Difficulty in airway management is considered a major cause of morbidity and mortality in anaesthesia. Hence it is important to identify patients at risk for tracheal intubation in an otherwise apparently normal airway. Difficult airway is defined as clinical situation in which a trained anaesthesiologist has difficulty with mask ventilation, tracheal intubation, or both. Intubation is termed difficult if trained anesthesiologist takes more than 3 attempts or more than 10 minutes for a successful tracheal intubation. [1] Difficult laryngoscopy is an indirect indicator of difficult intubation. A difficult intubation occurs in approximately one in 200 patients in the general surgical population. Candidates with potentially difficult airway
Prior to intubation for a surgical procedure, the anesthesiologist administered a single dose of the neuromuscular blocking agent, succinylcholine, to a 23-year-old female to provide muscular relaxation during surgery and to facilitate the insertion of the endotracheal tube. Following this, the inhalation anesthetic was administered and the surgical procedure completed.
This essay describes how the anaesthetic machine and airway management equipment are prepared in operating theatres and discusses how they are ensured safe for use. It evaluates the Association of Anaesthetists of Great Britain and Ireland (AAGBI) guidelines related to safe practice and the preparation of the ET tubes, laryngeal masks, guedels, Naso pharyngeal airways and the laryngoscope. The function of the anaesthetic workstation is to deliver a mixture of anaesthetic agents and gases safely to the patient during the induction process and throughout surgery. In addition, it also provides ventilation to support breathing and monitors the patient’s vital signs to minimise the anaesthetic risks to the patient whilst in the care of health professionals. The pre-use check is vital to patient safety as an inadequate check of the anaesthetic machine or airway management equipment can and does lead to significant harm of the patient including mortality (Medicines and Healthcare Products Regulatory Agency (MHRA), 2008 and Magee, 2012).
The EB’s case study said the female patient is 50 years old with symptoms of fever, chills, congestion, three weeks of coughing, shortness of breath when walking. The study implies that the patient is now seeking medical advice due to vital signs recording and the noting of decreased breath sounds and wheezing. She denies smoking and not taking any chronic medication.
In the case listed here Dr. Loren J. Borud was scheduled to perform surgery on Mr. Michael Hicks early on a Friday morning. The surgery was liposuction and a scar repair procedure. Dr. Loren informed the patient the procedure would take approximately ninety minutes, but ultimately ended up over seven hours long due to the fact Dr. Loren kept falling asleep during Mr. Hick’s surgery! Seven hours is way too long to be put under anesthesia for something as simple as liposuction. The longer a patient is under anesthesia they are higher chances of more risk and complications can occur during or even after the operation.
Breathing is the most important AL (Roper et al, 1998). A detailed assessment of her airway would be performed because protection of the airway throughout anaesthesia is essential (Yates, 2000). This does not just include recording of respiration rate and oxygen saturation (SpO2) but also noting any use of accessory muscles, shortness of breath, auscultation of chest and lungs areas for wheezes/crackles and asking patient about history of any respiratory illness/smoking (McArthur-Rouse, 2007).
Today I will be explaining the importance and details of tracheobronchitis also referred to as bronchitis. Tracheobronchitis as the name gives off is an inflammation of the trachea and bronchitis. The trachea and bronchi’s main role is to extend air into the lungs, so that they are able to reach the alveoli which are responsible for gas exchange in the lungs. Tracheobronchitis is often times not contagious depending upon the cause of inflammation, inflammation can result from an allergic reaction, bacterial infection or virus. Some important clinical manifestations that you may see include wheezing which are a result of inflamed airways,fever, dry or phlegm cough, night sweats, headache and sore throat. Tracheobronchitis does not always have to be severe it can also be acute and last only a few weeks.
It is suggested by Henderson (1998) that breathlessness in the UK today is a common and complex subjective set of symptoms. A vast range of medical and lifestyle choices cause and exacerbate breathlessness, which can be a frightening and sometimes a painful experience for the patient. A nurses interaction with a patient can help alleviate and reduce these episodes and make a substantial difference to patients both in the community and hospital setting.
