The Walls Manual of Emergency Airway Management

 

Description:

 

 

Long recognized as the gold standard emergency airway management textbook, The Walls Manual of Emergency Airway Management, Sixth Edition, remains the most trusted reference on this challenging topic. This practical reference, edited by Drs. Calvin A. Brown III, John C. Sakles, Nathan W. Mick, Jarrod M. Mosier, and Darren A. Braude, is the foundation text for these nationally recognized programs:  The Difficult Airway Course: Emergency™, The Difficult Airway Course: Critical Care™, The Difficult Airway Course: EMS™, and The Difficult Airway Course: Residency Edition™.  Its hands-on approach provides the concrete guidance you need to effectively respond wherever adult or pediatric airway emergencies may occur, including in and out of hospital settings, emergency departments, and urgent care centers. 

 

Table of Contents:

 

SECTION I: Principles of Airway Management

1. The Decision to Intubate

INTRODUCTION

INDICATIONS FOR INTUBATION

APPROACH TO THE PATIENT

2. Identification of the Anatomically Difficult Airway

INTRODUCTION

THE DIFFICULT AIRWAY

Difficult Laryngoscopy: LEMON

Difficult BMV: ROMAN

Difficult EGD: RODS

Difficult Cricothyrotomy: SMART

3. The Physiologically Difficult Airway

DEFINITION OF THE PHYSIOLOGICALLY DIFFICULT AIRWAY

PREDICTING THE PHYSIOLOGICALLY DIFFICULT AIRWAY

PREPARATION FOR THE PHYSIOLOGICALLY DIFFICULT AIRWAY

MANAGING THE PHYSIOLOGICALLY DIFFICULT AIRWAY

Oxygenation

Functional Residual Capacity

Denitrogenation

V/Q Mismatch

Who Should Be Intubated Awake?

How Do I Stratify Preoxygenation?

Hemodynamics

Stepwise Hemodynamic Strategy

Complicating Factor of Acidosis

Who Should Be Intubated Awake?

4. Identification of the Failed Airway

INTRODUCTION

THE FAILED AIRWAY

5. The Emergency Airway Algorithms

APPROACH TO THE AIRWAY

THE MAIN AIRWAY ALGORITHM

THE CARDIAC ARREST AIRWAY ALGORITHM

THE DIFFICULT AIRWAY ALGORITHM

THE FAILED AIRWAY ALGORITHM

6. Human Factors During Emergency Airway Management

INTRODUCTION

The Importance of Human Factors: Why the Human Factor Is Always a Factor

ERROR BASICS: “TO ERR IS HUMAN….”

CRM: THE BIG SIX

COMMUNICATION

INDIVIDUAL FACTORS

Stress and Other Adverse Physiologic States

Cognitive Readiness

Cognitive Bias

TEAM FACTORS

The Prebrief and the Zero Point Survey

Team Mental Models

COGNITIVE AIDS

ENVIRONMENTAL CONSIDERATIONS

SAFETY-I AND SAFETY-II

7. Applied Functional Anatomy of the Airway

INTRODUCTION

THE NOSE

Important Anatomic Considerations

THE MOUTH

THE PHARYNX

THE LARYNX

TRACHEA

SECTION II: Oxygenation and Ventilation

8. Principles of Peri-intubation Oxygenation

INTRODUCTION

PRINCIPLES OF PREOXYGENATION

Maintain an Upright Position for Optimal Preoxygenation

High-Concentration Oxygen Delivery Versus Traditional Supplemental Oxygen

Preoxygenation With and Without Positive Pressure

OXYGEN DELIVERY DEVICES

Low-Flow and High-Flow Nasal Oxygen

Simple Face Mask

Non-rebreather Mask

Bag-Valve Mask

Venturi Mask

Noninvasive Positive Pressure Ventilation for Preoxygenation

OTHER PREOXYGENATION CONCEPTS

Monitoring the Effectiveness of Preoxygenation Using End-Tidal OXYGEN

Concept of Delayed Sequence Intubation to Facilitate Preoxygenation

Apneic Oxygenation

Bagging During the Apneic Period

Rescue Oxygenation

9. Non-Invasive Positive Pressure Ventilation and High-Flow Nasal Oxygen

INTRODUCTION

TECHNOLOGY OF NONINVASIVE RESPIRATORY SUPPORT

MODES OF NONINVASIVE MECHANICAL VENTILATION

Continuous Positive Airway Pressure

Biphasic Positive Airway Pressure (BiPAP)

