• 제목/요약/키워드: airway management

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기도 유지가 어려운 정신지체 환자에서 후두마스크 삽입 하 치과치료 (USE OF LARYNGEAL MASK AIRWAY (LMA) FOR DENTAL TREATMENT IN MENTALLY RETARD PATIENT WITH DIFFICULT AIRWAY -A CASE REPORT-)

  • 이영은;서광석;김현정;신터전
    • 대한장애인치과학회지
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    • 제4권2호
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    • pp.88-91
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    • 2008
  • A female patient (14 years-old) with mental retardation was scheduled for ambulatory general anesthesia to treat peri-apical abscess and multiple dental caries. She had got cleft palate plasty at 5 years, but there was no past history of difficulty airway during general anesthesia or airway obstruction. Following induction of anesthesia using an inhalational anesthetic technique, conventional naso-tracheal intubation was tried. However, with conventional intubation technique we could not insert tube. And following several trial of intubation with laryngoscope, she developed an upper airway obstruction. Her lungs could not be ventilated using a facial mask and oxygen saturation was decreased. A #3 laryngeal mask airway (LMA) was inserted immediately, which allowed us to ventilate her lungs and restore the oxygen saturation. And dental treatment was carried out under LMA insertion successfully.

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전신마취를 시행한 구강외과 환자에서 어려운 기관내삽관: 후향적 연구 (Difficult Intubation in Patients Undergone Oromaxillary Surgery: Retrospective Study)

  • 권오선;김철홍
    • 대한치과마취과학회지
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    • 제8권2호
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    • pp.118-121
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    • 2008
  • Background: This retrospective study aims to describe the airway management and to search predictive parameter for difficult intubation in 700 patients undergoing oromaxillary surgery. Methods: The medical records of 700 patients undergone oromaxillary surgery were reviewed for airway management during perioperative period. The cases of difficult intubation were selected and those radiologic findings were reviewed. The mandibular depth (MD), mandibular length (ML), thyromental distance (TMD) were measured. Results: In 41 cases difficult intubation were recorded in anesthetic record. The grade of Cormack and Lehane was III in 36 patients and IV in 5 cases. The MD of difficult intubation cases was $4.2{\pm}3.2\;cm$. The ML of difficult intubation cases was $10.1{\pm}3.8\;cm$. The TMD of difficult intubation cases was $5.9{\pm}4.3\;cm$. Under the fiberoptic guided awake intubation was undertaken in 75 patient. In none of the cases was failed nasotracheal intubation. Conclusions: The patients undergoing oromaxillar surgery have a potentially difficult airway but, if managed properly during perioperative preiod, morbidity and mortality can be reduced or avoided. The radiologic findings were poor predict for difficult intubation. The fiberoptic guided awake intubation is a safe alternative to direct laryngoscopic intubation.

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외상성 기도 손상의 임상적 고찰 (Clinical Aanalysis of Airway Trauma)

  • 조현민;김영진;류한영;황정주
    • Journal of Trauma and Injury
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    • 제24권1호
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    • pp.7-11
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    • 2011
  • Purpose: Traumatic airway injuries have high rates of mortality and morbidity. Thus, we evaluated the clinical results of trauma-related airway-injury patients. Methods: A clinical analysis was performed for patients with airway trauma who were admitted and treated at the Department of Thoracic and Cardiovascular Surgery, Konyang University Hospital from Dec. 2002 to Dec. 2009. Results: Sixteen patients were admitted and treated. Fourteen patients were male, and the ages of the patients ranged from 16 to 75 years. Six cases were penetrating injuries, 4 were traffic-accident injuries. 3 were fall injuries, and. 3 were other blunt trauma injuries. Anato- mic injuries included 14 trachea cases (87.5%), 1 Rt. main bronchus (6.25%), and 1 Lt. main bronchus cases (6.25%). Diagnosis was made by using computed tomography and bronchoscopy. Five patients were treated with an explothoracotomy, and 7 underwent neck exploration with primary repair. Three patients simply needed conservative management, and 1 patient was treated with a closed thoracostomy. The post-operative mortality rate was 6.25 % (1 patient). Conclusion: Airway trauma is dangerous and should be treated as an emergency, so a high index of suspicion is essential for rapid diagnosis and successful surgical intervention in patients with airway injuries.

