• 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.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1976.06a
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• pp.87.2-87
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• 1976

Laryngeal granuloma following endotracheal anesthesia was reported as traumatic granuloma of the larynx by Clausen in 1932. Thereafter Harrison reported that 4% of the intubated cases developed larynx and upper respiratory tract injuries and 1% of the above mentioned injured cases later developed laryngeal granuloma with symptoms including voice change and even dyspnea in severe cases. The endotracheal intubation has been wedely used for general anesthesia or patency of the air way .and the reported cases of the laryngal granuloma Fig. 5. as its complication have been increased in number worldwidely. For a year from March 1975 to Feb. 1976, the authors have experienced the nine cases of laryngeal granuloma in our department and this is the report of clinical findings on these cases along with literature review.

• Journal of Chest Surgery
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• v.25 no.6
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• pp.581-587
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• 1992

Tracheoesophageal fistula[TEF] is a rare but life-threatening lesion that may occur from ventilation with a cuffed tube. It occurs most frequently when an inlying esophageal tube is also being used-usually for feeding purposes. The mechanism of injury appears to be pressure experted on the tracheal wall by the cuff, which then compresses the "party wall" of the trachea and esophagus against the foreign body that lies in the esophagus. The patient was 32 years old female who had been receiving a treatment of respiratory failure induced by postoperative sepsis with assist ventilator and nasogastric tubal feeding. Sudden attack of abdominal gas distention and massive drainage of gas through N-G tube were developed during assist ventilation in that patient, so we diagnosed as tracheal stenosis with a tracheoesophageal fistula induced by prolonged endotracheal intubation We performed tracheal reconstruction and primary closure of perforated esophagus after weaning ventilator. The postoperative course was uneventiful.eventiful.

• Korean Journal of Bronchoesophagology
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• v.8 no.1
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• pp.61-65
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• 2002

Background : Acquired tracheoesophageal fistula(TEF) results mostly from Prolonged tracheal intubation and insertion of nasogastric tube. Although the incidence has decreased since the usage of low pressure, high volume cuff of endotracheal tube, it is seldom cured spontaneously and needs surgical treatment. Material and Methods : We have retrospectively reviewed five cases of TEF who underwent surgical treatment for cure from March, 1990 to September, 2001 and analyzed the cause, treatment, postoperative complications and prognostic factors. Results : Majority were men(80% : 4 of 5 patients) and the mean age was 29.4 years old(range, 11-58). The most predominant etiology was prolonged intubation or tracheostomy(80% : 4 of 5 patients) and 3 of 5 patients were treated by tracheal resection and end to end anastomosis with primary closure of esophagus. Postoperative complications occurred in 4 patients the most common complications were wound infection(4 cases) and esophageal leakage(2 cases). Extubation was done on postoperative day 11.5(range, 1-33) days, and factors causing delayed extubation were status esophagus. epilepticus, edema, and tracheal stenosis. Conclusion : Spontaneous closure of TEF is seldom possible and the surgical treatment of choice is tracheal resection and end to end anastomosis with primary repair of the esophagus. preoperative pulmonary rehabilitation and early extubation postoperatively are important factors for success.

• Journal of The Korean Dental Society of Anesthesiology
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• v.10 no.2
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• pp.190-196
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• 2010

Difficult airway management including difficult intubation, difficult ventilation and difficult mask ventilation is a life threatening issue during anesthesia care. A 23-year-old woman with Treacher Collins syndrome was scheduled for distraction osteogenesis. She had hypoplasia of mandible and malar bone, bilateral deformities of auricles with partial deafness and antimongoloid slant of the palpebral fissures. A 56-year-old woman with mandibular hypoplasia due to childhood trauma was scheduled for distraction osteogenesis. She had a history of difficult intubation. We anticipated a difficult intubation and ventilation. Fiberoptic bronchoscopic guided awake intubation was selected for anesthesia induction. After intravenous injection of midazolam and remifentanil, 10% lidocaine pump spray on the pharyngolarynx with a direct laryngoscope and on the nasal canal. However fiberoptic bronchoscopic guided awake intubation was failed due to severe gag reflex. After intravenous injection of propofol and remifentanil using the target controlled infusion (TCI), mask ventilation was easily performed and, after intravenous injection of vecuronium, fiberoptic bronchoscopic guided intubation was easily performed using a wire reinforced endotracheal tube. The operation was completed successfully without any adverse events.

• Journal of The Korean Dental Society of Anesthesiology
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• v.3 no.1 s.4
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• pp.28-33
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• 2003

Background: The fundamental responsibility of an anesthesiologist is to maintain adequate gas exchange. Failure to maintain a patent airway can result in brain damage or death. Generally, in patients with mandibular prognathism, who have the protruded mandible, the mask ventilation was thought to be not easy. The purpose of this study was to observe the degree of the difficulty of airway management in mandibular prognathism using some anatomic criteria for defining and grading difficulty of airway and difficulty of endotracheal intubation with direct laryngoscope. Methods: The observations and measurements are done to the 54 patients with mandibular prognathism, who were scheduled for corrective esthetic surgery. The case study is done to the 30 patients with normal mandible for control group. In all patients, mouth opening distance (MOD), mouse opening angle (MOA), mandibular length (ML), mandibular depth (MD), thyromental distance (TMD), thyromental area (TMA), Mallampati grades, and Cormack and Lehane grades are measured. T-test and Chi-square test are done (P < 0.05). Results: In the mandibular prognathism cases, the measurements of MD, TMD and TMA are more greater than those of controls (P < 0.05). Mallampati grades with tongue thrust are higher in the female mandibular prognathism cases than those of female controls. Most of the grades of the mandibular prognathism cases with Cormack and Lehane grading system are I or II being easy intubation cases (P < 0.05) Conclusions: In the patients of mandibular prognathism, the intubation with laryngoscope will be easer than that of normal mandible in general. It is for that their laryngeal aperture can be easily visible when the laryngoscope are used.

• Archives of Craniofacial Surgery
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• v.9 no.2
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• pp.77-80
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• 2008

Purpose: The majority of nasal fractures have been treated by closed reduction. And they were manipulated under local anesthesia or general anesthesia. Under the local anesthesia, patients can feel the pain and fear, so general anesthesia through the endotracheal intubation became popularized recently to treat the nasal fracture. But it has still the drawbacks of postanesthetic complication. Therefore, under the mask ventilation anesthesia using oral airway, we tried to manipulate the nasal fracture. Methods: From July 2007 to November 2007, we worked with fifty patients that were manipulated the nasal fracture. Fifty patients were divided into two groups, general anesthesia with the endotracheal intubation group(n=25) and the mask ventilation using oral airway group(n=25). We checked up the anesthesia time, postanesthetic complication, postoperative aesthetic & functional problem of nose in two groups. Results: In total operation time and sore throat frequency among the postoperative anesthetic complications, there was statistically significant difference between the mask ventilation group and the endotracheal intubation group(p<0.05). But there was no difference statistically in nausea frequency(p>0.05). And no patients complained of postoperative nasal complication such as septal deviation, septal perforation, nasal obstruction and hump nose in two groups. Conclusion: Through the mask ventilation using oral airway, we could reach satisfactory results in the anesthetic time and postanesthetic complication.

• Fire Science and Engineering
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• v.28 no.6
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• pp.76-81
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• 2014

The purpose of this study was to comparative analysis of tidal volume and airway pressure after one-rescuer BVM, two-rescuer BVM, advanced airway devices with a Bag-valve mask using RespiTrainer. The data were obtained from June 2 to 10 in 2014. The collected data were analyzed using the SPSS WIN 18.0 program. The results showed that BVM ventilation using the endotracheal intubation produced higher mean tidal volume $497{\pm}78mL$, Two-rescuer ventilation $479{\pm}91mL$ One-rescuer ventilation $386{\pm}59mL$, King LTS-D $365{\pm}05mL$, Laryngeal mask airway (LMA) $351{\pm}35mL$. Peak airway pressure was higher in BVM ventilation using the endotracheal intubation. As a result, the study confirmed that the BVM Ventilation by endotracheal intubation and Two-rescuer BVM ventilation to one third the bag depth squeeze method is appropriate.

• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.3
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• pp.155-160
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• 2020

Submental or submandibular intubation has been reported to cause fewer complications than tracheostomy. However, the risk of infection is always inherent because oral wounds are exposed to microbial flora and bacteria in the oral cavity. A novel technique of submandibular intubation was devised to reduce infection and injury to the soft tissues. We would like to report a novel safe technique that can be performed in patients requiring submental or submandibular intubation. This is the first report of submandibular intubation using a sterile disposable camera cable drape. This novel technique of submandibular intubation is safer, more sterile, easier, and less invasive than conventional submandibular intubation.

• Journal of Chest Surgery
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• v.26 no.1
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• pp.64-66
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• 1993

We experienced 2 cases of surgical immobilization with Judet`s strut for flail chest with multiple rib fractures. The patients were undertaken explorative thoracotomy for unevacuated hematoma and chest wall fixation for paradoxically moving segments of ribs after initial trials of internal fixation, i.e. mechanical ventilation with endotracheal intubation. Immediately after operation, the patient`s general condition and respiratory status were improved remarkably. Mechanical ventilation and endotracheal intubtion were removed on postoperative second day without any events.