence Intubation A Guide for Assistants Working outwith the theatre setting Contents Course Aim...1 Course Objectives...1 Basic Airway Care and Oxygenation...2 Rapid Sequence Intubation...2 Definition...2
More informationVersion 7 Related Documents Monitoring; Handover; Emergency Anaesthesia Alasdair Corfield
Emergency Medical Retrieval Service (EMRS) www.emrs.scot.nhs.uk Standard Operating Procedure Public Distribution Title Patient Documentation Version 7 Related Documents Monitoring; Handover; Emergency
More informationConundrums in Ambulatory Anesthesia I
THE UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER DALLAS Parkland Hospital, Dallas, Texas Conundrums in Ambulatory Anesthesia I Girish P. Joshi, MBBS, MD, FFARCSI Professor of Anesthesiology and Pain
More informationKids, Cars, Falls and Brawls The Pediatric Golden Hour. Kids, Cars, Falls and Brawls The Pediatric Golden Hour. The Pediatric Golden Hour
Kids, Cars, Falls and Brawls Kids, Cars, Falls and Brawls M. Jeffrey Fein RN, CFRN Educator Critical Care Transport Team The Golden Hour The idea has been propagated from intuition and the writings of
More informationPatient Care Services Policy & Procedure Title: No. 8720-0059
Page: 1 of 8 I. SCOPE: This policy applies to Saint Francis Hospital, its employees, medical staff, contractors, patients and visitors regardless of service location or category of patient. This policy
More informationProposed procedure: Insertion of the LMA Supreme for airway management by flight paramedics.
Request for approval of a trial study This document follows Form #EMSA-0391 EMS Medical Director: Dr. Mark Luoto Local EMS Agency: Coastal Valleys EMS Agency Proposed procedure: Insertion of the LMA Supreme
More informationAirway and Breathing Skills Levels Interpretive Guidelines
Office of Emergency Medical Services and Trauma INDEX EFFECTIVE LAST REVIEW PAGES VERSION R-P11A 7/1/2011 7/1/2011 5 2011 Scope of Practice for EMS Personnel Emergency Medical Personnel are permitted to
More informationPatient Assessment/Management Trauma
Patient Assessment/Management Trauma Date: / / Test Site Location: Station #: Takes or verbalizes standard precautions (BSI) if appropriate based on patient scenario SCENE SIZE-UP Determines the scene
More informationPediatric Airway Management
Pediatric Airway Management Dec 2003 Dr. Shapiro I., PICU Adult Chain of Survival EMS CPR ALS Early Defibrillation Pediatric Chain of Survival Prevention CPR EMS ALS Out-of-Hospital Cardiac Arrest SIDS
More informationDifficult Pre-hospital Airway Management
Difficult Pre-hospital Airway Management Frans L. Rutten, MD, FDSA Elisabeth Hospital Tilburg, The Netherlands In management of patients with an emergency, airway management and ventilatory care are the
More informationPerioperative Management of Patients with Obstructive Sleep Apnea. Kalpesh Ganatra,MD Diplomate, American Board of Sleep Medicine
Perioperative Management of Patients with Obstructive Sleep Apnea Kalpesh Ganatra,MD Diplomate, American Board of Sleep Medicine Disclosures. This activity is supported by an education grant from Trivalley
More informationDiagnosis and Treatment
Sleep Apnea: Diagnosis and Treatment Sleep Apnea Sleep Apnea is Common Dangerous Easily recognized Treatable Types of Sleep Disordered Breathing Apnea Cessation of airflow > 10 seconds Hypopnea Decreased
More information4,871 Emergency Airway Encounters by Air Medical Providers: A Report of the Air Transport Emergency Airway Management (NEAR VI: A-TEAM ) Project
4,871 Emergency Airway Encounters by Air Medical Providers: A Report of the Air Transport Emergency Airway Management (NEAR VI: A-TEAM ) Project The Harvard community has made this article openly available.
