Intubation

BACKGROUND: Tracheal intubation may induce; hypertension, tachycardia, and/or arrhythmia. Fentanyl is a frequently used opioid that joins with hypnotic agents to diminish hemodynamic responses to tracheal intubation. Furthermore, lidocaine has a suppressive effect on the circulatory responses in patients undergoing laryngoscopy and tracheal intubation. However, intravenous lignocaine has shown variable results and large doses of fentanyl causes hypotension and cough. We compared the effectiveness

difficulty of intubation (Brien and Conlon, 2013). Its makes hard to insert laryngoscope when the patient have a large breast, the chance of bleeding and swelling increases due to oedema and vascularity of the upper respiratory tract, and the patient desaturate quicker as there is increase in oxygen requirements and there is reduced in functional residual capacity (Mushambi et al, 2015). As a result of all the changes during pregnancy, if the problems encountered during the intubation of Mrs D were

It has been established that inability to successfully manage very difficult airway was been responsible for as many as 30% of death totally attributable to anesthesia. (1) The routine use of endotracheal tube is to secure the airway and prevent the aspiration of gastric content in case of regurge or vomiting but there is a case series demonstrated that the routine use of the endotracheal tube did not reduce maternal death due to aspiration(2) Supraglottic airway devices have become a standard

responsibilities. Endotracheal intubation is more difficult in obese than in lean patients.3 Difficult tracheal intubation is defined by the American Society of Anesthesiologists (ASA) as tracheal intubation requiring multiple attempts in the presence or absence of tracheal pathology.4 1 Failure of tracheal intubation is one of the major causes of morbidity and mortality during anesthesia.5,6 Consequently, the use of new tools that increase the success of tracheal intubation, particularly in settings

the Greater Sydney Area Helicopter Emergency Medical Services (N=728). The emergency anesthesia standard operating procedure (SOP) was updated in July 2011, introducing apneic oxygenation during intubation as standard practice. Prior to implementation of apneic oxygenation, patients who required intubation were pre-oxygenated with either an NRB or a self-inflating bag-valve-mask (BVM) set to 15 L/min (n=310). The updated SOP required that a standard nasal cannula be placed, in addition to the NRB

could dislodge the biofilm into the airway and increase the risk of VAP (Moore. 2003; Morehead and Pinto. 2002). According to Hunter (2012, p.40) “VAP is a hospital acquired pneumonia that occurs 48 hours or more after tracheal intubation or acute tracheostomisation”. VAP is one of the most common nosocomial infection responsible for one third of mortal respiratory infections in European ICUs (Adib-Hajbaghery et al. 2011). Despite of its high incidence, identifying VAP infection

sleep apnea and large neck circumference with difficult intubation (2) Difficult airway is the clinical situation in which a trained anesthesiologist experiences difficulty with face mask ventilation, tracheal intubation or both.(3) The use of fibreoptic bronchoscope for difficult tracheal intubation has been gradually increased. Anesthesiologists still have limited skills with awake fibreoptic intubation. (4,5) The learning curve for intubation using the fiberoptic bronchoscope must be always developed

Although ventilation is not usually provided during the apnoeic period, some anaesthetists will give a single breath, or several gentle breaths, to both confirm that mask ventilation is possible and reduce the development of hypercapnia, acidaemia, and hypoxia. Some guidelines advocate use of mask ventilation for this reason in patients at elevated risk of hypoxia, for example, the pregnant patient.4,5 Apnoeic oxygenation is increasingly used, especially in critically unwell patients, to provide

to the ICU, as a result of a perforated viscus ulcer. Interview Did you hear anything? /can you describe what you heard? When asked questions, the patient expressed not hearing various things during the intubation procedure. Specifically, the patient remembered being told about the intubation and numerous muffled voices before the procedure. After the procedure, the patient noted hearing familiar voices of the family especially the patient's mom, asking how the patient was feeling. Further, the

following inclusion criteria: Patients were American Society of Anesthesiologists physical status II, ejection fraction (EF) ≥40% and scheduled for elective cardiac surgery under general anesthesia. No difficulties with their airway management or intubation were predicted during preoperative visits according to Mallampati score classification. Exclusion criteria were patients undergoing emergency surgery or those allergic to any of the drugs in the protocol, a history of reactive airway disease, gastroesophageal