Spontaneous and Spontaneous/Timed Modes

High-Flow Nasal Oxygen

INDICATIONS AND CONTRAINDICATIONS

INITIATING NONINVASIVE RESPIRATORY SUPPORT

Response to Therapy

10. Mechanical Ventilation

INTRODUCTION

TERMINOLOGY OF MECHANICAL VENTILATION

VENTILATION MODES

Pressure Support Ventilation

VENTILATOR TV DELIVERY

Volume-Control Ventilation

Pressure-Control Ventilation

INITIATING MECHANICAL VENTILATION

11. Oxygen and Carbon Dioxide Monitoring

PULSE OXIMETRY

Principles of Measurement

Indications

Limitations and Precautions

Response Time

END-TIDAL O2 MONITORING

END-TIDAL CO2 MONITORING

Basics of CO2 Monitoring

Colorimetric CO2 Detectors

Quantitative CO2 Monitors

Capnography Interpretation

Clinical Utility of Quantitative Capnometry and Capnography

SECTION III: Basic Airway Management

12. Bag-Mask Ventilation

INTRODUCTION

BAG-VALVE-MASK DEVICES

FACE MASK VENTILATION TECHNIQUE IN THE EMERGENCY SETTING

Optimizing Face Mask Seal

Face Mask Grip That Allows Maximal Mandibular Advancement—Thenar Grip

Head and Neck Maneuvers to Open the Upper Airway

Oral and Nasal Pharyngeal Airways

Neuromuscular Blockade to Facilitate BMV

Ventilation Parameters for Bag-Mask Ventilation

Assessing Adequacy of Bag-Mask Ventilation

Stomach Inflation, Sellick Maneuver, and Aspiration Risk With BMV

DIFFICULT AND IMPOSSIBLE MASK VENTILATION

Predicting Difficult or Impossible BMV

Optimal Technique and Troubleshooting Difficult BMV

EXPERIENCE, TRAINING, AND THE LEARNING CURVE FOR BMV

13. Extraglottic Devices

INTRODUCTION

INDICATIONS FOR USE IN EMERGENCY AIRWAY MANAGEMENT

Primary Airway

Secondary Airway

CONTRAINDICATIONS FOR USE

RETROGLOTTIC DEVICES

Esophageal Tracheal Combitube

Rusch Easytube

The Laryngeal Tube Airway

Insertion Technique—Assuming No Visualization

SUPRAGLOTTIC DEVICES

Laryngeal Mask Airways

Ambu LMA

Cookgas Air-Q

Intersurgical I-GEL

GENERAL TECHNIQUE FOR SGD USE

Select the Appropriate Size Device

Prepare the Device for Insertion

Prepare the Patient for Insertion

Insert the Device

Postplacement Management

COMPLICATIONS AND LIMITATIONS

14. Managing the Patient With an Extraglottic Device in Place

INTRODUCTION

MANAGING A PATIENT WITH AN EGD IN PLACE

ASSESSMENT

TROUBLESHOOTING OXYGENATION

TROUBLESHOOTING VENTILATION

OPTIMIZING EGD FUNCTION

WHEN TO CONSIDER SEMIELECTIVE EXCHANGE

HOW TO PERFORM A SEMIELECTIVE EXCHANGE FOR AN ETT

Removal With Routine Intubation via Direct/Video Laryngoscopy

Working Around the Device and Performing Intubation With Direct/Video Laryngoscopy

Blind Exchange

Endoscopic Exchange

REMOVAL AFTER INTUBATION

SURGICAL AIRWAY

SECTION IV: Tracheal Intubation

15. Direct Laryngoscopy

DIRECT LARYNGOSCOPY

BASICS OF DIRECT LARYNGOSCOPY

ANATOMY FOR DIRECT LARYNGOSCOPY

PREPARATION AND ASSISTANCE

PREINTUBATION ASSESSMENT AND EQUIPMENT CHOICE

HANDLING THE LARYNGOSCOPE AND POSTURE OF THE OPERATOR

PATIENT POSITIONING

STANDARD DIRECT LARYNGOSCOPY TECHNIQUE

PARAGLOSSAL (RETROMOLAR, RIGHT OR LEFT MOLAR) STRAIGHT-BLADE TECHNIQUE

BLIND INSERTION TECHNIQUE FOR THE STRAIGHT BLADE

INTUBATING THE TRACHEA (TUBE PASSAGE)

TROUBLESHOOTING DIFFICULT DIRECT LARYNGOSCOPY

Paralysis

External Laryngeal Manipulation

Positioning

Mandibular Advancement

Bougie (Endotracheal Tube Introducer)

FAILED LARYNGOSCOPY AND INTUBATION

CONFIRMING INTUBATION OF THE TRACHEA

16. Video Laryngoscopy

INTRODUCTION

ADVANTAGES OF VIDEO LARYNGOSCOPY

CLASSIFICATION OF VIDEO LARYNGOSCOPES

WHEN TO USE VIDEO LARYNGOSCOPY INSTEAD OF DIRECT LARYNGOSCOPY

DIFFERENCES IN TECHNIQUE FOR VIDEO LARYNGOSCOPY COMPARED TO DIRECT LARYNGOSCOPY

STANDARD GEOMETRY VIDEO LARYNGOSCOPES (MACINTOSH-STYLE)

Intubation With a Standard Geometry Video Laryngoscope

Summary

HYPERANGULATED VIDEO LARYNGOSCOPES

Intubation With a Hyperangulated Video Laryngoscope

Summary

COMPLICATIONS OF VIDEO LARYNGOSCOPES

CONCLUSION

17. Flexible Endoscopic Intubation

INTRODUCTION

INDICATIONS AND CONTRAINDICATIONS

TECHNIQUE

Overview

Scope Selection

Care of the Instrument

Technique of FEI

COMPLICATIONS

18. Blind Intubation Techniques

BLIND NASOTRACHEAL INTUBATION

INDICATIONS AND CONTRAINDICATIONS

TECHNIQUE

TROUBLESHOOTING

DIGITAL TRACHEAL INTUBATION

INDICATIONS AND CONTRAINDICATIONS

TECHNIQUE

SUCCESS RATES AND COMPLICATIONS

19. Emergency Surgical Airways

INTRODUCTION

Description and General Approach

Indications and Contraindications

TECHNIQUE

Anatomy and Landmarks

Equipment

Technique

Complications

Alternatives to Open Surgical Techniques

SECTION V: Pharmacology and Techniques of Airway Management

20. Rapid Sequence Intubation

DEFINITION

Indications and Contraindications

TECHNIQUE

Preparation

Preoxygenation

Physiologic Optimization

Paralysis With Induction

Positioning

Placement With Proof

Postintubation Management

Timing the Steps of RSI

Success Rates and Adverse Events

Delayed Sequence Intubation

21. Sedative-Induction Agents

INTRODUCTION

ETOMIDATE

Clinical Pharmacology

Indications and Contraindications

Dosage and Clinical Use

Adverse Effects

KETAMINE

Clinical Pharmacology

Indications and Contraindications

Dosage and Clinical Use

Adverse Effects

PROPOFOL

Clinical Pharmacology

Indications and Contraindications

Dosage and Clinical Use

Adverse Effects

BENZODIAZEPINES

Clinical Pharmacology

Indications and Contraindications

Dosage and Clinical Use

Adverse Effects

22. Neuromuscular Blocking Agents

INTRODUCTION

SUCCINYLCHOLINE

Clinical Pharmacology

Indications and Contraindications

Dosage and Clinical Use

Adverse Effects

COMPETITIVE NEUROMUSCULAR BLOCKING AGENT

Clinical Pharmacology

Indications and Contraindications

Dosage and Clinical Use

Adverse Effects

23. Optimizing First Attempt Intubation Success

IMPORTANCE OF FIRST ATTEMPT INTUBATION SUCCESS

KEYS TO OPTIMIZING FIRST ATTEMPT INTUBATION SUCCESS AND SAFETY

USE A STANDARDIZED APPROACH TO EMERGENCY INTUBATION

THE IMPORTANCE OF NEUROMUSCULAR BLOCKADE FOR EMERGENCY INTUBATION

Appropriate Use of Rapid Sequence Intubation

Use Awake Intubation When Both RSI and Rescue Oxygenation Are Likely to Fail

Avoid Sedation-Only Intubations