More informationTOWN OF FAIRFIELD HEALTH DEPARTMENT PUBLIC HEALTH NURSING
TOWN OF FAIRFIELD HEALTH DEPARTMENT PUBLIC HEALTH NURSING PROGRAM: School Health APPROVED BY: Board of Health School Medical Advisor POLICY: With Portable Suction Machine DATE: March 14, 1994 POLICY DEFINITION:
More informationModule 5 ADULT RECOvERY POSITION STEP 1 POSITION ThE victim
Module 5 ADULT RECOVERY POSITION The recovery position is used in the management of victims who are unresponsive but have breathing and pulse. When an unresponsive victim is lying supine, the airway may
More informationUnderwriting Sleep Apnea
Underwriting Sleep Apnea Joel Weiner, MD, FLMI April 29, 2014 WAHLU The Northwestern Mutual Life Insurance Company Milwaukee, WI A Brief Survey Before We Get Started The Weiner Sleepiness Scale How likely
More informationPain Management in the Critically ill Patient
Pain Management in the Critically ill Patient Jim Ducharme MD CM, FRCP President-Elect, IFEM Clinical Professor of Medicine, McMaster University Adjunct Professor of Family Medicine, Queens University
More informationThe EMT Instructional Guidelines in this section include all the topics and material at the EMR level PLUS the following material:
Airway Management, Respiration and Artificial Ventilation EMR Applies knowledge (fundamental depth, foundational breadth) of general anatomy and physiology to assure a patent airway, adequate mechanical
More informationEvaluation of the GlideScope Ò for tracheal intubation in patients with cervical spine immobilisation by a semi-rigid collar
doi:10.1111/j.1365-2044.2009.06075.x Evaluation of the GlideScope Ò for tracheal intubation in patients with cervical spine immobilisation by a semi-rigid collar I. Bathory, 1 P. Frascarolo, 2 C. Kern
More informationAn Evaluation of the Rapid Airway Management Positioner in Obese Patients Undergoing Gastric Bypass or Laparoscopic Gastric Banding Surgery
OBES SURG (2010) 20:1436 1441 DOI 10.1007/s11695-009-9885-8 CASE REPORT An Evaluation of the Rapid Airway Management Positioner in Obese Patients Undergoing Gastric Bypass or Laparoscopic Gastric Banding
More informationNational Registry of Emergency Medical Technicians Emergency Medical Technician Psychomotor Examination BLEEDING CONTROL/SHOCK MANAGEMENT
BLEEDING CONTROL/SHOCK MANAGEMENT Candidate: Examiner: Date: Signature: Possible Applies direct pressure to the wound 1 NOTE: The examiner must now inform the candidate that the wound continues to bleed.
More informationNational Registry of Emergency Medical Technicians Emergency Medical Responder Psychomotor Examination PATIENT ASSESSMENT/MANAGEMENT TRAUMA
PATIENT ASSESSMENT/MANAGEMENT TRAUMA Scenario # Note: Areas denoted by ** may be integrated within sequence of Primary Survey/Resuscitation SCENE SIZE-UP Determines the mechanism of injury/nature of illness
More informationPatient positioning is an important
PRINTER-FRIENDLY VERSION AT ANESTHESIOLOGYNEWS.COM Airway Management and Patient Positioning: A Clinical Perspective DAVIDE CATTANO, MD, PHD Assistant Professor, Medical Director of Anesthesia Clinic Department
More informationDiseases and Health Conditions that can Lead to Daytime Sleepiness
October 21, 2014 Diseases and Health Conditions that can Lead to Daytime Sleepiness Indira Gurubhagavatula, MD, MPH Associate Professor Director, Occupational Sleep Medicine University of Pennsylvania,
More informationCommunity Ambulance Service of Minot ALS Standing Orders Legend
Legend Indicates General Information and Guidelines Indicates Procedures Indicates Medication Administration Indicates Referral to Other Protocol Indicates Referral to Online Medical Direction Pediatric
More informationState of New Hampshire Department of Safety Division of Fire Standards and Training & Emergency Medical Services
State of New Hampshire Department of Safety Division of Fire Standards and Training & Emergency Medical Services September 2013 PATIENT ASSESSMENT / MANAGEMENT - TRAUMA Time allowed: 10 minutes SCENARIO
More informationAEC: INTERMEDIATE to PARAMEDIC PROGRAM MONDAY/WEDNESDAY @ AEC TRAINING CENTER OCTOBER 22, 2015 through JULY 23, 2016
AEC: INTERMEDIATE to PARAMEDIC PROGRAM MONDAY/WEDNESDAY @ AEC TRAINING CENTER OCTOBER 22, 2015 through JULY 23, 2016 Thursday 10/22/15 9a-4p 10/24/15 Orientation/Introduction Ground Ambulance Operations
More informationMedical Coverage Policy Monitored Anesthesia Care (MAC)
Medical Coverage Policy Monitored Anesthesia Care (MAC) Device/Equipment Drug Medical Surgery Test Other Effective Date: 9/1/2004 Policy Last Updated: 1/8/2013 Prospective review is recommended/required.
