• Title/Summary/Keyword: Advanced airway

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Comparison of Endotracheal Intubation in Difficult Postures by Using the SALT(Supraglottic Airway Laryngopharyneal Tube)

  • Yun, Seong-Woo
    • Journal of the Korea Society of Computer and Information
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    • v.25 no.12
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    • pp.227-233
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    • 2020
  • The purpose of this study is to compare the speed, confidence, and ease of endotracheal intubation in a difficult posture by using the SALT(Supraglottic Airway Laryngopharyngeal Tube), and a direct laryngoscope to improve the ability to implement professional airway management. The subject of the study was an experimental study by a randomized crossover design, targeting 30 first-class emergency medical technicians working in J-do fire station, and the SPSS 20.0 version was used for data analysis. The endotracheal intubation by using SALT showed a significant difference in speed compared to endotracheal intubation by using a direct laryngoscope(p<.001), and also showed a significant difference in confidence and ease(p<.001). If it is difficult to endotracheal intubation by direct laryngoscope, or in the case of trauma patients, if SALT is used, safe and rapid intubation will be possible. In addition, to improve the efficiency of professional airway management, it is believed that the introduction of SALT in domestic sites is necessary.

Endotracheal Intubation of Paramedics in a Moving Ambulance (이동 중 구급차에서 1급 응급구조사의 기관내 삽관)

  • Shim, Gyu-Sik
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.11
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    • pp.5292-5298
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    • 2012
  • The purpose of this study is to perform the effectively advanced airway management in an emergency patient with cardiac arrest and trauma by comparing the appearance of influence in a change of visual-field height upon endotracheal intubation according to a change in position with intubation of paramedics in a moving ambulance and by analyzing the appearance of the influence in a patient's change in position with intubation upon speed in endotracheal intubation. Research subjects were randomly extracted 60(30 people for control group, 30 people for experimental group) people as the paramedics who are working at 13 fire stations in C Province. Data analysis was carried out ${\chi}^2$-test, independent t-test, paired t-test by using SPSS WIN 14.0 Version. As a result of research, to improve speed of the advanced airway management, it is considered to be likely effective in a patient's sniffing position and in the endotracheal intubation in the upper space of the main stretcher. The self-confidence in intubation after experiment increased significantly. Thus, the continuous education(training) on the intubation position and method within ambulance is considered to be likely needed for improving efficiency of the advanced airway management.

CT Findings of Central Airway Lesions Causing Airway Stenosis-Visualization and Quantification: A Pictorial Essay (협착을 유발하는 중심 기관지 병변들의 전산화단층촬영 소견-시각화 및 정량화: 임상화보)

  • Myeong Jin Choi;Hee Kang
    • Journal of the Korean Society of Radiology
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    • v.82 no.6
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    • pp.1441-1476
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    • 2021
  • The tracheobronchial tree is a system of airways that allows the passage of air to aerate the lungs and entire body. Several pathological conditions can affect this anatomical region. Multidetector CT (MDCT) helps identify and characterize various large airway diseases. Post-processing tools, such as virtual bronchoscopy and automatic lung analysis, can help enhance the performance of imaging studies. In this pictorial essay review, we provide imaging findings of various bronchial lesions manifested as wall thickening and endoluminal nodules on conventional MDCT and advanced image visualization and analysis.

Successful Intubation with Intra-Oral Camera in Difficult Intubation Case (치과치료를 위한 전신마취 환자 중 기관삽관이 어려운 환자에서 구강카메라를 이용한 증례)

  • Song, Young-Gyun;Kim, Seung-Oh
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.12 no.1
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    • pp.33-37
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    • 2012
  • Dental treatment under general anesthesia is considered a good way for behavioral control in disabled patients. General anesthesia for disabled patients sometimes requires difficult airway management. In this case, intra-oral camera is great helpful to intubation. Originally, the intra-oral camera is designed to facilitate diagnosis dental disease. The intra-oral camera is very efficient on intubation. Laryngeal photo taken by Intra-oral camera can be good guide for difficult intubation. In this report, an 11-year-old boy with chromosomal anomaly received dental care under general anesthesia. And he had a potentially difficult airway. We achieved nasotracheal intubation successfully with intra-oral camera.

