Hung’s Difficult and Failed Airway Management PDF
Preview Hung’s Difficult and Failed Airway Management
Hung's DIFFICULT ANDF AILED AIRWAY MANAGEMENT NOTICE Mediicsi neaevn e r-cshcaineAgnsinc neegrw. e seaanrcdcl hi neixcpaelrb ireonaocdueekr nn owl edge, icnth raenagtaemnsded rn uttg h eraarrpeey q uTihraeeu dt.ha onrtdsh p eu bloifst hheisr worhka vceh ecwkietsdho urcest obb ere elliiieantvb heleedeifo f rrt tops r oviinodfrem atthiiaostn compalnegdte en eirnaa clclwoyir ttdhh s et anadcacredapsttt hetedi moefp ubliHcoawteivoenr., inv ieowft hpeo ssiobfhi ulmiatny o ercr hraonirgnm e esd isccaile nneciettshh,aee ur t hnoorrs thpeu blniosrh eoartn hpyea rrw thyo bheaeisnn voilntv hepedr epaorrpa utbiloinoc fta htiiso n worwka rrantthsie n tfhoartmc aotnitoahnie nrieeisdin e n v erreys apceccutor rca otmep laentde , thdeiys callralei smp onfsroi baeinrlyroi orotr mysi sosrifro ot nhrsee soublttasfio rnmue sdoe ft h e informcaotnitoainint n hweiodsr Rke.a daererens c outroca ognefidr imn ftohrecm oantitoani ned herweiitonht hseoru rFcoeerxs a.m apnlidenp articulaarared, v itrsocee hadedt cehkpre rs o duct inforsmhaetieintoc nli utndh peead c koaefga edc rhu tghp elyta oan d mintiobs ect eerrtt hataihtne informcaotnitaoiinntn heids i aswc ocrukar natdth eca hta nhgaevnseob te emna dient hree com menddeodso eri nt hceo ntraifnroda idcmaitniiosTnthsrir aset cioomnm.e inosdfp a atritoinc ular imporitnca onncnee wcittniheoo wnri nfrequusedenrdtu lgys . THIRD EDITION Hung's DIFFICULT ANDF AILED AIRWAY MANAGEMENT ORLANDO R.H UNG,B Sc(P HARMACY)M,D, F RCP()C Preosf,sD oerpratmeonfAtn ess thSeusrrigyaae,,n Pdh armacology DierctoofRr e search DepratmeonfAt ne sthPeasiMinaa n,a geamnePdne tr iopMeerdaitciivnee DalhoUunsiivee rsity QueeEnl izaIbHIee tahlS tiche nCceenst re DepartmoefAn nte sthesia HalaixNf,o vSaoc tiCaa,n ada MICHEALF .M URPHY,M D,F RCP()C PreosfsEomre r,iD teuprsatmeonfAt n estheasniPdoa liMoneg dyi cine UniveorfAs libteyr ta WaltCe Mra ckeHnezailSetic he nCceenst re EdmoonnAt,l beCratnaa,d a NewY orkC hicaSgaoFn r ancAitshceoLn osn doMna driMde xiCciot y MilaNne wD elhSii anpgorSey dnTeoyr onto Copyri©g h2t018b yM cGraw-HiEldlu catiAolnlr. i ghrtess ervEexdc.e pats p ermitutnedde trh eU niteSdt ates CopyrigAhctto f1 976n,o p arotf t hipsu blicamtaiyob ne r eproduocred di stribiunat neydf ormo rb ya nym eans, ors torienda d atabaosrre e triesvyaslt ewmi,t hotuhtep riowrr ittpeenr missoifot nh ep ublisher. ISBN:9 78-1-25-964055-1 MHID: 1-25-964055-8 Them ateriiantl h iesB ooka lsaop peairnst hep rinvte rsioofnt hitsi tlIeS:B N:9 78-1-25-964054-4, MHID:1 -25-964054-X. eBookc onversbiyoc no deMantra Versio1n. 0 Allt rademaarrkets r ademaorfkt sh eriers pectoiwvnee rRsa.t hetrh apnu ta trademasrykm boalft eerv eroyc cur rencoefa t rademarnkaemde w,e u sen ameisn a ne ditorfiaaslh ioonnl ya,n dt ot heb enefiotft het rademaorwkn er, witnho i ntentoifoi nn fringeomfet nhtet rademaWrhke.r es uchd esignataipopnesai rnt hibso okt,h ehya veb een printweidt ihn itciaapls . McGraw-HiEldlu catieoBno okasr ea vailaabtsl pee ciqaula ntidtiys coutnotu ss ea sp remiumasn ds alepsr omo tionosrf oru sei nc orporattrea inpirnogg ramTso.c ontaac rte presentpalteiavsveei, s tihte C ontaUcst p agea t www.mhprofessional.com. TERMS OF USE Thiiss a c opyrighwtoerdka ndM cGraw-Hill Eduacnadit tilsoi nc ensors arlerlsi egrhvitensa n dt ot hew orkU.s e oft hiwso rki ss ubjetcott h estee rmEsx.c epatsp ermitutnedde trh eC opyrigAhctto f1 976a ndt her ighttos tore andr etrioenveec opyo ft hew orky,o um ayn otd ecompidlies,a ssemrbelvee,r esneg inereerp,r odumcoed,i fy, creadteer ivatwiovrek s based truapnosnm,di its,t ribduitses,e minsaetlel,, puobrsl uibslhi cetnhsewe o rko ra ny parotf i tw ithoMuctG raw-HiEldlu catiopnr'isoc ro nsenYto.um ayu set hew orkf ory ouro wnn oncommercial andp ersonuaslea ;n yo theurs eo ft hew orki ss tricptrloyh ibiYtoeudrr. i ghttou set hew orkm ayb et erminaitfe d youf aitloc omplwyi tthh estee rms. THE WORK ISP ROVIDED" AS IS.M"c GRAW-HILL EDUCATIAONN D ITSL ICENSORSM AKE NO GUARANTEESO R WARRANTIESA S TO THE ACCURACY,A DEQUACY OR COMPLETENESSO F OR RESULTS TO BE OBTAINEDF ROM USINGT HE WORK,I NCLUDING ANIYN FORMATIONT HAT CAN BE ACCESSEDT HROUGH THE WORK VIAH YPERLINKO R OTHERWISEA,N D EXPRESSYL DIS CLAIMANY WARRANTY,E XPRESSO R IMPLIEDI,N CLUDINGB UT NOTL IMITED TIOM PLIEDW AR RANTIESO F MERCHANTABILITOYR FITNESFSO RA PARTICULARP URPOSEM.c Graw-HiEldlu cation andi tlsi censdoorn so tw arraonrtg uaranttheaett h efu nctiocnosn taiinnet dh ew orkw ilmle ety ourre quirements ort haitt osp eratwiiolnbl e u ninterruopret rerdo frr eeN.e ithMecrG raw-HiEldlu catinoonri tlsi censsohrasl l bel iabtloey ouo ra nyoneel sfeo ra nyi naccurearcryo,or ro missiroeng,a rdloefcs asu sien,t hew orko rf ora ny damagerse sulttihnegr efrMocmG.r aw-HiEldlu catihoansn or esponsibfioltrih tecy o nteonfta nyi nformataicon cessetdh routghhew orkU.n denro c ircumstasnhcaelMslc Graw-HiEldlu catiaonnd /oirtl si censboerl si abfloer anyi ndireicntc,i denstpaelc,i pauln,i ticvoen,s equenotrsi iamli ldaarm agetsh arte suflrto mt heu seo fo ri nability tou set hew orke,v eni fa nyo ft hemh asb eena dvisoefdt hep ossibiolfsi utcydh a mageTsh.i lsi mitaotfil oina bil itsyh alalp pltyo a nyc laiomr c ausweh atsoewvheert hseurc chl aiomr