Navigation Links
Need for emergency airway surgery for hard-to-intubate patients reduced
Date:11/17/2009

Be prepared, that old Boy Scout motto, is being applied with great success to operating room patients whose anatomy may make it difficult for physicians to help them breathe during surgery, Johns Hopkins researchers report in a new study.

When patients undergo general anesthesia, they stop breathing on their own and anesthesiologists must quickly insert a tube into the airway as a first step in machine-assisted breathing. The researchers showed that a comprehensive program designed to help physicians quickly identify and treat anesthetized patients in which placement of this tube is difficult has dramatically reduced the need for high-risk emergency surgical procedures to open obstructed airways.

At the heart of the program is a rolling cart armed with most any supply a physician would need to navigate a difficult airway and restart breathing, from flexible scopes and long catheters to medications and a surgical airway kit, just in case. While it may sound simple, the standardized cart cuts out the need for operating room staff to race here and there during a crisis to track down the gear needed to get oxygen flowing again, says Lauren C. Berkow, M.D., one of the study's leaders.

"It seems an obvious solution, but it's not what people are used to doing," says Berkow, an assistant professor of anesthesiology and critical care medicine at the Johns Hopkins University School of Medicine. "People had to run to five different places to get the right equipment.

"The stakes are pretty high. Oxygen is vital. Time is of the essence. You want to make sure you have everything you need and know how to use it when that patient with an emergency rolls through the door."

During the four years before Johns Hopkins put its difficult airway program into place, an average of 6.5 patients a year needed to have their airways opened surgically. Over the 11 years that followed ending in December 2006 an average of just 2.2 patients a year needed the emergency procedure. In the past year, Berkow says, no patients at Johns Hopkins have needed unplanned emergency airway surgery.

The findings are published online and will be in the December issue of the journal Anesthesia & Analgesia.

The cart is but one part of Hopkins' difficult airway program. Doctors have been educated how to spot someone with a potentially life-threatening obstruction and how to use the items on the cart to properly deal with it. When it is difficult to put a breathing tube in place for a particular patient, that information goes into the patient's electronic health record so future providers will be aware of and prepared to deal with potential problems.

The decrease in the number of surgical airway procedures at Hopkins occurred despite an increase in patients reported to have a "difficult airway" as well as an overall increase in the number of patients receiving anesthesia per year, Berkow says. Airway-related deaths also declined after the initiation of the program, but the difference was not statistically significant because of the small numbers.

More patients are appearing with difficult airways, she says, as the population gets older, sicker and larger all signals that inserting a breathing tube could be tricky. Presently, only one to 10 percent of patients have difficult airways, Berkow says. A miniscule number of those will require surgical intervention an incision just below the Adam's apple or into the trachea to ensure air is getting into the lungs.

"We took disorganization and created an organized, standardized system, which we've continued to adapt and update as new technology comes out. We keep all of our staff updated on the system," Berkow says, "and we found it improves outcomes."


'/>"/>

Contact: Stephanie Desmon
sdesmon1@jhmi.edu
410-955-8665
Johns Hopkins Medical Institutions
Source:Eurekalert

Related medicine news :

1. Retired NYPD Lieutenants William E. Keegan, Jr., Owen McCaffery and John Moran and Tom Thees, a former COO in the financial industry, announce today the formation of H.E.A.R.T (Healing Emergency Aid Response Team) 911.
2. Temple Emergency Medicine receives $1.8M to find best MRSA treatment
3. Academy releases emergency preparedness tools to enable millions more people to shelter in place
4. Texas Aviation Services: Over 20 Years of Creating Flying Emergency Rooms for Airborne EMS Customers in US and Latin America
5. American Heart Association Enhances eLearning for Emergency Cardiovascular Care (ECC)
6. Giving emergency nurses aromatherapy massages with music dramatically reduced stress levels
7. Mecklenburg EMS Introduces Most-Advanced Situational Training in America for Emergency Medical Personnel
8. Giving emergency nurses aromatherapy massages with music dramatically reduced stress levels
9. Verathon Inc. Introduces GlideScope(R) Ranger Single Use Video Laryngoscope for Emergency Departments, EMS and Military; Enables Fast Intubations and Eliminates Time-Consuming Disinfection
10. Connecticut Bishops Back Down over Provision of Emergency Contraception
11. Vital Work of Emergency Nurses Honored Across the Nation During Emergency Nurses Week, October 7-13, 2007
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/5/2016)... York, New York (PRWEB) , ... February 05, 2016 , ... ... life? The answer may be at the tips of your toes. Foot massage, whether ... as well as pure comfort and relaxation. The American Board of Multiple Specialties ...
(Date:2/5/2016)... ... February 05, 2016 , ... ... franchises from across the country gathered at the La Valencia Hotel in San ... PROSHRED Chicago was named the year’s most outstanding franchise, walking away with ...
(Date:2/5/2016)... ... 05, 2016 , ... Pivot Point Consulting, a leading national ... & Services for HIT Implementation Support & Staffing report with an outstanding score ... by healthcare executives, managers and clinicians representing over 4,500 hospitals and 2,500 clinics. ...
(Date:2/5/2016)... (PRWEB) , ... February 05, 2016 , ... Colorize ... from on one drop zone to the next using Colorize's dynamic moving camera. Colorize ... project. This package includes a 3D slideshow environment with 1 to 5 focus points ...
(Date:2/5/2016)... ... 05, 2016 , ... Calls Blacklist has just been updated by mobile app ... the developer has fixed known bugs within the app. Calls Blacklist allows its users ... not consuming any of their device’s battery power or memory. It provides a powerful ...
Breaking Medicine News(10 mins):
(Date:2/4/2016)... Feb. 4, 2016  SciClone Pharmaceuticals, Inc. (NASDAQ: ... has entered into a settlement agreement with the ... resolving the SEC,s investigation into possible violations of ... terms of the settlement agreement, SciClone has agreed ... disgorgement, pre-judgment interest and a penalty.  This payment ...
(Date:2/4/2016)... -- Global Immunology Market to 2022 - Large ... growth Summary Immune-mediated inflammatory diseases are ... affect 5–7% of western populations. Although they are ... key patient demographics, they are pathophysiologically linked, being ... inappropriate immune response. Generally, disease-modifying anti-rheumatic drugs, a ...
(Date:2/4/2016)...  Aethlon Medical, Inc. (Nasdaq: AEMD ), ... treat life-threatening diseases, today announced results for the ... 2015. --> --> ... our last quarterly call, we strategically advanced pre-clinical ... to establish the Aethlon Hemopurifier® as a leading ...
Breaking Medicine Technology: