Hung’s Difficult and Failed Airway Management

720 Pages·2017·63.075 MB·English

by  Orlando Hung, Michael F. Murphy

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
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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 ,
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informcaotnitoainint n hweiodsr Rke.a daererens c outroca ognefidr imn ftohrecm oantitoani ned
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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
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DepratmeonfAt ne sthPeasiMinaa n,a geamnePdne tr iopMeerdaitciivnee
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QueeEnl izaIbHIee tahlS tiche nCceenst re
DepartmoefAn nte sthesia
HalaixNf,o vSaoc tiCaa,n ada
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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
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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