Brody, Michael, and Donald Martin. “The Role of Anesthesiologists.” Physicians Protecting Patients. N.p. N.d. Web. October 21, 2015. An anesthesiologist is a physician who has received at least 8 years of schooling and has completed a residency program dealing with anesthesiology. Now, a licensed physician, an anesthesiologist deals with the administration of anesthesia during many medical procedures, including surgical or obstetric procedures, and pain management for acute and chronic illnesses, or cancer related pain. Anesthesiologists are also in charge of “anesthesia care teams” that include the anesthesiologist, an anesthesia assistant, certified registered nurse anesthetist, and an anesthesia technician. As the leader of the care team, the anesthesiologist is responsible for assessing the patient before, during, and after medical procedures, as well as developing and monitoring performance and quality of practices and standards in regards to administering anesthesia. The entirety of
2) “It’s difficult to determine who provides anesthesia care in the studies and the number of cases that actually involved a physician anesthesiologist (p. 11)” the ASA is claiming that the data collected and used in this review, are difficult to determine who did what and when. In other words it is unclear as to who was performing and providing care in these studies and very well could be, the care provided by an anesthesiologist. They say also that the data provided and used by the study has limiting factors to determine whether an anesthesiologist was available as needed, for rescue or advice by a patient being treated by a nurse anesthetist if they were to experience complications under the
American Association of Nurse Anesthetists. Professional Aspects of Nurse Anesthesia Practice. Philadelphia: F. A. Davis Company, 1994. Print.
Asthma is a disease that affects the breathing passages of the lungs (bronchioles). People who have asthma always have difficulty breathing. In the United States alone, over twenty-five million Americans are diagnosed with asthma. According to the Centers for Disease Control and Prevention (CDC), asthma is known to be the third most common disease as well as a leading cause to hospitalization in America. In 2008, one in two people were reported to have asthma attacks which is roughly about twelve million asthma attacks a year. In 2007, the United States spent more than fifty-six million dollars on medical costs, lost school and work days, and early deaths from asthma. Asthma is not visible to the human eye, so it is difficult in an emergency situation for the lay responder to tell whether the victim is having trouble breathing or having an asthma attack. Unlike people who are diabetic and have to wear medical ID bracelets, people with asthma are not required to wear them, but it should be recommended to help the lay responder, the doctors and the paramedics identify the situation they are dealing with at hand. For hours, days or even months a person may be normal but then an attack may suddenly happen out of nowhere.
The technology of general anesthesia was still in the early stages so it made many procedures extremely painful. A little
Most of you may not think of asthma as a killer disease, yet more that 5,000 Americans die of asthma each year. According to the Mayo Clinic web page, asthma also accounts for more that 400,000 hospital discharges annually. As the number of people with asthma increases, the more likely you are to come in contact with a person who has the disease. As far as I can remember, I have had asthma my whole life. My mother and one of my sisters also have asthma, so I have a first hand experience with it. This morning, I will discuss some interesting facts about asthma, I will specifically focus on what it is, warning signs, symptoms, causes, and the treatments that are used.
Webster CS, Merry AF, Larsson L, McGrath KA, Weller J. The frequency and nature of drug administration error during anaesthesia. Anaesth Intensive Care 2001; 29: 494-500.
Nursing Diagnosis I for Patient R.M. is ineffective airway clearance related to retained secretions. This is evidenced by a weak unproductive cough and by both objective and subjective data. Objective data includes diagnosis of pneumonia, functional decline, and dyspnea. Subjective data include the patient’s complaints of feeling short of breath, even with assistance with basic ADLs. This is a crucial nursing diagnosis as pneumonia is a serious condition that is the eighth leading cause of death in the United States and the number one cause of death from infectious diseases (Lemon, & Burke, 2011). It is vital to keep the airway clear of the mucus that may be produced from the inflammatory response of pneumonia. This care plan is increasingly important because of R.M.'s state of functional decline; he is unable to perform ADL and to elicit a strong cough by himself due to his slouched posture. Respiratory infections and in this case, pneumonia, will further impair the airway (Lemon, & Burke, 2011). Because of the combination of pneumonia and R.M's other diagnoses of lifelong asthma, it is imperative that the nursing care plan of ineffective airway clearance be carried out. The first goal of this care plan was to have the patient breathe deeply and cough to remove secretions. It is important that the nurse help the patient deep breathe in an upright position; this is the best position for chest expansion, which promotes expansion and ventilation of all lung fields (Sparks and Taylor, 2011). It is also important the nurse teach the patient an easily performed cough technique and help mobilize the patient with ADL's. This helps the patient learn to cough and clear their airways without fatigue (Sparks a...