IMPORTANCE OF A PREINTUBATION CHECKLIST

Assess the Airway

Position the Patient Perfectly

Prepare Excellent Suction

Select and Locate Rescue Devices

OPTIMAL PREOXYGENATION IS CRITICAL

MAKE THE FIRST ATTEMPT THE BEST ATTEMPT

Set the Scene

Use the Best Laryngoscope

Perform Optimal Laryngoscopy

Use a Bougie or Stylet With Straight-to-Cuff Shape

A SIMPLE ALGORITHM IS INVALUABLE WHEN INTUBATION ATTEMPTS FAIL

BACKUPS NEED TO BE AVAILABLE, WELL PROVEN, AND WELL PRACTICED

CALLING FOR HELP

TAKING OWNERSHIP, CONTINUOUS QUALITY IMPROVEMENT, AND THE AIRWAY LEAD

24. Anesthesia and Sedation for Awake Intubation

INTRODUCTION

INDICATIONS AND CONTRAINDICATIONS

Glottic Visualization

Awake Intubation

LOCAL ANESTHESIA FACTORS

Nasal Anesthesia

Oral Anesthesia

Oropharyngeal and Hypopharyngeal Anesthesia

Laryngeal Anesthesia

Tracheal Anesthesia

SEDATION TECHNIQUES

SECTION VI: Pediatric Airway Management

25. Differentiating Aspects of the Pediatric Airway

THE CLINICAL CHALLENGE

APPROACH TO THE PEDIATRIC PATIENT

General Issues

Specific Issues

Drug Dosage and Selection

Equipment Selection

INITIATION OF MECHANICAL VENTILATION

26. Pediatric Airway Techniques

INTRODUCTION

TECHNIQUES USED IN ALL CHILDREN

Bag-Mask Ventilation and Endotracheal Intubation

Laryngeal Mask Airways

Percutaneous Needle Cricothyrotomy or “Needle Cric”

TECHNIQUES USED IN ADOLESCENTS AND ADULTS

Blind Nasotracheal Intubation

King LTS-D

Surgical Cricothyrotomy

27. The Difficult Pediatric Airway

INTRODUCTION

COMMON CAUSES OF DIFFICULT AIRWAYS IN CHILDREN

Difficult Airways Secondary to Acute Infectious Causes

Difficult Airways Secondary to Noninfectious Processes

Difficult Airways Secondary to Congenital Anomalies

No Known Abnormality, with Unexpected Difficulty

TIMING THE INTERVENTION

28. Foreign Body in the Pediatric Airway

INTRODUCTION

PRESENTATION

TECHNIQUE

Partial Airway Obstruction

Complete Airway Obstruction

SECTION VII: EMS Airway Management

29. Introduction to EMS Airway Management

THE CLINICAL CHALLENGE

APPROACH TO THE AIRWAY

LEVELS OF TRAINING AND SCOPE OF AIRWAY PRACTICE

MECHANISMS FOR MAINTENANCE OF AIRWAY COMPETENCY

HUMAN FACTORS IN PREHOSPITAL AIRWAY MANAGEMENT

30. Techniques in Prehospital Airway Management

LOCATION/ENVIRONMENTAL FACTORS

PATIENT POSITIONING FOR AIRWAY MANAGEMENT

PATIENT MONITORING

ESSENTIAL SKILLS IN PREHOSPITAL AIRWAY MANAGEMENT

Bag-Mask Ventilation

Noninvasive Positive Pressure Ventilation

Endotracheal Intubation

VIDEO LARYNGOSCOPY

VERIFICATION OF AIRWAY MANAGEMENT PROCEDURES

MEDICATION-FACILITATED AIRWAY MANAGEMENT (MFAM)

Preparation

Preoxygenation

Physiologic Optimization

Paralysis With Induction

Positioning

Placement With Proof

Post-Intubation Management

TRANSPORT CONSIDERATIONS

Positioning

Packaging for Transport

OXYGEN CONSUMPTION/TANK FACTORS

31. Difficult and Failed Airway Management in EMS

THE PREHOSPITAL CHALLENGE

PREDICTION OF THE DIFFICULT AIRWAY IN THE PREHOSPITAL SETTING

THE PREHOSPITAL CONUNDRUM

WHEN IS IT BETTER TO WAIT?

