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Advanced Airway Management
Advanced airway management is the subset of airway management that involves advanced training, skill, and invasiveness. It encompasses various techniques performed to create an open or patent airway – a clear path between a patient's lungs and the outside world. This is accomplished by clearing or preventing obstructions of airways. Obstructions can be caused by many things, including the patient's own tongue or other anatomical components of the airway, foreign bodies, excessive amounts of blood and body fluids, or aspiration of food particles. Unlike basic airway management such as head tilt/chin lift or jaw-thrust maneuver, advanced airway management relies on the use of medical equipment and advanced training. Certain invasive airway management techniques can be performed "blind" or with visualization of the glottis. Visualization of the glottis can be accomplished either directly by using a laryngoscope blade or by utilizing newer video technology options. In roug ...
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Anesthesiologist
Anesthesiology, anaesthesiology, or anaesthesia is the medical specialty concerned with the total perioperative care of patients before, during and after surgery. It encompasses anesthesia, intensive care medicine, critical emergency medicine, and pain medicine. A physician specialized in anesthesiology is called an anesthesiologist, anaesthesiologist, or anaesthetist, depending on the country. In some countries, the terms are synonymous, while in other countries they refer to different positions, and ''anesthetist'' is only used for non-physicians, such as nurse anesthetists. The core element of the specialty is the study and use of anesthesia to safely support a patient's vital functions through the perioperative period. Since the 19th century, anesthesiology has developed from an experimental area with non-specialist practitioners using novel, untested drugs and techniques into what is now a highly refined, safe and effective field of medicine. In some countries anesthes ...
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Blind Insertion Airway Device
A blind insertion airway device (BIAD or blind insertion device) is a medical device used for airway management that ensures an open pathway between a patient's lungs and the outside world, as well as reducing the risk of aspiration, which can be placed without visualization of the glottis. Blind insertion airway devices are often used in the pre-hospital and emergency setting. While the term blind insertion airway device does not refer to an endotracheal tube, it too can also be blindly inserted in certain circumstances, or inserted using a BIAD as a conduit for an endotracheal tube, or by using a bougie or airway exchange catheter. Blind insertion devices have a number of limitations compared to endotracheal intubation, firstly the risk of aspiration is higher when using a blind insertion device. Examples of blind insertion airway devices are: * Combitube * Laryngeal tube * Laryngeal mask airway * Nasopharyngeal airway * Oropharyngeal airway Additional images Image:Comb ...
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ABC (medicine)
ABC and its variations are initialism mnemonics for essential steps used by both medical professionals and lay persons (such as first aiders) when dealing with a patient. In its original form it stands for ''Airway'', ''Breathing,'' and '' Circulation''. The protocol was originally developed as a memory aid for rescuers performing cardiopulmonary resuscitation, and the most widely known use of the initialism is in the care of the unconscious or unresponsive patient, although it is also used as a reminder of the priorities for assessment and treatment of patients in many acute medical and trauma situations, from first-aid to hospital medical treatment. Airway, breathing, and circulation are all vital for life, and each is required, in that order, for the next to be effective. Since its development, the mnemonic has been extended and modified to fit the different areas in which it is used, with different versions changing the meaning of letters (such as from the original 'Circulatio ...
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Intensive Care Medicine
Intensive care medicine, also called critical care medicine, is a medical specialty that deals with seriously or critically ill patients who have, are at risk of, or are recovering from conditions that may be life-threatening. It includes providing life support, invasive monitoring techniques, resuscitation, and end-of-life care. Doctors in this specialty are often called intensive care physicians, critical care physicians or intensivists. Intensive care relies on multidisciplinary teams composed of many different health professionals. Such teams often include doctors, nurses, physical therapists, respiratory therapists, and pharmacists, among others. They usually work together in intensive care units (ICUs) within a hospital. Scope Patients are admitted to the intensive care unit if their medical needs are greater than what the general hospital ward can provide. Indications for the ICU include blood pressure support for cardiovascular instability (hypertension/hypotensio ...
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Emergency Medicine
Emergency medicine is the Medical specialty, medical speciality concerned with the care of illnesses or Injury, injuries requiring immediate medical attention. Emergency physicians (often called “ER doctors” in the United States) continuously learn to care for unscheduled and undifferentiated patients of all ages. As first-line providers, in coordination with Emergency Medical Services, they are primarily responsible for initiating resuscitation and stabilization and performing the initial investigations and interventions necessary to diagnose and treat illnesses or injuries in the acute phase. Emergency physicians generally practise in Hospital, hospital emergency Emergency room, departments, Pre-hospital emergency medicine, pre-hospital settings via emergency medical services, and intensive care units. Still, they may also work in primary care settings such as urgent care clinics. Sub-specializations of emergency medicine include; disaster medicine, medical toxicology, Eme ...
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Anaesthesia
Anesthesia is a state of controlled, temporary loss of sensation or awareness that is induced for medical or veterinary purposes. It may include some or all of analgesia (relief from or prevention of pain), paralysis (muscle relaxation), amnesia (loss of memory), and unconsciousness. An individual under the effects of anesthetic drugs is referred to as being anesthetized. Anesthesia enables the painless performance of procedures that would otherwise cause severe or intolerable pain in a non-anesthetized individual, or would otherwise be technically unfeasible. Three broad categories of anesthesia exist: * General anesthesia suppresses central nervous system activity and results in unconsciousness and total lack of sensation, using either injected or inhaled drugs. * Sedation suppresses the central nervous system to a lesser degree, inhibiting both anxiety and creation of long-term memories without resulting in unconsciousness. * Regional and local anesthesia, which blocks ...
