High-Risk Airway Management in the Emergency Department. Part I : Diseases and Approaches

Published by Elsevier Inc..

BACKGROUND: Successful airway management is critical to the practice of emergency medicine. Emergency physicians must be ready to optimize and prepare for airway management in critically ill patients with a wide range of physiologic challenges. Challenges in airway management commonly encountered in the emergency department are discussed using a pearl and pitfall discussion in this first part of a 2-part series.

OBJECTIVE: This narrative review presents an evidence-based approach to airway and patient management during endotracheal intubation in challenging cases that are commonly encountered in the emergency department.

DISCUSSION: Adverse events during emergent airway management are common, with postintubation cardiac arrest reported in as many as 1 in 25 intubations. Many of these adverse events can be avoided with the proper identification and understanding of the underlying physiology, preparation, and postintubation management. Patients with high-risk features including severe metabolic acidosis; shock and hypotension; obstructive lung disease; pulmonary hypertension, right ventricle failure, and pulmonary embolism; and severe hypoxemia must be managed with airway expertise.

CONCLUSIONS: This narrative review discusses the pearls and pitfalls of commonly encountered physiologic high-risk intubations with a focus on the emergency clinician.

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:59

Enthalten in:

The Journal of emergency medicine - 59(2020), 1 vom: 14. Juli, Seite 84-95

Sprache:

Englisch

Beteiligte Personen:

Lentz, Skyler [VerfasserIn]
Grossman, Alexandra [VerfasserIn]
Koyfman, Alex [VerfasserIn]
Long, Brit [VerfasserIn]

Links:

Volltext

Themen:

Airway
Hypotension
Hypoxemia
Journal Article
Metabolic acidosis
Obstructive lung disease
Postintubation cardiac arrest
Pulmonary embolism
Pulmonary hypertension
Review
Shock

Anmerkungen:

Date Completed 23.06.2021

Date Revised 11.11.2023

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.jemermed.2020.05.008

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM311422527