• Title/Summary/Keyword: endotracheal intubation

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

  • Choi, Uk-Jin;Cho, Keun-Ja
    • The Korean Journal of Emergency Medical Services
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    • v.15 no.3
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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.

Selection of Appropriate Endotracheal Tube in Wild Birds

  • Jang, Jin-Ho;Park, Young-Seok;Kim, Hee-Jong;Kim, Hye Kwon;Yun, Young-Min
    • Journal of Veterinary Clinics
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    • v.35 no.5
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    • pp.184-189
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    • 2018
  • Wild birds rescued for various reasons are injured and admitted to a wild animal rescue center. With the case of collision with cars, buildings and wires on a power pole, most wild birds are severely traumatized or get fractured, which need intensive veterinary treatment. In general, inhalation anesthesia to wild birds is the best choice for the medical and surgical procedure, and intubation is recommended for the stable anesthesia. Although the certain size of an endotracheal tube can be chosen depending on the size and morphology of the bird, there are a few standardized guidelines. Therefore, the optimal endotracheal size of the rescued 162 individual birds of 41 species for four years from March 2014 to December 2017 was investigated and sorted empirically, suggesting possibly the appropriate endotracheal sizes for diverse avian species. It may provide practical information data for wildlife veterinarians to select the size of an endotracheal tube according to the size of the domestic wild bird species, especially during surgery in the emergency cases.

Clinical Experience of Tracheal Resection after Laser Ablation in a Patient having Tracheal Neurilemoma with Tracheal Stenosis. (기관폐쇄를 동반한 기관 신경초종 환자에 있어 레이져를 이용한 부분절제술후 기관절제술의 경험)

  • 박성민;김광택
    • Journal of Chest Surgery
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    • v.32 no.10
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    • pp.947-950
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    • 1999
  • Tracheal neurilemoma, an extremely rare benign tracheal tumor that there has been only one case reported in 1996 throughout the nation, is a slowly progressing disease that obliterates the upper airway, delays diagnosis for its symptom similarity to asthma, and makes intubation for operation difficult. Bronchoscopic is therefore needed for diagnosis. There are two options for the treatment methods, a bronchoscopic resection or open surgical resection; however if intubation is difficult, then the bronchoscopic resection is used first to keep the airway open for the surgical resection. In this case, the severe tracheal stenosis impeding intubation made the surgical resection of the primary tracheal neurilemoma with extratracheal mass impossible; therefore, bronchoscopic laser resection was applied first to optain the airway passage for endotracheal intubation, followed by a successful open surgical resection.

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Comparison of Educational Effects of Difficult Endotracheal Intubation in the 119 Rescue Service (119구급대의 어려운 기관내삽관 교육 전·후 비교)

  • Yun, Hyeong-Wan;Yu, Eun-Yeong;Yun, Young-Hyun
    • The Journal of the Korea Contents Association
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    • v.11 no.1
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    • pp.254-265
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    • 2011
  • The purpose of this study was to examine the effect of difficult endotracheal intubation education in the 119 rescue services. The subjects in this study were 60 members of the 119 rescue services that was under the umbrella of the Fire Service Headquarters of J province. A SPSS 14.0 program was utilized to find out the effect of tough tracheal intubation education on their relevant knowledge, self-confidence, academic self-efficacy and technical Performance in consideration of general characteristics. The findings of the study were as follows: 1. They showed a significant improvement in all the knowledge, self-confidence, academic self-efficacy and technical Performance after they received that education. 2. As for connections between general characteristics and knowledge before and after that education, there were significant differences in their knowledge according to gender and career of working in the hospital, and their rank and career of working in the hospital made a significant differences to their self-confidence. Their academic self-efficacy significantly differed with rank, career of working in the hospital and academic credential. There were significant gaps among them technical Performance Case 1 according to career of working in the 119 rescue services, and technical Performance Case 2 significantly varied with age and academic credential. There were significant gaps in technical Performance Case 3 according to career of working in the 119 rescue services and career of working in the hospital after that education was provided, and technical Performance Case 4 significantly varied with age and rank before and after the education was conducted. In conclusion, the kind of education programs that aim at stirring up the interest of the 119 rescue services in advanced airway and helping the members learn about tracheal intubation accurately with confidence is urgently required.

Subcutaneous Emphysema and Inflammation of the Neck after Tracheal Puncture by an Intubating Stylet

  • Jung, Gul;Byun, Woo-Mok;Lim, Hyung-Jun;Kim, Jong-Gyun;Kwak, Dong-Min;Lee, Deok-Hee;Kim, Sae-Yeon;Song, Sun-Ok;Seo, Il-Sook;Jee, Dae-Lim;Kim, Heung-Dae;Park, Dae-Pal
    • Journal of Yeungnam Medical Science
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    • v.24 no.2
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    • pp.344-350
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    • 2007
  • Laryngo-tracheal perforation caused by the use of a stylet during tracheal intubation is a rare complication. We present a case of subcutaneous emphysema and connective tissue inflammation after tracheal intubation. The patient was a 41-year-old male undergoing general anesthesia for an appendectomy. The intubation was difficult during laryngoscopy (Cormack- Lehane Grade III). An assistant provided an endotracheal tube with a stylet inside while the laryngoscope was in place. During intubation, a short, dull sound was heard with a sudden loss of resistance after the distal tip of the endotracheal tube passed the rima glottis. A sonogram and computerized tomography revealed subcutaneous emphysema from the neck to the upper mediastinum and fluid collection between the trachea and the thyroid. This lesion appeared to have been caused by the protruded, loose stylet. Anesthesiologists should be aware of the damage a loose stylet protruding beyond the tip of the endotracheal tube can cause.

