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Chapter 2 - Advanced airway management

from Section I: - Specific features of critical care medicine

Published online by Cambridge University Press:  06 July 2010

Edited by
Edited in association with
Fang Gao Smith
Affiliation:
University of Warwick
Joyce Yeung
Affiliation:
West Midlands Deanery
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Summary

Patients who present in emergency situations are assumed to have a full stomach and in the UK, it is recommended that a rapid sequence induction (RSI) is used in intubation. The majority of anaesthetic induction agents is vasodilators and has cardiodepressant effects. This chapter discusses extubation/weaning protocols. Tracheostomy is utilized in critical care units to facilitate weaning after prolonged ventilation. A cricothyroidotomy is usually performed as an emergency procedure when a secure airway is needed and attempts at orotracheal or nasotracheal intubation have failed. The anatomical landmark and insertion of a mini tracheostomy are similar to performing cricothyroidotomy. Generally they are not recommended for ventilation as the airway resistance is high but recent small studies have been carried out where the combination of a mini tracheostomy plus non-invasive ventilation (NIV) has been used in patients with respiratory failure due to neuromuscular disorder.
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Publisher: Cambridge University Press
Print publication year: 2010

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