More informationThe American Society of Anesthesiologists (ASA) has defined MAC as:
Medical Coverage Policy Monitored Anesthesia Care (MAC) sad EFFECTIVE DATE: 09 01 2004 POLICY LAST UPDATED: 11 04 2014 OVERVIEW The intent of this policy is to address anesthesia services for diagnostic
More informationAWAKE FIBREOPTIC INTUBATION THE BASICS ANAESTHESIA TUTORIAL OF THE WEEK 201
AWAKE FIBREOPTIC INTUBATION THE BASICS ANAESTHESIA TUTORIAL OF THE WEEK 201 18 TH OCTOBER 2010 Dr S Kritzinger Registrar in Anaesthetics Pinderfields General Hospital, Wakefield, UK Dr M van Greunen Consultant
More informationVirginia Office of Emergency Medical Services Scope of Practice - Procedures for EMS Personnel
Specific tasks in this document shall refer to the Virginia Education Standards. AIRWAY TECHNIQUES Airway Adjuncts Airway Maneuvers Alternate Airway Devices Cricothyrotomy Obstructed Airway Clearance Intubation
More informationAdministrative Policy and Procedure Policy Number: 300.005
Administrative Policy and Procedure Policy Number: 300.005 Subject: Sedation Page: 1 of 7 Effective: March 3, 1997 Revised: September 18, 2009 Approved: Signed by Kathy Guyette, VP and Chief Nursing Offcier
More informationPROCEDURAL SEDATION/ANALGESIA NCBON Position Statement for RN Practice
PROCEDURAL SEDATION/ANALGESIA NCBON Position Statement for RN Practice P.O. BOX 2129 Raleigh, NC 27602 (919) 782-3211 FAX (919) 781-9461 Nurse Aide II Registry (919) 782-7499 www.ncbon.com Issue: Administration
More informationEnables MDA Medical Teams to categorize victims in mass casualty scenarios, in order to be able to triage and treat casualties
MDA Disposable ALS + BLS Medical Ambulance Equipment Prices shown in CDN. Funds Items Description Picture Mass Casualty ID tag 1000 units = $350 Enables MDA Medical Teams to categorize victims in mass
More informationAIRWAY ASSESSMENT : PREDICTORS OF DIFFICULT AIRWAY
GUPTA, Indian J. Anaesth. SHARMA, 2005; JAIN 49 : (4) AIRWAY : 257-262 ASSESSMENT PREDICTORS OF DIFFICULT AIRWAY 257 AIRWAY ASSESSMENT : PREDICTORS OF DIFFICULT AIRWAY Dr. Sunanda Gupta 1 Dr. Rajesh Sharma
More informationEMERGENCY MEDICAL RESPONDER (EMR) PRACTICAL SKILLS EXAMINATION REPORT State Form 54407 (R / 5-13)
EMERGENCY MEDICAL RESPONDER (EMR) PRACTICAL SKILLS EXAMINATION REPT State Form 54407 (R / 5-3) INDIANA DEPARTMENT OF HOMELAND SECURITY EMERGENCY MEDICAL SERVICES CERTIFICATION 302 West Washington Street,
More informationThe Need for Airway Management Immediately following Traumatic Injury
GUIDELINE Emergency tracheal intubation immediately following traumatic injury: An Eastern Association for the Surgery of Trauma practice management guideline Julie Mayglothling, MD, Therese M. Duane,
More informationDegree of Intervention
Inglewood Care Centre Degree of Intervention Handbook for Residents and Families Index Introduction..................................................... 2 Beliefs, Values, and Wishes.........................................
More informationOne Lung Ventilation Module (OLV)
1 One Lung Ventilation Module (OLV) A Thoracic Surgery Directors Association (TSDA) Cardiothoracic Surgery Resident Boot Camp Syllabus The ability to isolate one of the lungs is an essential skill set
More information- Woody Kageler, M.D.
