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Surgical airway management (bronchotomy [1] 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.
However, there is a growing body of lower quality evidence (simulation studies, and studies utilising observational data from patients) that are encouraging in terms of increasing clinician's confidence in managing severely contaminated airways [8] [9] and improving intubation success rates as well as time to successful intubation [10] [11] [12 ...
Endotracheal intubation carries with it many risks, particularly when paralytics are used, as maintenance of the airway becomes a challenge if intubation fails. It should therefore be attempted by experienced personnel, only when less invasive methods fail or when it is deemed necessary for safe transport of the patient, to reduce risk of ...
Airway management can be classified into closed or open techniques depending on the system of ventilation used. Tracheal intubation is a typical example of a closed technique as ventilation occurs using a closed circuit. Several open techniques exist, such as spontaneous ventilation, apnoeic ventilation or jet ventilation.
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.
Intubation with a cuffed tube is thought to provide the best protection against aspiration. Downside of tracheal tubes is the pain and coughing that follows. Therefore, unless a patient is unconscious or anesthetized, sedative drugs are usually given to provide tolerance of the tube.
The laryngeal tube is also recommended for medical personnel not experienced in tracheal intubation, and as a rescue device when intubation has failed in adults. [16] According to the manufacturer the use of Laryngeal tubes is contraindicated in people with an intact gag reflex , known oesophageal disease , and people who have ingested caustic ...
It channels oxygen and inhalational anaesthetic to the lungs. It can be used during anaesthesia, or while a patient is unconscious. Laryngeal mask airways are designed to be an easy way to secure the airway and ventilate a patient – they are easier to place than tracheal intubation due to the lack of muscle relaxants and laryngoscopy.