Tongue-lip adhesion in Pierre Robin sequence

  • Kumar, K.S. Krishna;Vylopilli, Suresh;Sivadasan, Anand;Pati, Ajit Kumar;Narayanan, Saju;Nair, Santhy Mohanachandran
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제42권1호
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    • pp.47-50
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    • 2016
  • Patients with Pierre Robin sequence exhibit varying degrees of airway obstruction and feeding difficulty. In some patients, airway obstruction may be profound, warranting surgical intervention to maintain a patent airway. The purpose of this article is to highlight the advantages of the tongue-lip adhesion procedure for the management of airway obstruction in such patients compared to the currently available options.

119구급대 1급 응급구조사의 전문기도유지술과 자기효능감과의 관계 (The Relationship between Advanced Airway Management and Self-Efficacy by Level 1 Emergency Medical Technicians(EMT) in 119 Emergency Medical Service)

  • 정범준;최성수;윤성우
    • 한국산학기술학회논문지
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    • 제14권4호
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    • pp.1709-1717
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    • 2013
  • 본 연구는 119 구급대의 1급 응급구조사에 의한 심장 마비 환자에 대한 전문기도유지술 실시횟수의 관련 요인을 파악하였다. 광주소방 본부의 1급 응급구조사 95명을 대상으로 구조화된 설문지를 이용하여 일반적 특성, 직업관련 특성, 자기효능감, 전문기도유지술을 시행하는데 저해요인을 조사하였고, 2010년 1월 1일부터 2011년 6월 30일까지 전문기도유지술 실시한 자료는 광주 소방본부에서 제공받았다. 본 연구의 결과로, 전문기도유지술 관련 특성과 실시횟수와 상관관계를 분석한 결과, 필요를 느낀 횟수(r=0.397, p<0.01)와 자기효능감(r=0.419, p<0.01)이 상관관계를 보였고, 저해요인과 실시횟수와 상관관계를 분석한 결과 자신감(r=-0.036, p<0.01)과 경험문제(r=-0.405, p<0.01)가 상관관계가 있었다. 결론적으로, 전문기도유지술의 필요성을 제대로 인식하도록 하고, 자기효능감을 향상시킬 수 있도록 현장위주의 교육 프로그램과 인적자원관리에 대한 대책 마련이 필요할 것이다.

Chronic Obstructive Pulmonary Disease: Respiratory Review of 2013

  • Kim, Yu-Il
    • Tuberculosis and Respiratory Diseases
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    • 제76권2호
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    • pp.53-58
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    • 2014
  • Chronic obstructive pulmonary disease (COPD) is a common airway disease that has considerable impact on disease burdens and mortality rates. A large number of articles on COPD are published within the last few years. Many aspects on COPD ranging from risk factors to management have continued to be fertile fields of investigation. This review summarizes 6 clinical articles with regards to the risk factors, phenotype, assessment, exacerbation, management and prognosis of patients with COPD which were being published last year in major medical journals.

경추 고정 마네킹에게 직접 후두경(Macintosh laryngoscope), 부지(Gum elastic bougie), 비디오 후두경(Pentax AirWay Scope)을 사용한 기관내삽관 비교 (A Comparison of Endotracheal Intubation using the Macintosh Laryngoscope, the Gum Elastic Bougie and the Pentax AirWay Scope in Neck-Stabilized Manikin)

  • 최욱진;조근자
    • 한국응급구조학회지
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    • 제15권3호
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    • pp.71-80
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    • 2011
  • Purpose : This research was designed to provide basic data for advanced pre-hospital airway management by comparing the ease of intubation, the success rate and the time for intubation performed with Macintosh Laryngoscope, Gum Elastic Bougie and Pentax AirWay Scope on the floor and table. Methods : Intubation was performed 30 times in total, including 5 times for each of intubation using Macintosh Laryngoscope, Gum Elastic Bougie and Pentax Airway Scope on the table and floor, only on subjects who passed the practice test of the national exam for paramedics. Data were collected by measuring the ease of intubation, the success rate and the time for intubation, and then analyzed by descriptive analysis, paired t-test, ANOVA using SPSS 18.0. Results : 1. There was a significant difference in the ease of intubation according to intubation devices. 2. There was a significant difference in the ease of intubation according to table height for intubation. 3. There was a significant difference in the success rate according to intubation devices. 4. There was no significant difference in the success rate according to table height for intubation. 5. There was a significant difference in the intubation time according to intubation devices. 6. There was a partially significant difference in the intubation time according to table height for intubation. Conclusion : Sufficient training not only with Macintosh Laryngoscope but also with Gum Elastic Bougie and Pentax Airway Scope could improve the survival rate by intubation in patients with difficult airway.