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The Effect for Intracranial Pressure during Laryngoscopy and Endotracheal Intubation (기관내삽관이 뇌압변동에 미치는 영향)

  • Kim, Heung-Dae;Chi, Yong-Chul
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.45-51
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    • 1985
  • It is well known that intracranial pressure (ICP) and mean arterial pressure (MAP) are increased by laryngoscopy and endotracheal intubation during induction of general anesthesia, and It may be very dangerous in neurosurgical patients who had increased ICP. Therefore, this study was performed to know the range of ICP increase during induction of the conventional general anesthesia with intubation following thiopental and succinylcholine injections. Intracranial pressure and MAP were measured in 13patients who underwent cramotomy. All the patients were monitored cerebral epidural ICP and intra-arterial pressure pre-operatively. The results were as follow: 1. Intracranial pressure was increased of $7.1{\pm}7.23mmHg$. 2. Arterial pressure was increased of $43.5{\pm}25.46mmHg$. 3. Cerebral perfusion pressure was increased of $33.3{\pm}27.53mmHg$. It is stressed that certain procedures are necessary to prevent from further increase of ICP due to induction of general anesthesia in patients with increased ICP.

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Successful Treatment of Tracheal Invasion Caused by Thyroid Cancer Using Endotracheal Tube Balloon Inflation under Flexible Bronchoscopic Guidance

  • Han, Yang-Hee;Jung, Bock-Hyun;Kwon, Jun Sung;Lim, Jaemin
    • Tuberculosis and Respiratory Diseases
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    • v.77 no.5
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    • pp.215-218
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    • 2014
  • Tracheal invasion is an uncommon complication of thyroid cancer, but it can cause respiratory failure. A rigid bronchoscope may be used to help relieve airway obstruction, but general anesthesia is usually required. Tracheal balloon dilatation and stent insertion can be performed without general anesthesia, but complete airway obstruction during balloon inflation may be dangerous in some patients. Additionally, placement of the stent adjacent to the vocal cords can be technically challenging. An 86-year-old female patient with tracheal invasion resulting from thyroid cancer was admitted to our hospital because of worsening dyspnea. Due to the patient's refusal of general anesthesia and the interventional radiologist's difficulty in completing endotracheal stenting, we performed endotracheal tube balloon dilatation and argon plasma coagulation. We have successfully treated tracheal obstruction in the patient with thyroid cancer by using endotracheal tube balloon inflation and a flexible bronchoscope without general anesthesia or airway obstruction during balloon inflation.

Successful repair of a partially transected endotracheal tube with Dermabond surgical adhesive during a Lefort osteotomy: a case report

  • Daniel Ahn;Tuan-Hsing Loh
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.23 no.2
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    • pp.117-119
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    • 2023
  • Damage to the endotracheal tube (ETT) during oral and maxillofacial surgeries is a rare but serious intraoperative complication. Herein, we present a case of a partially damaged ETT that was repaired using Dermabond surgical adhesive (Ethicon, Sommerville, NJ, USA) during a Lefort osteotomy. Dermabond surgical adhesive can be a simple and viable tool to repair partially transected ETTs where ETT exchange carries a high risk of airway loss. Our case adds to one of the several techniques for managing damaged ETT in an intraoperative setting.

Awake intubation in a patient with huge orocutaneous fistula: a case report

  • Kim, Hye-Jin;Kim, So-Hyun;Kim, Tae-Heung;Yoon, Ji-Young;Kim, Cheul-Hong;Kim, Eun-Jung
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.17 no.4
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    • pp.313-316
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    • 2017
  • Mask ventilation, the first step in airway management, is a rescue technique when endotracheal intubation fails. Therefore, ordinary airway management for the induction of general anesthesia cannot be conducted in the situation of difficult mask ventilation (DMV). Here, we report a case of awake intubation in a patient with a huge orocutaneous fistula. A 58-year-old woman was scheduled to undergo a wide excision, reconstruction with a reconstruction plate, and supraomohyoid neck dissection on the left side and an anterolateral thigh flap due to a huge orocutaneous fistula that occurred after a previous mandibulectomy and flap surgery. During induction, DMV was predicted, and we planned an awake intubation. The patient was sedated with dexmedetomidine and remifentanil. She was intubated with a nasotracheal tube using a video laryngoscope, and spontaneous ventilation was maintained. This case demonstrates that awake intubation using a video laryngoscope can be as good as a fiberoptic scope.