Three-dimensional analysis of pharyngeal airway change of skeletal class III patients in cone beam computed tomography after bimaxillary surgery

  • Kwon, Young-Wook;Lee, Jong-Min;Kang, Joo-Wan;Kim, Chang-Hyen;Park, Je-Uk
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.38 no.1
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    • pp.9-13
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    • 2012
  • Introduction: To evaluate the 3-dimensional changes in the pharyngeal airway of skeletal class III patients after bimaxillary surgery. Materials and Methods: The study sample consisted of 18 Korean patients that had undergone maxillary setback or posterosuperior movement and mandibular bilateral sagittal split osteotomy setback surgery due to skeletal class III malocclusion (8 males, 10 females; mean age of 28.7). Cone beam computed tomography was taken 1 month before and 6 months after orthognathic surgery. Preoperative and postoperative volumes of the nasopharyngeal, oropharyngeal, and laryngopharyngeal airways and minimum axial areas of the oropharyngeal and laryngopharyngeal spaces were measured. Moreover, the pharyngeal airway volume of the patient group that had received genioplasty advancement was compared with the other group that had not. Results: The nasopharyngeal and laryngopharyngeal spaces did not show significant differences before or after surgery. However, the oropharyngeal space volume and total volume of pharyngeal airway decreased significantly (P<0.05). The minimum axial area of the oropharynx also decreased significantly. Conclusion: The results indicate that bimaxillary surgery decreased the volume and the minimum axial area of the oropharyngeal space. Advanced genioplasty did not seem to have a significant effect on the volumes of the oropharyngeal and laryngopharyngeal spaces.

Advanced airway management for the prehospital traumatic patient (병원 전 환경의 외상성 응급환자를 위한 전문기도관리)

  • Shim, Gyu-Sik;Kim, Eun-Mee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.5
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    • pp.2360-2367
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    • 2013
  • The purpose of this study was to improve the paramedics skills to manage advanced airway by comparing speed and success rate between endotracheal intubation and laryngeal mask airway(LMA) insertion in a moving ambulance. Sixty subjects were randomly recruited and samely divided into control group and experimental group. And they were asked to join a practical experiment using dummy model. Data analysis was done by SPSS WIN 14.0 Version. As a result of this research, in terms of difference in speed according to patient's intubation posture, the speed of control group was indicated to be good in sniffing position(t=-4.038, p<.001). There was no difference in speed between two groups in neutral position. In the neutral posture given the endotracheal intubation, tooth fracture occurred in 16 people(53.3%). There was no difference in success rate between two groups. As for a change in self-confidence before and after experiment, the post self-confidence was indicated to have been enhanced in both groups. In conclusion, it is effective to use LMA in the traumatic patient who is unable to receive endotracheal intubation in sniffing position. It is very important for the paramedics to receive the continuous training of the airway management skills.

Pediatric advanced life support and sedation of pediatric dental patients

  • Kim, Jongbin
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.16 no.1
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    • pp.9-15
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    • 2016
  • Programs provided by the Korea Association of Cardiopulmonary Resuscitation include Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), and Korean Advanced Life Support (KALS). However, programs pertinent to dental care are lacking. Since 2015, related organizations have been attempting to develop a Dental Advanced Life Support (DALS) program, which can meet the needs of the dental environment. Generally, for initial management of emergency situations, basic life support is most important. However, emergencies in young children mostly involve breathing. Therefore, physicians who treat pediatric dental patients should learn PALS. It is necessary for the physician to regularly renew training every two years to be able to immediately implement professional skills in emergency situations. In order to manage emergency situations in the pediatric dental clinic, respiratory support is most important. Therefore, mastering professional PALS, which includes respiratory care and core cases, particularly upper airway obstruction and respiratory depression caused by a respiratory control problem, would be highly desirable for a physician who treats pediatric dental patients. Regular training and renewal training every two years is absolutely necessary to be able to immediately implement professional skills in emergency situations.

