A&A practice
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Patient care duties will expose health care workers to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Many are concerned about subsequent household exposure to their families, particularly those family members with high risk of complications or mortality, potentiating additional community spread. ⋯ The design is simple, expedient, and can be built with locally sourced inexpensive supplies. A viewing and access window facilitates safe family interaction and decreases the emotional costs of isolation while providing a route to pass items as necessary.
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Case Reports
From Tracheal Stenosis to Tracheostomy Displacement: A Case Report on a Seemingly Never-Ending Difficult Airway.
We report a case of undiagnosed tracheal stenosis that culminated in acute respiratory failure in an inpatient unit. After failed intubation attempts, the placement of a supraglottic airway resulted in successful ventilation and was followed by a tracheostomy in the operating room. Postoperatively, the tracheostomy tube became accidentally dislodged necessitating emergency measures with eventual reinsertion of a longer tracheostomy tube. We present this case to highlight life-saving airway strategies that may be considered in such emergency situations and propose 2 simple algorithms to guide anesthesiologists in managing similar airway emergencies.
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Awake endotracheal intubation is the technique of choice to secure the airway when both mask ventilation and intubation are anticipated to be difficult. We present a case of a patient with a known difficult airway, bronchopleural fistula (BPF), and acute respiratory distress syndrome (ARDS) who was intubated with a double-lumen endotracheal tube (DL ETT) under awake condition using a videolaryngoscope. ⋯ The patient was treated successfully for ARDS and discharged home. To our knowledge, this is the first reported case of successful videolaryngoscope-assisted DL ETT intubation in an awake patient.
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Case Reports
Systemic Air Embolism in a Patient With Lung Lesion Undergoing Neurosurgery in Sitting Position: A Case Report.
Systemic air embolism secondary to venous air embolism is a known complication of sitting position surgery. However, the possibility of an isolated systemic air embolism must be considered, especially in patients with preexisting lung disease receiving positive pressure ventilation. These patients may benefit from a comprehensive preoperative evaluation and advanced intraoperative monitoring. We report a case of a 53-year-old woman with chronic obstructive airway disease and a preexisting fibrocavitary lung lesion, who developed isolated air entrainment into the left heart during sitting position surgery.
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This case report describes a neonate with tracheal aplasia first diagnosed after birth due to the presentation of respiratory distress, absence of crying, and unsuccessful tracheal intubation. The most common finding with tracheal aplasia is polyhydramnios. ⋯ The only lifesaving treatment available is ventilation through esophageal intubation or tracheostomy. However, in some cases, tracheostomy is not an option.