sábado, 17 de diciembre de 2016

Manejo prehospitalario de la vía aérea / Prehospital airway management

Diciembre 8,  2016. No. 2532






Avances en el manejo prehospitalario de la vía aérea
Advances in prehospital airway management.
Int J Crit Illn Inj Sci. 2014 Jan;4(1):57-64. doi: 10.4103/2229-5151.128014.
Abstract
Prehospital airway management is a key component of emergency responders and remains an important task of Emergency Medical Service (EMS) systems worldwide. The most advanced airway management techniques involving placement of oropharyngeal airways such as the Laryngeal Mask Airway or endotracheal tube. Endotracheal tube placement success is a common measure of out-of-hospital airway management quality. Regional variation in regard to training, education, and procedural exposure may be the major contributor to the findings in success and patient outcome. In studies demonstrating poor outcomes related to prehospital-attempted endotracheal intubation (ETI), both training and skill level of the provider are usually often low. Research supports a relationship between the number of intubation experiences and ETI success. National standards for certification of emergency medicine provider are in general too low to guarantee good success rate in emergency airway management by paramedics and physicians. Some paramedic training programs require more intense airway training above the national standard and some EMS systems in Europe staff their system with anesthesia providers instead. ETI remains the cornerstone of definitive prehospital airway management, However, ETI is not without risk and outcomes data remains controversial. Many systems may benefit from more input and guidance by the anesthesia department, which have higher volumes of airway management procedures and extensive training and experience not just with training of airway management but also with different airway management techniques and adjuncts.
KEYWORDS: Airway; anesthesiology; emergency; management; prehospital
Manejo prehospitalario de la vía aérea
Prehospital Airway Management
Flavia Petrini, Maurizio Menarini,  and Elena Bigi2
University of Chieti-Pescara
Bologna, Italy
Emergency Medicine - An International Perspective
Neumonía de inicio temprano en paro cardiaco no temprano fuera de hospital con atención especial en el manejo prehospitalario de la vía aérea
Early-Onset Pneumonia in Non-Traumatic Out-of-Hospital Cardiac Arrest Patients with Special Focus on Prehospital Airway Management.
Med Sci Monit. 2016 Jun 13;22:2013-20.
Abstract
BACKGROUND More than half of all non-traumatic out-of-hospital cardiac arrest (OHCA) patients die in the hospital. Early-onset pneumonia (EOP) has been described as one of the most common complications after successful cardiopulmonary resuscitation. However, the expanded use of alternative airway devices (AAD) might influence the incidence of EOP following OHCA. MATERIAL AND METHODS We analyzed data from all OHCA patients admitted to our hospital between 1 January 2008 and 31 December 2014. EOP was defined as proof of the presence of a pathogenic microorganism in samples of respiratory secretions within the first 5 days after hospital admission. RESULTS There were 252 patients admitted: 155 men (61.5%) and 97 women (38.5%), with a mean age of 69.1±13.8 years. Of these, 164 patients (77.6%) were admitted with an endotracheal tube (ET) and 62 (27.4%) with an AAD. We found that 36 out of a total of 80 respiratory secretion samples (45.0%) contained pathogenic microorganisms, with Staphylococcus aureus as the most common bacteria. Neither bacterial detection (p=0.765) nor survival rates (p=0.538) differed between patients admitted with ET and those with AAD. CONCLUSIONS Irrespective of increasing use of AAD, the incidence of EOP remains high.
Regional Anesthesiology and Acute Pain Medicine Meeting
April 6-8, 2017, San Francisco, California, USA
ASRA American Society of Regional Anesthesia and Pain Medicine
California Society of Anesthesiologists
Annual Meeting April 27-30, 2017
San Francisco California
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