APPLYING THE EMS AIRWAY ALGORITHM FOR MFAM PRACTITIONERS

THE DIFFICULT AIRWAY FOR THE NON-MFAM PROVIDER

RAPID OR CRITICAL OXYGEN DESATURATION

32. Controversies in EMS Airway Management

INTRODUCTION

FRONT OF NECK ACCESS

AIRWAY STRATEGIES FOR OHCA

MEDICATION-FACILITATED AIRWAY MANAGEMENT

DELAYED SEQUENCE INTUBATION

SCENE TIMES

NUMBER OF PROVIDERS

INVASIVE PEDIATRIC AIRWAYS

RAPID SEQUENCE AIRWAY

PREHOSPITAL NIPPV

INITIAL TRAINING AND SKILL MAINTENANCE

SECTION VIII: Special Clinical Circumstances

33. The Unstable Patient: Cardiopulmonary Optimization for Emergency Airway Management

THE CLINICAL CHALLENGE

OPTIMIZATION FOR FIRST LARYNGOSCOPY ATTEMPT SUCCESS

Timing of Airway Management

Preoxygenation Considerations in the Unstable Patient

Hemodynamic Optimization

Induction

Postintubation Management

SUMMARY

34. The Trauma Airway

THE CLINICAL CHALLENGE

APPROACH TO THE AIRWAY

Assessment of Difficulty

Special Clinical Considerations

TECHNIQUE

Paralysis Versus Rapid Tranquilization of the Combative Trauma Patient

RSI of the Trauma Patient

Choice of Neuromuscular Blocking Agent

Choice of Induction Agent

THE FAILED AIRWAY

35. The Neurocritical Patient

THE CLINICAL CHALLENGE

Status Epilepticus

APPROACH TO THE AIRWAY

Self-Limited Seizure

Prolonged Seizure Activity

TECHNIQUE

Elevated Intracranial Pressure

Reflex Sympathetic Response to Laryngoscopy

ICP Response to Neuromuscular Blockade

Choice of Induction Agent

Device Selection

APPROACH TO THE AIRWAY

INITIATING MECHANICAL VENTILATION

36. Reactive Airways Disease

THE CLINICAL CHALLENGE

APPROACH TO THE AIRWAY

Technique

Drug Dosing and Administration

POSTINTUBATION MANAGEMENT

Mechanical Ventilation

Complications of Mechanical Ventilation

37. Distorted Airways and Acute Upper Airway Obstruction

THE CLINICAL CHALLENGE

APPROACH TO THE AIRWAY

When Should an Intervention Be Performed?

What Options Exist if the Airway Deteriorates or Obstruction Occurs?

What Are the Advantages and Risks of an Awake Technique?

Is RSI Reasonable?

38. The Pregnant Patient

THE CLINICAL CHALLENGE

APPROACH TO THE AIRWAY

Recommended Intubation Sequence

Postintubation Management

Management of the Failed Intubation

SUMMARY

39. Cardiovascular Emergencies

THE CLINICAL CHALLENGE

Reflex Sympathetic Response to Laryngoscopy

Choice of Induction Agent

Choice of Paralytic Agent

APPROACH TO THE AIRWAY

Recommended Intubation Sequence

INITIATING MECHANICAL VENTILATION

40. Intubating the Highly Infectious Patient

THE CLINICAL CHALLENGE

LIMITING EXPOSURE

LIMITING AEROSOL PRODUCTION

NONINVASIVE OXYGENATION STRATEGIES AND RISK

41. The Massively Soiled Airway

THE CLINICAL CHALLENGE

APPROACH TO THE AIRWAY

Strategies to Prevent Regurgitation During Airway Management

Strategies to Manage Regurgitation

Steps of the SALAD Technique

SUMMARY

42. The Geriatric Patient

THE CLINICAL CHALLENGE

Decreased Cardiorespiratory Reserve

Increased Incidence of Difficult Airways

Ethical Considerations

APPROACH TO THE AIRWAY

Drug Dosage and Administration

POSTINTUBATION MANAGEMENT

43. The Morbidly Obese Patient

THE CLINICAL CHALLENGE

APPROACH TO THE AIRWAY

TECHNIQUE

Drug Dosage and Administration

POSTINTUBATION MANAGEMENT

44. Foreign Body in the Adult Airway

THE CLINICAL CHALLENGE

APPROACH TO THE AIRWAY

Incomplete Obstruction by a Foreign Body

Complete Obstruction of the Airway

POSTINTUBATION MANAGEMENT

45. Safe Extubation in the Emergency Airway Patient

THE CLINICAL CHALLENGE

PLANNING FOR EXTUBATION

EXTUBATION CRITERIA

RISK STRATIFICATION

ADDITIONAL TESTING

PROCESS OF EXTUBATION

General Extubation

Complications

ADJUNCTS TO EXTUBATION

Airway Exchange Catheter

NONINVASIVE VENTILATION AND HIGH-FLOW NASAL OXYGEN

SEDATION DURING EXTUBATION

Index

 

An aparitie	9 Sept. 2022
Autor	Calvin A Brown III MD
Dimensiuni	178 x 254 mm
Editura	LWW
Format	Paperback
ISBN	9781975190682
Limba	Engleza
Nr pag	512