c ausaer isiensc ontratcotro,tr o therwise. ASSOCIAETDEI TORS ThomaJsC. o onaMnD,,F RCPC() J.A damL a,wM D,F RCPC() ProfeDsespoarr,to mAfen netssta hneSdsu irag ery ProfeDsespoarr,to mAfen netssta hneSdsu irag ery DalhoUunsiivee rsity AssoHceiaadt e QueEelni zIaHIbe eatSlhct ihe nces Centre DeparotAfmne enstt PhaeMisnai naa,g eamnePdne tr iaotpievre DeparotAfmne enstt hesia Medicine HaalxiN,fo vSac oCtainaa,d a FacuolfMt edyi cDianleh,oU unsiivee rsity Queen EIlHIie zaaSlbcteihte hn ces Centre NaarsimhJaang naanthaMnD, HaalxiN,fo vSac oCtainaa,d a AssoCchiaaitreAm caand,eA fmafiicr s DierctPoerd,i AantersitcRhe esseiaar ch lna R.M orr,Bi EnsgM,D ,F RCP(CD)A,B AF, ACEP Ann RobHer.Lt u rCihei ldHroesinpto'afCsl h icago PreosfsDoerp,a rotAfmne enstt hesia & AssoPcrioaftoeefAs n seosrt hesiology DalhoUunsiivee rsity NorthwUensitveeFrrenns ibietSrycg h oofMo eld icine Queen EIlHIie zaaSlbcteihte hn ces Centre ChicIalgloi,n ois DeparotAfmne enstt hesia HaalxiN,fo vSac oCtainaa,d a GeorKgoev acMsD,,F RCCP)( ProfeEsmseorrgM,ee ndciyc ine RonalDd.S tewratO,C ,O NS,E CN(Sh o,nB )AB, Sc,M D, DalhoUunsiivee rsity FACEP,( hDoSnc) AttenEdmienrgg ency Physician Professor Emeritus NovSac oHteiaaAl utthh ority DepartomAfen netssta hneEdsm iear gMeedniccyi ne QueEelni zIaHIbe eatSlhct ihe Cnecnetsr e FacuolfMt edyi cDianleh,oU unsiivee rsity HaliNfaoxvS,ac oCtainaa,d a Queen EIlHIie zaaSlbcteihte hn ces Centre VictGoernieHaro asalpSl ii tte HaalxiN,fo vSac oCtainaa,d a DEDICAOTNI Wew oullidk teh atonouk fr a imlfiroet sh euinrd erstaannsddu ipnpogofo r utar c a demainccd l inwiocrbakyld edictahteiidsni gtt i:oJo ena nCehtrties,t Doapvhiedr,, anAdn aH unagn tdo D ebbAim,an dRaya,na ,n Tded dMyu rhpyW.e aldseod icate theidsi ttioto htnei reefloferostfsas l wlh ot eaacihr wmaayn ageWmeea nrgter. a utle f frot heciorm mittmote hnpetr eveonfdt eiaoatnnh dd i saybr eillaitttoae idr wmaayn agemfeianltu re. CONTENTS Contribu.t.o.r.s. .............................................x.i.i.i. .............................. Forewo.r.d. .................................................x.i.x. ................................. Prfeace xxi . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Acknowledgme.n.t.s.. .........................................x.x.i.i.i. .......................... PRINCIOPFAL IERSW MAAYN AGEMENT 1.E valuatoifto hne A irwa.y. ........ 2 4.P harmacoloofgD yr ugUss ed . . . . . . . . MichaFeM lu rphayn d inA irwaMya nagemen. .t. . . . . . . . . . . . .8.6. . JohannMe.sH uitink JonathGa.Bn a ilReoy,n alBd.G eorge, andO rlanRd.Ho u ng 2.T heA lgorithms 17 . . . . . . . . . . . . . . . . . . . . . . . . . . MichaFeM lu rphEy,d warT.dC rosby, 5.A spiratRiiosnka:sn dP revent.i.o.n.. ..1. 