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This chapter discusses the diagnosis, evaluation and management of upper airway emergencies. It presents special circumstances with regard to foreign bodies in the airway. The first step in the evaluation of the patient with suspected upper airway emergency is to determine the need for emergent intubation or surgical airway. If possible, a brief history should be obtained focusing on history of cancer, allergies, exposure to medications including ACE inhibitors, family history of C1 esterase inhibitor deficiency, trauma, and recent surgery. A targeted physical examination should include assessment for stridor, hoarseness, urticaria, edema of skin, lips, mouth, and throat. Given the high-risk, time-sensitive nature of these presentations, all practitioners should be familiar with their local resources, algorithms, and airway management options prior to seeing patients. In patients with a rapidly evolving upper airway obstruction, awake evaluation can provide invaluable information about potential complications before paralytics are administered.
To evaluate the effectiveness of stainless steel (Fe alloy) cooking pots in reducing Fe-deficiency anaemia in food aid-dependent populations.
Repeated cross-sectional surveys. Between December 2001 and January 2003, three surveys among children aged 6–59 months and their mothers were conducted in 110 households randomly selected from each camp. The primary outcomes were changes in Hb concentration and Fe status.
Two long-term refugee camps in western Tanzania.
Children (6–59 months) and their mothers were surveyed at 0, 6 and 12 months post-intervention. Stainless steel pots were distributed to all households in Nduta camp (intervention); households in Mtendeli camp (control) continued to cook with aluminium or clay pots.
Among children, there was no change in Hb concentration at 1 year; however, Fe status was lower in the intervention camp than the control camp (serum transferrin receptor (sTfR) concentration: 6·8 v. 5·9 μg/ml; P < 0·001). There was no change in Hb concentration among non-pregnant mothers at 1 year. Subjects in the intervention camp had lower Fe status than those in the control camp (sTfR concentration: 5·8 v. 4·7 μg/ml; P = 0·003).
Distribution of stainless steel pots did not increase Hb concentration or improve Fe status in children or their mothers. The use of stainless steel prevents rusting but may not provide sufficient amounts of Fe and strong educational campaigns may be required to maximize use. The distribution of stainless steel pots in refugee contexts is not recommended as a strategy to control Fe deficiency.
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