Dear Parent/Guardian, We all want our children with asthma to be healthy! Asthma can be a frightening experience for kids, as well as their parents. Let Darby BoIngg be your partner, along with your physician,
More information2012 Mississippi EMT Transitional Refresher Curriculum EMT Refresher Training- Curriculum Transition: EMT-Basic EMT Timeline: February 2012-March 2015
2012 Mississippi EMT Transitional Refresher Curriculum EMT Refresher Training- Curriculum Transition: EMT-Basic EMT Timeline: February 2012-March 2015 Introduction This document provides the statewide
More informationScenario 2 Is it ever safe enough?
IRECA BLS Competition 2011 Scenario 2 Is it ever safe enough? Team Name Captain Name Judge 1 Judge 2 The Event: You are dispatched to a shooting for two injured at a local bar. Witnesses have told police
More informationGround Vehicle Supply Requirements for EMR Quick Response Units.
Ground Vehicle Supply Requirements for EMR Quick Response Units. Ring cutters 2 Blood pressure cuffs, one adult, one pediatric 2 Stethoscopes, one adult and one pediatric or combination 2 Heavy duty shears
More informationEmergency Medical Services Advanced Level Competency Checklist
Emergency Services Advanced Level Competency Checklist EMS Service: Current License in State of Nebraska: # (Copy of license kept in file at station) Date of joining EMS Service: EMS Service Member Name:
More informationMany newer supraglottic airways such as the LMA ProSeal. What s New in Supraglottic Airways? Three Decades of Evolution to Tract Separation
PRINTER-FRIENDLY VERSION AT ANESTHESIOLOGYNEWS.COM What s New in Supraglottic Airways? Three Decades of Evolution to Tract Separation DARWIN C. VIERNES, MD Acting Instructor and Senior Fellow Department
More informationChanges in the Evaluation and Treatment of Sleep Apnea
Changes in the Evaluation and Treatment of Sleep Apnea Joseph DellaValla, MD FACP Medical Director Center for Sleep Medicine At Androscoggin Valley Hospital Sleep Related Breathing Problems Obstructive
More informationCITY OF HOUSTON Department of Health and Human Services Emergency Medical Services Program
Ambulance Service Permit Application Process New Applicants: Please read and complete the following application carefully. Make sure all information is accurate to prevent a delay in verification and processing.
More informationTwo Hundred Sixty Pediatric Emergency Airway Encounters by Air Transport Personnel
ORIGINAL ARTICLE Two Hundred Sixty Pediatric Emergency Airway Encounters by Air Transport Personnel A Report of the Air Transport Emergency Airway Management (NEAR VI: A-TEAM ) Project William Wallace
More informationNorthwestern Health Sciences University. Basic Life Support for Healthcare Providers
Northwestern Health Sciences University Basic Life Support for Healthcare Providers Pretest May 2005 This examination to be used only as a PRECOURSE TEST for BLS for Healthcare Providers Courses Based
More informationCITY OF HOUSTON Department of Health and Human Services Emergency Medical Services Program
Ambulance Service Permit Application Process New Applicants: Please read and complete the following application carefully. Make sure all information is accurate to prevent a delay in verification and processing.
