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Procedural Sedation And Analgesia
Procedural sedation and analgesia (PSA) is a technique in which a sedating/dissociative medication is given, usually along with an analgesic medication, in order to perform non-surgical procedures on a patient. The overall goal is to induce a decreased level of consciousness while maintaining the patient's ability to breathe on their own. Airway protective reflexes are not compromised by this process Walls, Ron M., MD; Hockberger, Robert S., MD; Gausche-Hill, Marianne, MD, FACEP, FAAP, FAEMS (2018). ''Rosen's Emergency Medicine: Concepts and Clinical Practice. Ninth Edition''. Elsevier. and therefore endotracheal intubation is not required. PSA is commonly used in the emergency department, in addition to the operating room. Medical uses This technique is often used in the emergency department for the performance of painful or uncomfortable procedures. Common purposes include: * laceration repair * setting fractures * draining abscesses * reducing dislocations * performing endoscop ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Tracheal Intubation
Tracheal intubation, usually simply referred to as intubation, is the placement of a flexible plastic tube into the trachea (windpipe) to maintain an open airway or to serve as a conduit through which to administer certain drugs. It is frequently performed in critically injured, ill, or anesthetized patients to facilitate ventilation of the lungs, including mechanical ventilation, and to prevent the possibility of asphyxiation or airway obstruction. The most widely used route is orotracheal, in which an endotracheal tube is passed through the mouth and vocal apparatus into the trachea. In a nasotracheal procedure, an endotracheal tube is passed through the nose and vocal apparatus into the trachea. Other methods of intubation involve surgery and include the cricothyrotomy (used almost exclusively in emergency circumstances) and the tracheotomy, used primarily in situations where a prolonged need for airway support is anticipated. Because it is an invasive and uncomfortable me ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Central Nervous System
The central nervous system (CNS) is the part of the nervous system consisting primarily of the brain and spinal cord. The CNS is so named because the brain integrates the received information and coordinates and influences the activity of all parts of the bodies of bilaterally symmetric and triploblastic animals—that is, all multicellular animals except sponges and diploblasts. It is a structure composed of nervous tissue positioned along the rostral (nose end) to caudal (tail end) axis of the body and may have an enlarged section at the rostral end which is a brain. Only arthropods, cephalopods and vertebrates have a true brain (precursor structures exist in onychophorans, gastropods and lancelets). The rest of this article exclusively discusses the vertebrate central nervous system, which is radically distinct from all other animals. Overview In vertebrates, the brain and spinal cord are both enclosed in the meninges. The meninges provide a barrier to chemicals ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Anesthesia Recovery Modified
Anesthesia is a state of controlled, temporary loss of sensation or awareness that is induced for medical or veterinary purposes. It may include some or all of analgesia (relief from or prevention of pain), paralysis (muscle relaxation), amnesia (loss of memory), and unconsciousness. An individual under the effects of anesthetic drugs is referred to as being anesthetized. Anesthesia enables the painless performance of procedures that would otherwise cause severe or intolerable pain in a non-anesthetized individual, or would otherwise be technically unfeasible. Three broad categories of anesthesia exist: * General anesthesia suppresses central nervous system activity and results in unconsciousness and total lack of sensation, using either injected or inhaled drugs. * Sedation suppresses the central nervous system to a lesser degree, inhibiting both anxiety and creation of long-term memories without resulting in unconsciousness. * Regional and local anesthesia, which blo ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Emergency Department
An emergency department (ED), also known as an accident and emergency department (A&E), emergency room (ER), emergency ward (EW) or casualty department, is a medical treatment facility specializing in emergency medicine, the acute care of patients who present without prior appointment; either by their own means or by that of an ambulance. The emergency department is usually found in a hospital or other primary care center. Due to the unplanned nature of patient attendance, the department must provide initial treatment for a broad spectrum of illnesses and injuries, some of which may be life-threatening and require immediate attention. In some countries, emergency departments have become important entry points for those without other means of access to medical care. The emergency departments of most hospitals operate 24 hours a day, although staffing levels may be varied in an attempt to reflect patient volume. History Accident services were provided by workmen's compensation ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Supplemental Oxygen
Oxygen therapy, also known as supplemental oxygen, is the use of oxygen as medical treatment. Acute indications for therapy include hypoxemia (low blood oxygen levels), carbon monoxide toxicity and cluster headache. It may also be prophylactically given to maintain blood oxygen levels during the induction of anesthesia. Oxygen therapy is often useful in chronic hypoxemia caused by conditions such as severe COPD or cystic fibrosis. Oxygen can be delivered via nasal cannula or face mask, or via high pressure conditions such as in endotracheal intubation or hyperbaric chamber. It can also be given through bypassing the airway, such as in ECMO therapy. Oxygen is required for normal cellular metabolism. However, excessively high concentrations can result in oxygen toxicity, leading to lung damage and respiratory failure. Higher oxygen concentrations can also increase the risk of airway fires, particularly while smoking. Oxygen therapy can also dry out the nasal mucosa without humi ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Oxygen Saturation
