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Influence of Airway Management Strategy on No-Flow-Time - Essay Example

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Summary
Following the introduction of laryngeal tube due to changes in supraglottic airway, health professionals conducted the manikin study and discovered various issues. No-flow-time (NFT) reduced significantly once the LTS-D came into application. The LTS-D appears to save time more…
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Influence of Airway Management Strategy on No-Flow-Time
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CARDIOPULMONARY RESUSCITATION Findings Following the introduction of laryngeal tube due to changes in supraglottic airway, health professionals conducted the manikin study and discovered various issues. No-flow-time (NFT) reduced significantly once the LTS-D came into application. The LTS-D appears to save time more compared to the BMV group (Bein, 2005, p. 587). This is because utilizing LTS-D increases the levels of adherence to the instructions. Provided by ERC to ninety-six percent compared to thirty percentile recorded in the BMV category. Establishment of LTS-D between two patients in the same group required several attempts. On establishing, the same resulted in one hundred percent ventilation in terms of effectiveness. Most patients opted for the LTS-D rather than the BMV in providing ventilation during cardiac arrest processes. This means that while carrying out cardiac arrest, the LTS-D is the best alternative (Goedecke, 2006, p. 72). This is when compared to BMV during provision and maintenance of the patent airway. Utilization of the same safeguards new health practitioners in endotracheal intubation. Doctors who introduced the laryngeal tube expected that device would allow controlled ventilation or permit unprompted breathing when a patient is under anesthesia. In the end, the results showed that the laryngeal tube was an acceptable option for bag-mask ventilation referred to by other scholars as endotracheal intubation (Hilker, 2000, p. 169). This is when the doctors are carrying out resuscitation. At the end of the research, people carrying out the study found that various types of supraglottic airways are available and applicable. However, researchers in this study only compared bag-mask device and LTS-D applied unilaterally. The ERC revised some of its guidelines in two thousand and five defining the no-flow-time (NFT) as duration taken without compressing the chest reducing it to its lowest. This was a change from the norm where NFT remained high few minutes after the start of the resuscitation exercise. Further findings include upholding the traditional fact that endotracheal intubation continues to serve as the standard of managing airway (Jackson, 2007, p. 390). Efforts to try tube placement should not take more than thirty seconds. The research recommended that only experienced hands should attempt tube placement. This is because it would help in minimizing the possibilities of accidental hypoxia as well as unrecognized oesophageal occurring. Scholars who participated in the study also recommended that optional management of airway should apply during resuscitation because most of the health personnel in the emergency unit do not understand endotracheal tube (Kattwinkel, & Bloom, 2000, Para 7). It is not easy to invade bag-mask-ventilation (BMV) making it the most applicable. Implementation After starting the resuscitation exercise, it took slightly more than thirteen seconds for the health professionals to record the first respiration. This is the reason that the recommended time for the first respiration is a range from nine to eighteen seconds (Salako, 2006, p. 352). In the duration, include the time taken while confirming the unconsciousness (European Resuscitation Council, 2005, S, 112). However, it leaves out time taken for the initial thirty compressions for the chest. Provided time consumed came before recording the initial ventilation. Important however, is to note that during the experiment, the BMV took slightly more than twenty-three seconds to record the first respiration when they included the initial thirty chest compressions? (Genzwuerker, 2002, p. 223) This explains why there is an increase in the range from nineteen to thirty-five seconds. While using the manikin, ventilation will take slightly less than four seconds within range of between one point nine seconds to five point three seconds. This covers both expiration and inspiration of the manikin. Before implementing any of the programs for resuscitation, they must meet various basic guidelines. Both people with experience and amateurs must be able to handle the airway device under utilization (Kette, 2005, p. 22). Furthermore, users of the devices must be sure that prevention against aspiration remains protected. While using the laryngeal tube, users must understand that device came as an alternative to safeguarding the complex airway. Following on the same, gradual development of laryngeal tube resulted in the development of its version that contains the gastric suction alternative. The new device meets the outlined qualities since coming into practice in two thousand and two (Bayley, 2007, p. 711). It is also important to remember that although the device came for use in anesthesia, professionals in the emergency unit continue to develop interest I using the same machine. It is necessary to have optional airway devices in the management of ventilation during the process of cardiac arrest (Genzwuerker, 2005, p. 2). According to the ERC, ICU nurses do not understand processes of using endotracheal intubation. This means that they do not have sufficient training as well as