More informationMODEL SEDATION PROTOCOL FOR MODERATE SEDATION AND ANALGESIA PERFORMED BY NON-ANESTHESIA PROVIDERS DURING PROCEDURES
MODEL SEDATION PROTOCOL FOR MODERATE SEDATION AND ANALGESIA PERFORMED BY NON-ANESTHESIA PROVIDERS DURING PROCEDURES ON ADULTS AND CHILDREN OLDER THAN 10 YEARS OF AGE. PURPOSE This policy has been established
More informationROLE OF ORAL APPLIANCES TO TREAT OBSTRUCTIVE SLEEP APNEA
1 ROLE OF ORAL APPLIANCES TO TREAT OBSTRUCTIVE SLEEP APNEA There are three documented ways to treat obstructive sleep apnea: 1. CPAP device 2. Oral Appliances 3. Surgical correction of nasal and oral obstructions
More informationPost-Traumatic Stress Disorder
Post-Traumatic Stress Disorder It s natural to be afraid when you re in danger. It s natural to be upset when something bad happens to you or someone you know. But if you feel afraid and upset weeks or
More informationa guide to understanding pierre robin sequence
a guide to understanding pierre robin sequence a publication of children s craniofacial association a guide to understanding pierre robin sequence this parent s guide to Pierre Robin Sequence is designed
More informationSign up to receive ATOTW weekly - email worldanaesthesia@mac.com
OBSTRUCTIVE SLEEP APNOEA AND ANAESTHESIA ANAESTHESIA TUTORIAL OF THE WEEK 152 21 ST SEPTEMBER 2009 Dr Shona Bright Royal Hobart Hospital Correspondence to shona.bright@dhhs.tas.gov.au QUESTIONS Before
More informationMODERATE SEDATION RECORD (formerly termed Conscious Sedation)
(POLICY #DOC-051) Page 1 of 6 WELLSPAN HEALTH - YORK HOSPITAL NURSING POLICY AND PROCEDURE Dates: Original Issue: September 1998 Annual Review: March 2012 Revised: March 2010 Submitted by: Brenda Artz
More informationOutside Patient Transfers. National Pediatric Nighttime Curriculum Written by Erin Augustine, MD Lucile Packard Children s Hospital at Stanford
Outside Patient Transfers National Pediatric Nighttime Curriculum Written by Erin Augustine, MD Lucile Packard Children s Hospital at Stanford Case 1 A 5 year old male is being transferred from an outside
More information5/30/2014 OBJECTIVES THE ROLE OF A RESPIRATORY THERAPIST IN THE DELIVERY ROOM. Disclosure
THE ROLE OF A RESPIRATORY THERAPIST IN THE DELIVERY ROOM Ona Fofah, MD FAAP Assistant Professor of Pediatrics Director, Division of Neonatology Department of Pediatrics Rutgers- NJMS, Newark OBJECTIVES
More informationRecurrent & Persistent Papillary Thyroid Cancer Central Nodal Dissection vs. Node-Picking Patterns of Nodal Metastases Recurrent Laryngeal Nerve,
Recurrent & Persistent Papillary Thyroid Cancer Central Nodal Dissection vs. Node-Picking Patterns of Nodal Metastases Recurrent Laryngeal Nerve, Larynx, Trachea, & Esophageal Management Robert C. Wang,
More informationNational Registry of Emergency Medical Technicians Emergency Medical Responder Psychomotor Examination BVM VENTILATION OF AN APNEIC ADULT PATIENT
BVM VENTILATION OF AN APNEIC ADULT PATIENT Candidate: Examiner: Date: Signature: Possible Points Checks responsiveness NOTE: After checking responsiveness and breathing for at least 5 but no 1 Checks breathing
More informationRECERTIFICATION PROTOCOL FOR EMERGENCY MEDICAL SERVICES PERSONNEL MANUAL
RECERTIFICATION PROTOCOL FOR EMERGENCY MEDICAL SERVICES PERSONNEL MANUAL UTAH DEPARTMENT OF HEALTH DIVISION OF FAMILY HEALTH AND PREPAREDNESS BUREAU OF EMERGENCY MEDICAL SERVICES AND PREPAREDNESS November
More informationAirway Management of the Parturient. Kevin C. Dennehy, MB, BCh, FFARCSI May C. M. Pian-Smith, MD
Airway Management of the Parturient Kevin C. Dennehy, MB, BCh, FFARCSI May C. M. Pian-Smith, MD Anesthesiologists involved in the care of the obstetric patient must consider airway management as an essential
More informationObstructive Sleep Apnoea
Obstructive Sleep Apnoea What is obstructive sleep apnoea? People who suffer from Obstructive Sleep Apnoea (OSA) reduce or stop their breathing for short periods while sleeping. This can happen many times
More informationPerioperative risk factors in obese patients for bariatric surgery: a Singapore experience
Original Article Singapore Med J 2011; 52(2) : 94 Perioperative risk factors in obese patients for bariatric surgery: a Singapore experience Iyer U S, Koh K F, Chia N C H, Macachor J, Cheng A Department
More informationTHE AIRWAY IN AEROMEDICAL EVACUATION. PBLD (Problem Based Learning Discussion)
