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Tracheal intubation is anticipated to be difficult in this child with a massive ameloblastoma. Tracheal intubation is not a simple procedure and the consequences of failure are grave. Therefore, the patient is carefully evaluated for potential difficulty or complications beforehand.
Advanced techniques require specialized medical training and equipment, and are further categorized anatomically into supraglottic devices (such as oropharyngeal and nasopharyngeal airways), infraglottic techniques (such as tracheal intubation), and surgical methods (such as cricothyrotomy and tracheotomy). [2]
[4] [5] While UpToDate recommends only using abdominal thrusts in adults and children more than one-year-old. [6] In some areas, such as Australia, authorities believe there is not enough scientific evidence to support the use of abdominal thrusts, and their use is not recommended in first aid. Instead, chest thrusts are recommended. [7]
These are followed by infraglottic techniques, such as tracheal intubation and finally surgical techniques. Advanced airway management is a key component in cardiopulmonary resuscitation, anesthesia, emergency medicine, and intensive care medicine. The "A" in the ABC mnemonic for dealing with critically ill patients stands for airway management ...
As all techniques, cricoid pressure has indications, contraindications and side effects. It is associated with nausea/vomiting and it may cause esophageal rupture and also may make tracheal intubation and make ventilation difficult or impossible. Cricoid force greater than 40 N can compromise airway patency and make tracheal intubation difficult.
Downside of tracheal tubes is the pain and coughing that follows. Therefore, unless a patient is unconscious or anesthetized, sedative drugs are usually given to provide tolerance of the tube. Other disadvantages of tracheal intubation include damage to the mucosal lining of the nasopharynx or oropharynx and subglottic stenosis.
Rapid sequence intubation refers to the pharmacologically induced sedation and neuromuscular paralysis prior to intubation of the trachea. The technique is a quicker form of the process normally used to induce general anesthesia. A useful framework for describing the technique of RSI is the "seven Ps". [27]
Airtraq is a fibreoptic intubation device used for indirect (video or optic assisted) tracheal intubation in difficult airway situations. It is designed to enable a view of the glottic opening without aligning the oral with the pharyngeal, and laryngeal axes as an advantage over direct endotracheal intubation and allows for intubation with minimal head manipulation and positioning.