adequate experience in endotracheal intubation. This makes it mandatory for them to keep distance during implementation exercise (Doerges, 2001, p. 189). While carrying out resuscitation, ICU nurses should keep off using the devices and stick to the traditional BMV as the only method of maintaining ventilation. Utilization of BMV does not require too much experience while at the same time results recorded after putting into use the LTS-D showed better services compared to BMV used by nurses (Wrobel, 2004, p. 707). This proves that LTS-D is superior to BMV. Using Cardiopulmonary Resuscitation The lives of the patient and the rescuer change depending on the ability to understand when to use cardiopulmonary resuscitation (CPR) (Asai, 2005, p. 733). Situations where a patient goes into immediate cardiac arrest or stops breathing warrant the use of the CPR. In this case, the individual has no impulse because his or her heart has stopped. This is the moment physicians pose that the individual is I the process of dying. CPR helps a patient unable to breathe as well as whose ability to pump blood to circulate is low. CPR keeps in position the circulation of blood and gives oxygen to whoever cannot get his or her own. Utilization of CPR continues while awaiting heart and blood experts’ arrival to attempt reviving the patient. This constitutes a team with advancement knowledge in the medical profession (Gaitini, 2004, p. 317). CPR supplies oxygenated blood across the entire body in the same way the heart would do under normal conditions (Kattwinkel, & Bloom, 2011, p. 76). People need to understand that using the CPR is easy and simple if learnt. Simple steps include placing the patient’s back on hard a surface and making confirmations he or she is still breathing. Alternatively, the helper may put one hand on the patient’s forehead while the other hand holds below the chin. In the process, the helper ought to adjust the back of the head of the patient. The next two steps are easy and entail blowing two breathes in the mouth of the patient and pinching his or her nose (Cook, 2003, p. 376). Drawing nonexistent lines between the nipples of the patient follows these steps. The helper should interlock the fingers of the patient after holding the breastbone of the patient with the hand’s heel. Finally, the helper gives two breathes after very thirty compressions. Values of CPR It is important for people to comprehend that receiving certification of CPR is as significant as its function. People get the chance to save lives, the capacity to put AED into action during relevant situations, and the enrichment they need respond to particular actions during necessary moments. CPR saves lives of most people around the globe (Agro, 1999, p. 285). This is especially important during emergencies. This is considering the fact that statistics from the American Red Cross show that more than one hundred and sixty thousand people across the world can die if exposed to cardiac arrest without immediate help. The same report indicates that the leading cause of deaths among mature people remains cardiac arrest worldwide. Bibliography Agro F, (1999). A new prototype for airway management in an emergency: the Laryngeal Tube. Resuscitation Journal Vol 41:284–286. Asai T, (2005). Br J. Anaesthesia. 2005; 95: 729–736. Bayley, G, (2007). A comparison of four different advanced airway mannequins for training DAS guidelines. Anaesthesia Vol 62:708–712. Bein, B, (2005). Supraglottic airway devices. Best Practices in Resuscitation in Clinical Anesthesiology Vol 19:581–593. Cook, M, (2003). Randomized comparison of laryngeal tube with classic laryngeal mask airway for anaesthesia with controlled ventilation. Br J Anaesthesia Vol 91:373–378. Doerges, V, (2001). Intubating laryngeal mask airway, laryngeal tube, and 1100 ml self-inflating bag – alternatives for basic life support. Resuscitation Vol 51:185–191. European Resuscitation Council, (2005). European Resuscitation Council Guidelines for Resuscitation. Resuscitation Journal Vol 67: S1– S189. Gaitini, A, (2004). A randomized controlled trial comparing the Pro Seal Laryngeal Mask Airway with the Laryngeal Tube Suction in mechanically ventilated patients. Anesthesiology Vol 101:316–320. Genzwuerker, V, (2002). Use of the laryngeal tube for out-of-hospital resuscitation. Resuscitation Journal vol; 52:221–224. Genzwuerker, V, (2005). Emergency airway management by first responders with the laryngeal tube – intuitive and repetitive use in a manikin. Scand J Trauma Resuscitation Emergency Medical Journal Vol 13:1–4. Goedecke, A, (2006). Mask ventilation as an exit strategy of endotracheal intubation. Anesthetist Vol 55:70–79. Hilker, T, (2000). The laryngeal tube: a new adjunct for airway management. Pre-hospital Emergence Care Vol 4, 168–172. Jackson, M, (2007). A comparison of four different advanced airway mannequins for training SAD insertion. Anaesthesia Vol 62:388–393. Kattwinkel, J., & Bloom, S. (2000). Textbook of neonatal resuscitation. [Dallas, Tex.?], American Heart Association. http://catalog.hathitrust.org/api/volumes/oclc/45588002.html. Kattwinkel, J., & Bloom, S. (2011). Textbook of neonatal resuscitation. [Elk Grove Village, Ill.?], American Academy of Pediatrics. Kette F, (2005). The use laryngeal tube by nurses in out-of-hospital emergencies: Preliminary experience. Resuscitation Journal Vol 66:21–25. Salako, E. (2006). The declaration of Helsinki 2000: ethical principles and the dignity of difference. Med Law Vol 25:341–354.  Wrobel, M, (2004). Laryngeal tube versus laryngeal mask airway in anaesthetized non-paralyzed patients. A comparison of handling and postoperative morbidity. Anesthetist Vol 53:702–708. Read More
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