Challenges of Airway Management in Emergency Situations: A Literature Review
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2019, Vol 16, Issue 1
Abstract
In emergency situations the approach of the airways is crucial for the reduction of the hypoxemia and consequently of the neurological damages. In prehospital care, the advanced management of the airways is pointed out as one of the five research priorities in prehospital critical care. The management of the airways is the first intervention in emergency situations as one of the recommendations of Advanced Trauma Life Support. Endotracheal intubation is a procedure of choice for doctors. However, the use of the pocket-valve-mask is effectively evidenced by a new two-hand sealing technique. The objective of this study is to perform a review on the management of the airways in emergency situations. The management of the airways in emergency situations is considered one of the main life-saving acts [1]. According to Advanced Trauma Life Support recommendations for the management of patients with life-threatening injuries, airway protection is the first intervention [2]. Endotracheal intubation is the technique of choice because it is a fast, more frequently successful procedure and allows the use of a larger tube [1,2]. They are indications for endotracheal intubation and emergency: maintenance of airway permeability, respiratory failure unrelated to upper airway obstruction, decreased risk of aspiration of gastric contents [2]. Evidence corroborated the findings that the efficacy of bag-valve-mask use in emergencies, most emergency intubations occur in situations of cardiorespiratory arrest, the difference in the development of pneumonia due to invasive airway management in a pre-operative environment -hospital and hospital are not significant and the combination of ketamine and propofol (known as cetofol) is an alternative for etomidate in sedation for maintaining hemodynamic stability [2-11]. The objective of this study is to perform a review on the management of the airways in emergency situations. Discussion Air Handling in Emergency Situations In emergency situations the approach of the airways is crucial for the reduction of the hypoxemia and consequently of the neuro logical damages. In prehospital care, the advanced management of the airways is pointed out as one of the five research priorities in prehospital critical care [3]. Bag-valve-mask ventilation is a technique used in emergency situations [4]. The upgrades of Advanced Cardiovascular Life Support point to a high efficacy of the use of pocket-valve-mask in cardiorespiratory arrest when compared to endotracheal intubation [5]. The studies corroborate the lack of high-quality evidence that favors the use of endotracheal intubation compared to bag-valve-mask ventilation or an advanced airway device in relation to overall survival or favorable neurological outcome [5]. Many challenges are heightened in the emergency scenario and with this, physicians must be skilled with the management of the airways. Advances in airway management technology have helped improve many aspects of emergency management; however, besides the specialization, it is necessary to use the right equipment and the adequate understanding of the new technologies [6].
Authors and Affiliations
Marco Felipe Bouzada Marcos, Fernando Peribanez, Larissa Alexsandra da Silva Neto Trajano, Marco Aurélio dos Santos Silva, Carlos Eduardo Cardoso, Eduardo Tavares Lima Trajano, Victor Hugo Bastos, Silmar Teixeira, Acary Bulle Oliveira, Marco Orsini
Keywords
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- EP ID EP591860
- DOI 10.26717/BJSTR.2018.06.001290
- Views 189
- Downloads 0
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