Oxygen saturation (symbol SO2) is a relative measure of the concentration of oxygen that is dissolved or carried in a given medium as a proportion of the maximal concentration that can be dissolved in that medium at the given temperature. It can be measured with a dissolved oxygen probe such as an oxygen sensor or an optode in liquid media, usually water. The standard unit of oxygen saturation is percent (%). Oxygen saturation can be measured regionally and noninvasively. Arterial oxygen saturation (SaO2) is commonly measured using pulse oximetry. Tissue saturation at peripheral scale can be measured using NIRS. This technique can be applied on both muscle and brain. In medicine In medicine, oxygen saturation refers to ''oxygenation'', or when oxygen molecules () enter the tissues of the body. In this case blood is oxygenated in the lungs, where oxygen molecules travel from the air into the blood. Oxygen saturation (() sats) measures the percentage of hemoglobin binding s ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Laryngeal Mask Airway
A laryngeal mask airway (LMA), also known as laryngeal mask, is a medical device that keeps a patient's Respiratory tract, airway open during anaesthesia or while they are Unconsciousness, unconscious. It is a type of supraglottic airway device. They are most commonly used by anaesthetists to channel oxygen or Inhalational anesthetic, inhalational anaesthetic to the lungs during surgery and in the pre-hospital setting (for instance by paramedics and emergency medical technicians) for unconscious patients. A laryngeal mask is composed of an airway tube that connects to an elliptical mask with a cuff which is inserted through the patient's mouth, down the Trachea, windpipe, and once deployed forms an airtight seal on top the glottis (unlike tracheal tubes which pass through the glottis) allowing a secure respiratory tract, airway to be managed by a health care provider. The laryngeal mask was invented by British people, British anaesthesiologist Archie Brain, Archibald Brain in th ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Glidescope
Laryngoscopy () is endoscopy of the larynx, a part of the throat. It is a medical procedure that is used to obtain a view, for example, of the vocal folds and the glottis. Laryngoscopy may be performed to facilitate tracheal intubation during general anaesthesia or cardiopulmonary resuscitation or for surgical procedures on the larynx or other parts of the upper tracheobronchial tree. Direct laryngoscopy Direct laryngoscopy is carried out (usually) with the patient lying on his or her back; the laryngoscope is inserted into the mouth on the right side and flipped to the left to trap and move the tongue out of the line of sight, and, depending on the type of blade used, inserted either anterior or posterior to the epiglottis and then lifted with an upwards and forward motion ("away from you and towards the roof "). This move makes a view of the glottis possible. This procedure is done in an operation theatre with full preparation for resuscitative measures to deal with respi ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Thyromental Distance
Thyromental distance (TMD) measurement is a method commonly used to predict the difficulty of intubation Intubation (sometimes entubation) is a medical procedure involving the insertion of a tube into the body. Patients are generally anesthetized beforehand. Examples include tracheal intubation, and the balloon tamponade with a Sengstaken-Blake ... and is measured from the thyroid notch to the tip of the jaw with the head extended. If it is less than 7.0 cm with hard scarred tissues, it indicates possible difficult intubation. See also * Mallampati score * Simplified Airway Risk Index References {{Anesthesia Anesthesia ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Mallampati Score
In anesthesia, the Mallampati score or Mallampati classification, named after the Indian anaesthesiologist Seshagiri Mallampati, is used to predict the ease of endotracheal intubation. The test comprises a visual assessment of the distance from the tongue base to the roof of the mouth, and therefore the amount of space in which there is to work. It is an indirect way of assessing how difficult an intubation will be; this is more definitively scored using the Cormack-Lehane classification system, which describes what is actually seen using direct laryngoscopy during the intubation process itself. A high Mallampati score (class 3 or 4) is associated with more difficult intubation as well as a higher incidence of sleep apnea. Technique The score is assessed by asking the patient, in a sitting posture, to open their mouth and to protrude the tongue as much as possible. The anatomy of the oral cavity is visualized; specifically, the assessor notes whether the base of the uvula, fau ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Informed Consent
Informed consent is a principle in medical ethics and medical law, that a patient must have sufficient information and understanding before making decisions about their medical care. Pertinent information may include risks and benefits of treatments, alternative treatments, the patient's role in treatment, and their right to refuse treatment. In most systems, healthcare providers have a legal and ethical responsibility to ensure that a patient's consent is informed. This principle applies more broadly than healthcare intervention, for example to conduct research and to disclosing a person's medical information. Definitions of informed consent vary, and the standard required is generally determined by the state. Informed consent requires a clear appreciation and understanding of the facts, implications, and consequences of an action. To give informed consent, the individual concerned must have adequate reasoning faculties and possess all relevant facts. Impairments to reasoning ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
ASA Physical Status Classification System
The ASA physical status classification system is a system for assessing the fitness of patients before surgery. In 1963 the American Society of Anesthesiologists (ASA) adopted the five-category physical status classification system; a sixth category was later added. These are: #Healthy person. #Mild systemic disease. #Severe systemic disease. #Severe systemic disease that is a constant threat to life. #A moribund person who is not expected to survive without the operation. #A declared brain-dead person whose organs are being removed for donor purposes. If the surgery is an emergency, the physical status classification is followed by "E" (for emergency) for example "3E". Class 5 is usually an emergency and is therefore usually "5E". The class "6E" does not exist and is simply recorded as class "6", as all organ retrieval in brain-dead patients is done urgently. The original definition of emergency in 1940, when ASA classification was first designed, was "a surgical procedure wh ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
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