THE AIRWAY IN AEROMEDICAL EVACUATION PBLD (Problem Based Learning Discussion) D. John Doyle MD PhD 2012 Edition Image Credit: http://www.arabianaerospace.aero/media/images/stories/medevac%20services.jpg
More informationProvider Sedation Education
Provider Sedation Education Purpose: To provide sedation education for IU Health physicians and dentists seeking moderate and deep sedation credentials. Credentialing requirements: Moderate sedation credentials:
More informationAHA Instructor Renewal
AHA Instructor Renewal Thank you for your continuing on as American Heart Association AHA Instructor! In this packet you will we have provided information on: A detailed outline of the process to renew
More informationDELINEATION OF PRIVILEGES - EMERGENCY MEDICINE
KALEIDA HEALTH Name: Date DELINEATION OF PRIVILEGES - EMERGENCY MEDICINE LEVEL I (CORE) PRIVILEGES Physicians with these privileges are expected to have training and/or experience and competence on a level
More informationNational Registry Skill Sheets
Bleeding Control/Shock Management BVM Ventilation of an Apneic Adult Patient Cardiac Arrest Management/AED Joint Immobilization Long Bone Immobilization Oxygen Administration By Non-Rebreather Mask Patient
More informationSMO: Anaphylaxis and Allergic Reactions
REGION I EMERGENCY MEDICAL SERVICES STANDING MEDICAL ORDERS EMT Basic SMO: Anaphylaxis and Allergic Reactions Overview: Allergic reactions can vary in severity from a mild reaction consisting of hives
More informationGuidelines for the Treatment of Trauma
Guidelines for the Treatment of Trauma ACKNOWLEDGEMENT We would like to thank Steven Briggs, MD from Sanford Medical Center-Fargo and Amy Eberle RN, former North Dakota State Trauma Program Manager for
More informationThe Difficult Airway in Head and Neck Tumor Surgery. Niels F. Jensen, MD. Jonathan L. Benumof, MD
1 The Difficult Airway in Head and Neck Tumor Surgery Niels F. Jensen, MD Jonathan L. Benumof, MD 1. Assistant Professor, Department of Anesthesiology, University of Iowa 2. Professor, Department of Anesthesiology,
More informationHow To Treat A Pregnant Woman With A Miscarriage
Special Patient Populations Obstetrics EMR Education Standard Recognizes and manages life threats based on simple assessment findings for a patient with special needs while awaiting additional emergency
More informationScope of Practice Approved by the State Board of EMS (EMS Board), within the Division of EMS of the Ohio Department of Public Safety
Scope of Practice Approved by the State Board of EMS (EMS Board), within the Division of EMS of the Ohio Department of Public Safety This document offers an at-a-glance view of the Scope of Practice for
More informationEmergency Scenario. Chest Pain
Emergency Scenario Chest Pain This emergency scenario reviews chest pain in a primary care patient, and is set up for roleplay and case review with your staff. 1) The person facilitating scenarios can
More informationAnterior Cervical Decompression and Fusion or Anterior Cervical Corpectomy and Fusion
Anterior Cervical Decompression and Fusion or Anterior Cervical Corpectomy and Fusion DO NOT TAKE ANY ASPIRIN PRODUCTS OR NON-STEROIDAL ANTI- INFLAMMATORY DRUGS (ie NSAIDs, Advil, Celebrex, Ibuprofen,
More informationSUBJECT: BASIC LIFE SUPPORT AMBULANCE EQUIPMENT REFERENCE NO. 710
SUBJECT: BASIC LIFE SUPPORT AMBULANCE EQUIPMENT REFERENCE NO. 70 POLICY: NOTE: Ambulances dedicated for infant transportation or when staffed and equipped for use in conjunction with newborn intensive
More informationSecrets of the Pediatric Intubated Patient:
Secrets of the Pediatric Intubated Patient: Evidence-Based Keys to Success Leslie Grant, RN, BSN, CFRN, CCRN Matt Payne, RN, CFRN, FP-C Ranked #1 in Virginia by U.S. News & World Report VCU Total Artificial
More informationEQUIPMENT FOR GROUND AMBULANCES Summary of Changes 2009-2014
EQUIPMENT FOR GROUND AMBULANCES Summary of Changes 2009-2014 American Academy of Pediatrics American College of Emergency Physicians American College of Surgeons Committee on Trauma Emergency Medical Services
More informationSpinal Cord Injury Education. An Overview for Patients, Families, and Caregivers
Spinal Cord Injury Education An Overview for Patients, Families, and Caregivers Spinal Cord Anatomy A major component of the Central Nervous System (CNS) It is 15 to 16 inches long, and weighs 1 to 2 ounces
More information