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Cardiopulmonary Resuscitation
Cardiopulmonary resuscitation (CPR) is an emergency procedure consisting of chest compressions often combined with artificial ventilation in an effort to manually preserve intact brain function until further measures are taken to restore spontaneous blood circulation and breathing in a person who is in cardiac arrest. It is recommended in those who are unresponsive with no breathing or abnormal breathing, for example, agonal respirations. CPR involves chest compressions for adults between and deep and at a rate of at least 100 to 120 per minute. The rescuer may also provide artificial ventilation by either exhaling air into the subject's mouth or nose ( mouth-to-mouth resuscitation) or using a device that pushes air into the subject's lungs ( mechanical ventilation). Current recommendations place emphasis on early and high-quality chest compressions over artificial ventilation; a simplified CPR method involving only chest compressions is recommended for untrained rescuers. ...
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Surgical Airway Management
Surgical airway management (bronchotomy or laryngotomy) is the medical procedure ensuring an open airway between a patient’s lungs and the outside world. Surgical methods for airway management rely on making a surgical incision below the glottis in order to achieve direct access to the lower respiratory tract, bypassing the upper respiratory tract. Surgical airway management is often performed as a last resort in cases where orotracheal and nasotracheal intubation are impossible or contraindicated. Surgical airway management is also used when a person will need a mechanical ventilator for a longer period. The surgical creation of a permanent opening in the larynx is referred to as laryngostomy. Surgical airway management is a primary consideration in anaesthesia, emergency medicine and intensive care medicine. Surgical methods for airway management include cricothyrotomy and tracheostomy History Asclepiades of Bithynia is credited with being the first person who proposed ...
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Tracheal Intubation
Tracheal intubation, usually simply referred to as intubation, is the placement of a flexible plastic tube into the trachea (windpipe) to maintain an open airway or to serve as a conduit through which to administer certain drugs. It is frequently performed in critically injured, ill, or anesthetized patients to facilitate ventilation of the lungs, including mechanical ventilation, and to prevent the possibility of asphyxiation or airway obstruction. The most widely used route is orotracheal, in which an endotracheal tube is passed through the mouth and vocal apparatus into the trachea. In a nasotracheal procedure, an endotracheal tube is passed through the nose and vocal apparatus into the trachea. Other methods of intubation involve surgery and include the cricothyrotomy (used almost exclusively in emergency circumstances) and the tracheotomy, used primarily in situations where a prolonged need for airway support is anticipated. Because it is an invasive and uncomfortable me ...
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General Anaesthesia
General anaesthesia (UK) or general anesthesia (US) is a medically induced loss of consciousness that renders the patient unarousable even with painful stimuli. This effect is achieved by administering either intravenous or inhalational general anaesthetic medications, which often act in combination with an analgesic and neuromuscular blocking agent. Spontaneous ventilation is often inadequate during the procedure and intervention is often necessary to protect the airway. General anaesthesia is generally performed in an operating theater to allow surgical procedures that would otherwise be intolerably painful for a patient, or in an intensive care unit or emergency department to facilitate endotracheal intubation and mechanical ventilation in critically ill patients. A variety of drugs may be administered, with the overall goal of achieving unconsciousness, amnesia, analgesia, loss of reflexes of the autonomic nervous system, and in some cases paralysis of skeletal musc ...
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Laryngeal Mask Airway
A laryngeal mask airway (LMA), also known as laryngeal mask, is a medical device that keeps a patient's Respiratory tract, airway open during anaesthesia or while they are Unconsciousness, unconscious. It is a type of supraglottic airway device. They are most commonly used by anaesthetists to channel oxygen or Inhalational anesthetic, inhalational anaesthetic to the lungs during surgery and in the pre-hospital setting (for instance by paramedics and emergency medical technicians) for unconscious patients. A laryngeal mask is composed of an airway tube that connects to an elliptical mask with a cuff which is inserted through the patient's mouth, down the Trachea, windpipe, and once deployed forms an airtight seal on top the glottis (unlike tracheal tubes which pass through the glottis) allowing a secure respiratory tract, airway to be managed by a health care provider. The laryngeal mask was invented by British people, British anaesthesiologist Archie Brain, Archibald Brain in th ...
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Nasopharyngeal Airway
In medicine, a nasopharyngeal airway, also known as an NPA, nasal trumpet (because of its flared end), or nose hose, is a type of ''airway adjunct'', a tube that is designed to be inserted through the nasal passage down into the posterior pharynx to secure an open airway. It was introduced by in 1958. When a patient becomes unconscious, the muscles in the jaw commonly relax and can allow the tongue to slide back and obstruct the airway. This makes airway management necessary, and an NPA is one of the available tools. The purpose of the flared end is to prevent the device from becoming lost inside the patient's nose. Sizes As with other catheters, NPAs are measured using the French catheter scale, but sizes are usually also quoted in millimeters. Typical sizes include: 6.5 mm/28FR, 7.0 mm/30FR, 7.5 mm/32FR, 8.0 mm/34FR, and 8.5 mm/36FR. Indications and Contraindications These devices are used by emergency care professionals such as EMTs and paramedic ...
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