0 7 andJ .A damL aw SauPly tkaan dE dwarCdr osby 3.P reparatfoirAo wna keI ntubat.i.o..n.. . .3 9 6.H umanF actoarnsdA irway /anR .M orris Manageme.n.t. .... . ......... . ... .....1. 28 PetGe.rB rindley AIRWTAEYC HNIQUES 7.C ontext-SenAsiirtwiavye 10.F lexiBbrloen choscIonptiucb at.i.o.n.1 72 . . Managemen. .t. . . . . . . . . . . . . . . . . . . .1. .3.6. . /aRn .M orris OrlanRd.Ho u nga ndM ichaFeM lu rphy 11.R igiFdi beropatnidc 8.B agM-ask-Venti.l.a.t.i.o.n .....1 43 Video-Laryngoscopes 198 . . . . . . . . . . . . . . . . . . . . . . . . . . . George KovacsF,M uMripchhy,a ealn d RichaMr.Cd o opearn dJ .A damL aw NichoSloawse rs 12.N onvisuIanlt ubatTieocnh niqu.e.s. ..2 22 . . 9.D ireLcatr yngosc. o. .p.y. . . . . . . . . . . .1. .5.5. ChrC.i sC hristodoOurlloaunR,d. Ho u ng, RichaMr.Ld e vitaanndG eorgKeo vacs andJ inbZihna ng vii viiCio ntents 13. ExtraglDoetvtiiccfe osrV entilation 14. Cricothyro.t.o.m.y. ..........2.5.9. ....... andO xygenat.i.o.n. ..........2.3.8. ....G.or.d o0.n L auncelLoitat,nB e.J o hnson, LieHmo ,T homaJs.C oonaann,d DaviTdW onga,n dO rlanRd.Ho u ng OrlanRd.Ho u ng 15.T racheot.o.m.y. ............2.7.0. ........ TimotF.h yB E.r owann dL ianBe.J ohnson PRE-HOSAPIIRTWAMALAY N AGEMENT 16.W hatI sU niquAeb ouAti rway 19.A irwaMya nagemenofta Race Managemenitnt heP re-Hospital CarD rivweirt ah Full-FHaeclem et Settin.g.?. ................2.7.8. ....F.o.l.l.o.w.ai C nrga s.h. ............3.05. ....... MarkV uD,a viPde trMiiec,h aF.eM lu rphy, MarkP V uA,n geliGnuaz zaon,d andE riNk.V u OrlanRd.Ho u ng 17.A irwaMya nagemenofta Patiewnitt h 20.A irwaMya nagemenofta Morbidly TraumatBirca iInn ju(rTBy)I . .......2.8.7. .. ObeseP atieSnuftef rinfrgo m J.A damL aw,E dwarTdC rosbay,n dA ndyJ agoda aC ardiAarcr e.s.t. ............3.11. ........ SauPly tkaan dD anaKera hn 18.A irwaMya nagemenofta n UnconsciPoautsi eWnhto IsT rapped 21.A irwaMya nagemenwtit hB lunt InsitdheeV ehicFloel lowai nMgo tor AnteriNoerc kT raum.a. ...........3.2.0. ... VehicCloel lis.i.o.n. ...........3.00. ....D.a.v.iA d.C aro ArniVml attanednM atthiHaesl m AIRWMAAYN AGEMIENNT TH EE MERGERNOCOYM 22.A irwaMya nagemenintt he 26.A irwaMya nagemenitna Patient EmergenDceyp artme.n.t. .......3.2.6. ...w itAhn gioede.m.a. ............34.5. ..... JohnC. SaklaensdM ichaF.eM lu rphy GeneviMeavceK innMoinc,h aF.eM lu rphy, andD aviPde trie 23. Patiewnitt hD eadlAys thmRae quires Intubat.i.o.n. ..............3.31. ..2.7...A .i.r.w.aM.ya nagemenfotr P enetrating KerryaBn.Bn r oderaincdJk e nniWf eZrh an FaciTarla um.a. ..............3.5.0. ........ DaviAd.C araon dA aroE.n B air 24. TracheIanlt ubatiinao nnU ncooperative PatieWnitt ha NeckI nju.r.y. ......3.3.7. .2.8.. A irwaMya nagemenitna Patient KerryaBn.Bn r oderick witah DeepN eckI fnectio.n. ........3.5.5. KirJk.M acQuarrie 25.A irwaMya nagemenfotrt he BurnP atie.n.t. ..............3.41. ......... LaebeLne staenrdD arreBnra ude Contenitxs AIRWMAAYN AGEMIENNT TH EI NTENSCIAVRUEEN I(TI CU) 29.U niquAei rwaIys suienst he 32.M anagemenofta PatieAndtm ittteod IntensCiavreUe n i.t. ...........3.6.4. ....I.C Uw ithE bolVai ruasn dI mpending ShawnD. HickJsA.,d amL aw,a nd RespiraFtaoirly.u .r.e. ...........38.3. ..... MichaF.eM lu rphy LouiEslel aarnddD aviTdW ong 30.M anagemenoftE xtubatoifoa n P atient 33. Pefrorminagn E lectPievrec utaneous Followai nPgr olongPeedr ioofd DilatiTornaaclh eotoinma y P atient MechaniVceanlt ila.t.i.o.n. ......3.7.0. ....o n MechaniVceanlt ila.t.i.o.n. .....3.9.0. . RichaMr.dC ooper AngeliGnuaz zLoi,a nBe.J ohnson, andO rlanRd.Ho u ng 31. AirwaMya nagemenofta Patieinnat Halo-JawcikteAhtc utOeb struction 34. Managemenofta Patiewnitt h ofa ReifonrceTdr acheTaulb .e. .....3.7.7. . a RespiraAtrorreyis ntt he DietrHiecnhz ler IntermedCiaartUeen i.t. ..........4.0.0. ... PetGe.rB rindley AIRWMAAYN AGEMIENNT TH EO PERATRIONOGM 35. AirwaMya nagemenofta n 41.A irwaMya nagemenitna Patiewnitt h UncooperatDiovwenS yndrome AspiratoifGo ans trCiocn tents Patiewnitt ahn U pperG lB lee.d. ......4.0.8 FollowiInngd uctoifoA nn esthe.s.i.a.. 4.6 3 MichaF.eM lu rphy KathrSypna rroawn dO rlanRd.Hou ng 36.A irwaMya nagemenofta Patient 42.A irwaMya nagemenofta Patient witah HistoorfOy r aaln dC ervical withH istoorfDy i fifcuAlitr way RadiatTihoenr a.p.y. ............41.3. ....W.h o Refusetso H aveA wake /aRn .M orris TracheIanlt ubat.i.o.n. ................ .469 DmitProyr tnaonydC ariAn.H agberg 37. AirwaMya nagemenitnP enetrating NeckI nju.r.y. ................4.24. ..4.3.. M.a.n.a.g emenofta Patiewnitt OhS A /anR .M orris forT otaTlh yroidect.o.m.y. .......4.8.1. .. Jinbin Zhang, Frances Chung, and 38. AirwaMya nagemenofta Patient OrlanRd.Ho u ng inP ronPeo sit.i.o.n. ...........4.4.0. ..... DennDisra peaaun dO rlanRd.Ho u ng 44.A irwaMya nagemenofta Patient witah DifficAuilrtw aRye quiring 39. LungS eparatiinot nh eP atient MicrolaryngoTsrcaocphye,o scopy, witah DififcuAlitr wa.y. ..........4.5.0. ... andP haryngoesophDaigleaatl.i .o.n.. 4.9 2 ianR .M orris JeaneStctoet Dt,a viVdo keasn,dL DVu ggan 40.A irwaMya nagemenofta Patiewnitt h SuperiVoern aC avaO bstruction Syndrom.e. ................4.5.7. ......... MathiAesus ealnindG ordo0.n L auncelott
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