Impossible Intubation Essay

Anesthesiology is the science of administering anesthetics. An anesthesiologist is a medical doctor who cares for a patient before, during and immediately following a surgical or medical procedure by administering appropriate anesthesia and monitoring the patient for reactions and complications, and to ensure comfort and manage pain.

The work of an anesthesiologist is fulfilling with many benefits. A person would desire to become an anesthesiologist because there is a high standard of excellence due to a low percentage of doctors in this special field, not to mention the high salary. This occupation benefits the doctor through a feeling of personal gratification while receiving a great education. The community benefits through his or her help relieving the pain accompanied by surgery. Becoming an anesthesiologist involves extensive education and training, while also having many requirements and a good salary range.

Cardiopulmonary resuscitation also known as CPR is an important part of helping someone survive during an emergency. Learning CPR can cause many positive outcomes for a victim in a critical moment. This paper will discuss not only those effects but also the basics of CPR, different types and process that is thought to save a person’s life.

Although when it happens, there can be a devastating impact on patients as well as to the multidisciplinary theatre team involved. Consequently, the DAS has produced a consensus set of guidelines for managing failed intubations in adult and paediatric patients, but there are as yet no such nationally-agreed guidelines in obstetrics, therefore each obstetric unit should have their own flowchart with regards to management of failed intubation (Brien and Conlon, 2013). Furthermore, in light of the latest DAS guidelines, several aspects of clinical anaesthetic practise have changed over recent years (Frerk at al, 2015). Amongst the changes are the use of new drugs such as rocuronium and suggamadex and using electronic video-laryngoscopes (Frerk et al, 2015). Further work had also looked at extending the period of apnoea without causing desaturation by optimising the preoxygenation process and adequate patient positioning (Frerk et al, 2015). As a result, updated guidelines for difficult intubations in adult patients were published in 2015; these guidelines provide a flowchart to be used when endotracheal intubation proves difficult or impossible and focus on the central importance of oxygenation while reducing the amount of airway interventions in order to minimize trauma to the delicate airway (Frerk et al, 2015). The main message of the revised guidelines is

On arrival to UKMC the patient received a Glasgow Coma Score of 3, which is an indication that intubation is needed. Bipap therapy was attempted but failed, due to respiratory failure. This was confirmed by arterial blood gases. After being assessed by the team at UKMC, the patient was intubated for respiratory failure, as well as shock of an unclear etiology. Rapid sequence intubation drugs, Etomidate and Succinylcholine where administered prior to intubation. A 7.5 endotracheal tube was used

Anesthesia was developed in order to block or prevent pain during medical procedures. Anesthesia has been the backbone of the medical world for around 100 years now. Early anesthetics were primitive and many patients simply did not trust anesthetics. Anesthesia is still a risky process even in todays advanced medical world. Anesthesia is not used to treat or diagnose any specific disease; the sole purpose is to aid both the patient and surgeon through procedures. However, anesthesia is used in different ways based on the magnitude of the procedure. There are three levels of anesthesia which include; local, regional, and general anesthesia. An anesthesiologist determines which type of anesthesia will be needed.

Anesthesiologists use chemistry every single day on the job. These doctors are responsible for administering the appropriate amount and type of anesthesia and monitoring the patient throughout the procedure. However, anesthesiologists complete a significant amount of pre-operative and post-operative work to ensure the patient survives. This includes gathering the medical and family history and evaluating the patient’s condition by administering a physical exam. After gathering this information, the anesthesiologist will then use his or her chemistry background to accurately calculate the amount of anesthesia and the type of anesthesia needed to be given, depending on the types of medications or risk factors involved.

I agree that with chest trauma, it is imoportant to act immediety. Total morbidity and mortality in traumatiezed emergencry patients is due to chest trauma. Up to 25% of all deaths are due to trauma related to chest injuries, and mortality dramatically increasesd as a function of increased chest trauma force (Ragaller & RIchter, 2011). LIke you mention, the nurse and the emergency team need to work together the best and fast care for the patient.

Situations in which OLV are indicated can be classified into, either to separate both lungs as in case of hemothorax, massive hemorrhage, bronchopleural fistulae and unilateral pulmonary diseases or to facilitate surgical procedures such as pneumonectomies, lobectomies, thoracoscopies and esophageal resection (4).Intraoperative hypoxemia during OLV is observed in approximately from 1 % up to 27% of patients inspite the use of high inspiratory oxygen fraction (Fio2) (5, 6). The incidence of this hypoxemia is affected by many factors e.g. used ventilator settings, the kind of surgery performed, the patient's position during surgery, and anesthesiologist's experience in OLV thoracic anesthesia (7).

Recognizing the potential for a difficult airway (DA) before anaesthesia allows time for optimal preparation, proper selection of equipment and technique and participation of personnel experienced in DA management.

Respiratory distress syndrome (RDS) is a breathing disorder that affects newborns. RDS rarely occurs in full-term infants. The disorder is more common in premature infants born about 6 weeks or more before their due dates. It usually develops in the first 24 hours after birth. RDS is more common in premature infants because their lungs aren't able to make enough surfactant. Surfactant is a liquid that is produced from the alveolar type two cells and coat the inside of the lungs. It breaks up the surface tension found within in the alveoli. Without enough surfactant, the alveoli will stick together and the lungs will collapse, which means the infant has to work much harder to be able to breathe. He or she might not be able to breathe in enough oxygen to support the body's organs. The lack of oxygen can damage the baby's brain and other organs if proper treatment isn't given. According to an article titled “What is the Respiratory Distress Syndrome” by the National Heart, Lung, and Blood Institution, states that “In fact, nearly all infants born before 28 weeks of pregnancy develop RDS (2012, p. 1).” This paper will discuss the pathophysiologic problems,

The optimal timing for elective tracheostomy is still a subject of debate. In the1980s, tracheostomy was considered “early” if it was performed within 21 days of endotracheal intubation. Otorhinolaryngology literatures recommended performance of tracheostomy within 3 days of intubation to prevent vocal cord damage from endotracheal intubation [13]. Several studies have shown early tracheostomy (within 7 days) reduced the duration of mechanical ventilation and the length of ICU stay as well as overall hospital length of stay in trauma patients [14]. The early tracheostomy group had a statistically significant lower incidence of pneumonia (78% vs. 96%, p < 0.05) compared to late tracheostomy (greater than 7 days) [14, 15, 16]. It is believed

I feel that with experience and practice that any medical-surgical nurse can tackle any situation whether stopping fluid from leak out of an abdominal incision site to suctioning a tracheostomy patient. A nurse should address situation under pressure but remain calm and to be able to think of the next step.

Demonstrate stabilized fluid volume with balanced intake and output, breath sounds clear/clearing, vital signs within acceptable range, stable weight, and absence of edema.

In a conscious patient, or where a pulse and breathing are clearly present, the care provider will initially be looking to diagnose immediately life-threatening conditions such as severe asthma, pulmonary oedema or haemothorax. Depending on skill level of the rescuer, this may involve steps such as: