By Gabrielli, Yu, Layon
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Extra resources for Civetta, Taylor, and Kirby’s Manual of Critical Care
4) sIs there a reasonable expectation for successful mask ventilation? sIs intubation of the trachea expected to be problematic? sShould the airway approach be nonsurgical or surgical? sShould an awake or a sedated/unconsciousness approach be pursued? sShould spontaneous ventilation be maintained? sShould paralysis be pursued? sMay allow laryngeal mask airway (LMA) insertion sMay allow indirect fiberoptic techniques (rigid and flexible) or proceeding with a surgical airway sAccess to the airway via cricothyroid membrane puncture via large-bore catheter insertion with either modified tubing or a jet device to ventilate, or via Melker cricothyrotomy kit, is an option prior to other awake or asleep methods.
Hypoventilation syndromes c. Hypoxemic respiratory failure d. Failure of pulmonary toilet e. Inability to protect airway 2. Evaluate for potential difficulty re-establishing the airway a. Difficult airway b. Limited access to the airway c. Inexperienced personnel pertaining to airway skills d. Airway injury, edema formation TA B L E 2 . 75 in LWBK937-Gabrielli-v1 August 11, 2011 Chapter 3: Temporary Cardiac Pacemakers TA B L E 2 . 1 4 STRATEGY AND PREPARATION FOR ENDOTRACHEAL TUBE (ET) EXCHANGE 1.
SMore invasively, transtracheal jet ventilation via a largegauge (12- or 14-gauge) IV catheter through the cricothyroid membrane may be an appropriate alternative. sAirway management also constitutes maintaining control of the airway into the postextubation period. 11). s“Difficult extubation” is defined as the clinical situation when a patient presents with known or presumed risk factors that may contribute to difficulty re-establishing access to the airway. sReintubation, immediately or within 24 hours, may be required in up to 25% of intensive care unit patients.