좌심실형성부전증후군 환아의 치과치료를 위한 전신마취 시 강화 후두마스크를 이용한 기도 유지 (Airway Management with Reinforced Laryngeal in Mask Airway in a Child with Hypoplastic Left Heart Syndrome)

  • 김경진;신터전;현홍근;김영재;김정욱;장기택;이상훈;김종철;서광석
    • 대한치과마취과학회지
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    • 제13권4호
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    • pp.221-224
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    • 2013
  • Despite the laryngeal mask airway (LMA) has been widely used in anesthesia, its use is rare in the field of dentistry. Placing LMA in the oral cavity may interrupt dental treatment. However, there are some circumstances in which LMA is more advantageous than tracheal intubation for managing the airway. Especially, the reinforced LMA has a flexible tube shaft, rendering it more accessible for dental treatment. We report a case of dental treatment of a 3-year-old patient with hypoplastic left heart syndrome combined with pulmonary hypertension using reinforced LMA for airway management under general anesthesia. We also discuss the considerations of utilizing the reinforced LMA for dental treatment.

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

  • Yun, Seong-Woo
    • 한국컴퓨터정보학회논문지
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    • 제25권12호
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    • pp.227-233
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    • 2020
  • 본 연구는 성문위기도기 인후두 튜브(Supraglottic Airway Laryngopharyngeal Tube, SALT)와 직접 후두경을 이용하여 어려운 자세에서 기관내삽관의 신속성과 자신감, 용이성 등을 비교하여 전문기도관리 시행 능력을 향상 시키는데 있다. 연구대상은 J도 소방서에서 근무하고 있는 1급 응급구조사 30명을 대상으로 무작위 교차방법(Randomized crossover design)으로 디자인한 실험연구로 자료 분석은 SPSS 20.0 Version을 사용하였다. 어려운 자세에서 SALT를 이용한 기관내삽관은 직접 후두경을 이용한 기관내삽관 보다 신속성에서 유의한 차이를 보였으며(p<.001), 자신감과 용이성에서도 유의한 차이를 나타냈다(p<.001). 직접 후두경을 사용한 기관내삽관이 어려운 환경이나 외상환자의 경우 SALT를 이용한다면 안전하고 신속한 삽관을 할 수 있을 것이다. 또한 전문기도관리의 효율성 향상을 위해서 국내 현장에 SALT의 도입이 필요 할 것으로 사료된다.

초보자에서 후두튜브기도기와 후두마스크기도기의 삽관 비교 - 마네킨 연구 - (Comparison between laryngeal tube suction II and laryngeal mask airway in novice users - A manikin study -)

  • 황지영;조근자
    • 한국응급구조학회지
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    • 제16권3호
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    • pp.19-28
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    • 2012
  • Purpose : The present study was designed to provide basic data for advanced pre-hospital airway management by comparing the insertion time and success rate between laryngeal tube suction II (LTS II) and laryngeal mask airway (LMA) in a manikin. Methods : A total of 32 participants were novice users to both of devices among paramedic students. After taking the introductory lecture and demonstrations, the participants made an attempt to insert the LTS II and LMA to compare the insertion time and success rate. They marked the easiness of insertion of the score ranged from 1 to 10 score scale and preference of the two devices. Results : The insertion time of the LTS II was significantly shorter than that of the LMA (p =.000). There was no significant difference between LTS II and LMA in the success rate. In the easiness of insertion, the score of LTS II $(8.47{\pm}1.41score)$ was significantly higher than that of LMA $(7.19{\pm}1.98score)$(p =.001). The preference of LTS II (75%) was much higher than that of LMA (25%). Conclusion : The manikin study data showed that the LTS II may be a good alternative airway device for providing and maintaining a patent airway.