A Case of Locally Advanced Well-Differentiated Fetal Adenocarcinoma of the Lung Treated with Concurrent Chemoradiation Therapy

  • Kyung, Chanhee;Kim, Sang Young;Lim, Beom Jin;Cha, Jung-Joon;Kim, Hyung Jung;Ahn, Chul Min;Park, Heejin;Cho, Eun Na;Chang, Yoon Soo
    • Tuberculosis and Respiratory Diseases
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    • v.74 no.5
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    • pp.226-230
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    • 2013
  • Fetal adenocarcinoma is a rare adenocarcinoma subtype of pulmonary blastoma. A 48-year-old male patient is being referred to our hospital due to progressive dyspnea. A chest X-ray showed a lung mass of unknown origin that was obstructing the right main bronchus. After relieving the airway obstruction with stent insertion via bronchoscopy, a diagnosis of fetal adenocarcinoma is being confirmed through thoracoscopic biopsy. Due to the locally advanced state of the lung cancer, it seemed to be inoperable, and concurrent chemo-radiation therapy was being administered with docetaxel. The stent was removed after improvements in the airway obstruction followed by a lung mass shrinkage. Comparing to other contexts which describe fetal adenocarcinoma as lower grade malignancy with low-associated mortality, herein, we describe a case of locally-advanced fetal adenocarcinoma (T4N3M0). This is the first documented case being treated with concurrent chemoradiation therapy. The followed-up image studies represent a partial response and the patient is currently under further observations.

Comparison of Ventilatory Volume and Airway Pressures Using Oxylator EM-100 (옥시레이터 EM-100을 활용한 환기량과 기도내압 비교)

  • Shin, So-Yeon;Roh, Sang-Gyun
    • Fire Science and Engineering
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    • v.29 no.5
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    • pp.104-109
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    • 2015
  • The purpose of this study was to compare the ventilatory volume and airway pressure of a facial mask, endotracheal intubation, King tube, and I-gel devices with an Oxylator EM-100 using a RespiTrainer. The data were obtained from July 20 to 21, 2015. Data were analyzed using SPSS WIN 18.0 software. The ventilatory volume for endotracheal intubation was 537 ml (95% CI 530~545 ml), that for the King tube was 502 ml (95% CI 499~506 ml), that for the I-gel was 88 ml (95% CI 485~491 ml), and that for the facial mask was 499 ml (95% CI 496~503 ml). The airway pressure for endotracheal intubation was $11.34cmH_2O$ (95% CI $11.21{\sim}11.41cmH_2O$), that for the King tube was $10.67cmH_2O$ (95% CI $10.60{\sim}10.75cmH_2O$), that for the I-gel was $10.42cmH_2O$ (95% CI $10.35{\sim}10.67cmH_2O$), and that for the facial mask was $10.61cmH_2O$ (95% CI $10.55{\sim}10.68cmH_2O$). As a result, we were able to identify the appropriate ventilatory volume using the Oxylator EM-100.

Physical Factors Affecting Success Rate During Endotracheal Intubation

  • Han, Song-Yi;Yun, Seong-Woo
    • Journal of the Korea Society of Computer and Information
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    • v.24 no.10
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    • pp.167-174
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    • 2019
  • In this paper, We propose the purpose the examine the physical factors that influence the success rate during the endotracheal intubation and to provide the basic data for effective intubation success. The subject of this study was 42 students in emergency rescue department who had completed the BLS Health Care-provider and a specialized airway maintenance course dealing with endotracheal intubation and it is a similar experimental study after the non-equivalence single group. For data analysis, SPSS 23.0 Version was used. The study methods were measuring the grip fotce of subjects, the angle of arm during intubation tube, distance from manikin, palm length, etc. The results showed that there was a correlation between the time of successful endotracheal intubation and the physical characteristics. In particular, when performing endotracheal intubation, it was related to the angle of the arm and the execution time of the performer, and the narrower the angle of the arm, the shorter the execution time. The results of this study suggest that successful endotracheal intubation could be implemented if the operator tried to reduce the angle of the arm when performing endotracheal intubation, and through further research on various job groups, identify the possibility of clinical use will be necessary.