Failed Airway Management in a Patient with Wound Hematoma After Partial Mandibulectomy and Reconstruction with Free Flap

2013 ◽  
Vol 13 (3) ◽  
pp. 127
Author(s):  
Seokkon Kim ◽  
Jaegyok Song ◽  
Bongjin Kang ◽  
Cheolwhan Choi ◽  
Gyuwoon Choi
Keyword(s):  
Airway Management ◽  
Free Flap ◽  
Failed Airway

scholarly journals Airway Management Failure after Delayed Extubation in a Patient with Oral Malignant Melanoma Who Underwent Partial Mandibulectomy and Reconstruction with a Free Flap

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Min A. Kwon ◽  
Jaegyok Song ◽  
Seokkon Kim ◽  
Pyeung-wha Oh ◽  
Minji Kang
Keyword(s):  
Airway Management ◽  
Free Flap ◽  
Radical Neck Dissection ◽  
Maxillofacial Surgery ◽  
Supraglottic Airway ◽  
Surgical Trauma ◽  
Emergency Tracheostomy ◽  
Delayed Extubation ◽  
Failed Airway ◽  
Bag Mask Ventilation

Maxillofacial surgery may cause severe complications in perioperative airway management. We report a case of failed airway management in a patient who underwent segmental mandibulectomy, radical neck dissection, and reconstruction with a free flap. The patient was extubated approximately 36 hours after surgery. Approximately 7 hours after extubation, the patient complained of dyspnoea, and respiratory failure followed. Bag-mask ventilation, direct laryngoscopy, video laryngoscopy, and supraglottic airway access were ineffective. The surgical airway was secured with an emergency tracheostomy while performing cardiopulmonary resuscitation. However, the patient experienced permanent hypoxic brain damage. The airway of patients with oral cancer may be compromised postoperatively due to surgical trauma and bulky flap reconstruction. Patients should be closely monitored during the postoperative period to prevent airway failure. Early diagnosis and airway management before airway failure occurs are important. Medical staff should be aware of airway management algorithms, be trained to perform difficult airway management, and have the required equipment readily available.

scholarly journals High Flow Humidified Nasal Oxygen in Pregnant Women

2018 ◽  
Vol 46 (1) ◽  
pp. 36-41 ◽  
Author(s):  
P. C. F. Tan ◽  
A. T. Dennis
Keyword(s):  
Pregnant Woman ◽  
Airway Management ◽  
Pregnant Women ◽  
Current Literature ◽  
Clinical Applications ◽  
High Flow ◽  
Failed Airway ◽  
Obstetric Population ◽  
Apnoeic Oxygenation ◽  
Safety Strategy

Failed airway management in the obstetric patient undergoing general anaesthesia is associated with major sequelae for the mother and/or fetus. Effective and adequate pre-oxygenation is an important safety strategy and a recommendation in all current major airway guidelines. Pre-oxygenation practice in the obstetric population may be suboptimal based on current literature. Recently, clinical applications for high flow nasal oxygen, also known as transnasal humidified rapid insufflation ventilatory exchange or THRIVE, are expanding in the non-obstetric population and may have theoretical benefits if used for pre-oxygenation and apnoeic oxygenation in the obstetric population. We review the current literature surrounding high flow nasal oxygen relevant to the pregnant woman. We also propose a basis for potential advantages and complications for its use in this context.

scholarly journals (P1-62) The Risk Factors for Difficult or Failed Airway: A Prosepctive Cohor Study

2011 ◽  
Vol 26 (S1) ◽  
pp. s118-s118
Author(s):  
C. Hsu
Keyword(s):  
Risk Factors ◽  
Airway Management ◽  
Difficult Airway ◽  
Healthcare Providers ◽  
Positive Association ◽  
Daily Practice ◽  
Trauma Patients ◽  
Airway Trauma ◽  
Failed Airway ◽  
Airway Devices

The risk factors for difficult airway or failed airway: a prospective cohort study Airway management is always the first priority and time-treasures in critical ill-patients. Improper managementof difficult airway or resultant fail airway would bring poor prognosis to patients. We investigated the risk factors of difficult or fail airway from the multiple dimension of factors including patients, healthcare and airway devices. We enrolled 252 intubated patients, including 37 trauma patients, 55 patients (22%) with difficult airway, and 22 patients (8.7%) with fail airway. In analysis of risk factors of difficult airway, factors including obesity, short neck or thickness of soft tissue, facial deformities and oral-nasal bleeding have positive association with fail airway, but the seniority of healthcare providers had no effect. However, experienced healthcare providers have more success rate after the occurrence of fail airway. The most complications of fail airway include airway trauma and hypoxia. As compared with non-trauma patients, trauma patients have more episodes of fail airway, difficult airway, and use of RSI, rescue airway for fail airway, airway trauma and vomiting. Therefore, it is necessary to establish an easy and safe standard guideline in daily practice of difficult and urgent airway management for healthcare providers.

scholarly journals A Cohort and Database Study of Airway Management in Patients Undergoing Thyroidectomy for Retrosternal Goitre

