| Title: |
Protection of respiratory integrity and haemodynamic stabilization |
| Authors: |
Muschart, X; Domjan, V; Mergny, E; Watelet, Jean-Baptiste |
| Source: |
B-ENT ; ISSN: 0001-6497 |
| Publication Year: |
2016 |
| Collection: |
Ghent University Academic Bibliography |
| Subject Terms: |
Medicine and Health Sciences; Protection of the respiratory integrity; airway; haemodynamic stabilization; circulation; HOSPITAL CARDIAC-ARREST; EMERGENCY CARDIOVASCULAR CARE; RESUSCITATION-COUNCIL GUIDELINES; DIFFICULT TRACHEAL INTUBATION; ADVANCED AIRWAY MANAGEMENT; ADVANCED LIFE-SUPPORT; ENDOTRACHEAL INTUBATION; SUPRAGLOTTIC AIRWAY; CARDIOPULMONARY-RESUSCITATION; TRANEXAMIC ACID |
| Description: |
Objectives: To perform an analysis of the protection of respiratory integrity and haemodynamic stabilization based on the literature review and the experiences and perspectives of emergency and ENT specialists. Methodology: A comprehensive literature search was undertaken through PubMed and MEDLINE, using the following keywords: [protection of the respiratory integrity], [intubation], [hypotension] and [haemodynamic stabilization]. Articles were selected if the topic was relevant to current ENT and emergency practice. Additional articles were identified through a careful review of reference lists in Uptodate. A critical review of ENT and emergency specialists was carried out. Evidence staging and recommendation levels were established using the Paul Shekelle scale. Results : Firstly, protection of the airway is necessary before starting haemodynamic stabilization. Fibre-optic examination and laryngeal intubation form the gold standard of diagnosis and treatment in the protection of the airway. For circulation, a short catheter with a large size allows the management of intravenous fluids, with vasopressors if necessary. Aetiologic and specific treatments are also very important. Conclusions : Appropriate and collaborative management is necessary with the "ABCDE" approach: Airway and immobilization of the neck; Breathing; Circulation; Disability and Exposure. A fibre-optic examination is the gold standard of airway diagnosis. Laryngeal intubation is the most effective treatment for protection of the respiratory integrity. The management of circulation includes the implementation of a venous route to initiate administration of IVFs, preferably with isotonic saline. Vasopressors and inotropes are used as second line agents. A multidisciplinary and team approach is preferred, in order to achieve diagnosis and therapeutics simultaneously. |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
https://biblio.ugent.be/publication/8511029; https://biblio.ugent.be/publication/8511029/file/8511031 |
| Availability: |
https://biblio.ugent.be/publication/8511029; https://hdl.handle.net/1854/LU-8511029; https://biblio.ugent.be/publication/8511029/file/8511031 |
| Rights: |
info:eu-repo/semantics/restrictedAccess |
| Accession Number: |
edsbas.FD721B07 |
| Database: |
BASE |