Current opinion in anaesthesiology
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Simulators can be used to teach simple technical skills or used in more realistic settings to teach or assess various cognitive/affective skills. Although simulators have become widespread, their use and efficacy in these various areas have not been delineated and are still being explored. This review will discuss the present state of using medical simulation for airway-management training. ⋯ Simulators are here to stay. Presently their usage in teaching psychomotor skills has scientific validity in specific tasks but their efficacy for teaching higher-order cognitive skills is still evolving. Future studies will continue to delineate the usage in different areas by studying the outcome in skills training and retention.
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Curr Opin Anaesthesiol · Dec 2004
The Williams Airway Intubator, the Ovassapian Airway and the Berman Airway as upper airway conduits for fibreoptic bronchoscopy in patients with difficult airways.
In this article we will summarize the available information on airways that have been suggested to provide a conduit for the bronchoscope in its passage through the upper airway during fibreoptic intubation. ⋯ Though the Williams Airway Intubator and the Berman Oropharyngeal Airway are superior in this role, all the airways discussed here have major deficiencies in their function. Further research is needed in this field to meet the requirements of endoscopists in situations when it is crucial that equipment reliably fulfils its function.
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This review will summarize the progress made during the last year in improving difficult-airway management. ⋯ Significant steps have been made in our management of the difficult airway, and the majority of the problems encountered can be solved with recourse to simple published guidelines.
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Capnography has been used in the operating room by anesthesiologists for over a decade. Along with pulse oximetry, it has reduced anesthesia-related morbidity and mortality. Traditionally, capnography has been used to confirm the placement of the endotracheal tube. This review looks into the literature for an update on the use of capnography in the spontaneously breathing patient. ⋯ Capnography has become a mandatory or recommended monitoring tool in the practice of anesthesiology. It is making inroads into other medical specialties as a monitoring and diagnostic tool. The use of this technology by non-anesthesiologists will continue to increase. In the opinion of the authors capnography should be used in all cases requiring sedation either in or out of the operating room.
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To present recent advances in the role of the laryngeal mask airway (LMA) and its newer modifications in the management of difficult airway. ⋯ ILMA and PLMA have been shown to be effective in the management of difficult airway. We recommend that training in the use of these devices be made mandatory.