2014 ◽  
Vol 42 (6) ◽  
pp. 700-708 ◽  
Author(s):  
N. Gilfillan ◽  
C. M. Ball ◽  
P. S. Myles ◽  
J. Serpell ◽  
W. R. Johnson ◽  
...  
Keyword(s):  
Airway Management ◽  
Difficult Airway ◽  
General Anaesthesia ◽  
Thyroid Surgery ◽  
Good Evidence ◽  
Anaesthetic Induction ◽  
Tracheal Compression ◽  
Induction Technique ◽  
Failed Airway ◽  
Symptoms And Signs

Patients undergoing thyroid surgery with retrosternal goitre may raise concerns for the anaesthetist, especially airway management. We reviewed a multicentre prospective thyroid surgery database and extracted data for those patients with retrosternal goitre. Additionally, we reviewed the anaesthetic charts of patients with retrosternal goitre at our institution to identify the anaesthetic induction technique and airway management. Of 4572 patients in the database, 919 (20%) had a retrosternal goitre. Two cases of early postoperative tracheomalacia were reported, one in the retrosternal group. Despite some very large goitres, no patient required tracheostomy or cardiopulmonary bypass and there were no perioperative deaths. In the subset of 133 patients managed at our institution over six years, there were no major adverse anaesthetic outcomes and no patient had a failed airway or tracheomalacia. In the latter cohort, of 32 (24%) patients identified as having a potentially difficult airway, 17 underwent awake fibreoptic tracheal intubation, but two of these were abandoned and converted to intravenous induction and general anaesthesia. Eleven had inhalational induction; two of these were also abandoned and converted to intravenous induction and general anaesthesia. Of those suspected as having a difficult airway, 28 (87.5%) subsequently had direct laryngoscopy where the laryngeal inlet was clearly visible. We found no good evidence that thyroid surgery patients with retrosternal goitre, with or without symptoms and signs of tracheal compression, present the experienced anaesthetist with an airway that cannot be managed using conventional techniques. This does not preclude the need for multidisciplinary discussion and planning.

Unrecognized failed airway management using a supraglottic airway device

Resuscitation ◽  
2017 ◽  
Vol 119 ◽  
pp. 1-4 ◽  
Author(s):  
Veer D. Vithalani ◽  
Sabrina Vlk ◽  
Steven Q. Davis ◽  
Neal J. Richmond
Keyword(s):  
Airway Management ◽  
Airway Device ◽  
Supraglottic Airway ◽  
Supraglottic Airway Device ◽  
Failed Airway

scholarly journals ¿ Caminamos hacia el manejo del videolaringoscopio como primera opción en una vía aérea difícil?

2020 ◽  
Vol 12 (7) ◽  
pp. 1
Author(s):  
Juan José Correa Barrera ◽  
Mónica San Juan Álvarez ◽  
Blanca Gómez Del Pulgar Vázquez ◽  
Gholamian Ovejero Soraya
Keyword(s):  
Decision Making ◽  
Tracheal Intubation ◽  
Airway Management ◽  
Difficult Airway ◽  
The Other ◽  
Optimal Decision ◽  
Difficult Airway Management ◽  
Toma De Decisiones ◽  
Failed Airway ◽  
Optimal Decision Making

Determinar los factores predictivos de una vía aérea difícil constituye un reto para el médico anestesiólogo. La mayoría de guías actuales, sitúan los videolaringoscopios como elementos de rescate de una vía aérea fallida, tras una laringoscopia tradicional óptima. Establecer un algoritmo que en base a unas características físicas, permita determinar qué pacientes se beneficiarán del uso del videolaringoscopio como primera opción, puede suponer una ventaja y una disminución en los problemas relacionados con la vía aérea. Por otra parte, establecer cuáles de estos factores predicen con más fuerza una dificultad con el videolaringoscopio, nos ayudará a realizar mejores planes de abordaje y una óptima toma de decisiones sobre una vía aérea difícil. Este algoritmo ha sido capaz de conseguir la intubación traqueal de todos los pacientes en los que se ha previsto una laringoscopia difícil. ABSTRACT Moving towards videolaryngoscopy handling as first option in difficult airway management? Determining the predictors of a difficult airway is a challenge for the anesthesiologist. Most current guides place videolaryngoscopes as recue elements of a failed airway, after an optimal traditional laryngoscopy. Establishing an algorithm which, based on physical charcteristics, allows to determine which patients will benefit from the use of videolaryngoscopy as a first option, may lead to a potential advantage and a net decrease in airway related problems. On the other hand, establishing which of those factors predict in a more reliable way a difficulty with the videolaryngoscopy, will contribute to make better plans of approach as well as an optimal decision making on a difficult airway. This algorithm has been able to achieve tracheal intubation of all patients for which a difficult laryngoscopy is expected.

Failed airway management with the GlideScope: it is not the same tool in infants

2015 ◽  
Vol 27 (6) ◽  
pp. 534-535 ◽  
Author(s):  
Bridget L. Muldowney ◽  
Lianne L. Stephenson ◽  
Lana M. Volz ◽  
Guelay Bilen-Rosas
Keyword(s):  
Airway Management ◽  
Failed Airway
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