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Image Acquisition using Portable Sonography for Emergency Airway Management
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Published on: September 28, 2022

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Acute airway management.

Nikhil Panda1, Dean M Donahue1

  • 1Division of Thoracic Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA.

Annals of Cardiothoracic Surgery
|May 1, 2018
PubMed
Summary
This summary is machine-generated.

Acute airway management has evolved significantly, yet remains a critical challenge. Current standards favor transoral intubation, with surgical options for emergencies, emphasizing patient stability and clinician expertise.

Keywords:
Airway obstructionpercutaneous tracheostomypost-intubation tracheal stenosissurgical cricothyroidotomy

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Area of Science:

  • Medical history
  • Surgical innovation
  • Anesthesiology

Background:

  • Acute airway management presents enduring clinical challenges despite millennia of practice.
  • Historical advances by surgeons and anesthesiologists have shifted techniques from tracheostomy to endotracheal intubation.
  • Understanding airway anatomy and disease is crucial, yet acute airway compromise remains life-threatening.

Purpose of the Study:

  • To provide a historical perspective on acute airway management.
  • To review current medical and surgical approaches for acute airway management.
  • To emphasize the role of thoracic surgeons in preventing and managing tracheal obstruction.

Main Methods:

  • Historical review of airway management milestones.
  • Analysis of current medical and surgical interventions for acute airway emergencies.
  • Evaluation of risks, benefits, and appropriateness of different airway management strategies.

Main Results:

  • Transoral intubation under direct laryngoscopy is the standard of care, with indirect laryngoscopy as an adjunct.
  • Cricothyroidotomy followed by tracheostomy is the preferred surgical approach after failed intubation.
  • Percutaneous tracheostomy is an alternative, but carries risks of damage and increased intubation time.

Conclusions:

  • Effective acute airway management prioritizes patient stability, airway patency, oxygenation, and ventilation.
  • The choice of airway intervention depends on patient stability, equipment, clinician training, and desired outcomes.
  • Thoracic surgeons play a vital role in preventing airway obstruction and monitoring patients with chronic tracheal issues.