Der Krikoiddruck/Sellick-Handgriff beschreibt die Kompression des Ösophagus über Druck (ca. 4,5 kg) auf das Krikoid. Dieses Manöver war lange Zeit fester Bestandteil einer klassischen RSI. Die Annahme war, dass die Hinterwand des Larynx die Speiseröhre okkludiert und damit einer Regurgitation sowie einer pulmonalen Aspiration vorgebeugt werden kann. Diese Annahme ist jedoch nicht belegt. Durch den Krikoiddruck kann die (Masken‑)Beatmung erschwert werden und am Ösophagus kann es zu Verletzungen bis zum Einriss kommen. Der Krikoiddruck ist daher nur als Option im Einzelfall zu erwägen, um eine Regurgitation bzw. Aspiration zu verhindern. Es sollte jedoch gelockert bzw. aufgehoben werden, wenn sich eine erschwerte Beatmung zeigt.
Bei der rsi machst du keine maskenbeatmung. In dem Moment wenn der Tubus durch die stimmritze ist und geblockt wurde ist ja ein Aspirationsschutz gegeben und der cricoiddruck hinfällig. Ist aber wohl eher was für den Straßengraben als das sichere Umfeld in der Klinik
Do you have any tips for irrational anesthesia anxiety? I'm EXTREMELY scared of my next operation. The funny thing is, I'm very interested in anesthesiology and it seems like an interesting career path. Side tangent away, I really need help with my anxiety because it's way too bad for what it is. I don't have any specific fear except of the anesthesia. I'm not afraid of my anesthesiologist or my surgeon, just the anesthesia itself.
Hi Neurologica. Fear around anaesthesia is very common and something that we as anaesthesiologists deal with all the time. Even with very complicated or invasive surgeries I often find that it is the anaesthesia that my patient is most afraid of. After all, it's not something we experience every day! I find that there are two main ways that people deal with this; some people want me to tell them very little as it scares them, others find that lots of information about all the steps puts them at ease. You may already know which would suit you better. Knowing and trusting your anaesthesiologist will also help. We do this thousands of times and with all our modern drugs and safety equipment anaesthesia has never been safer. If fact many people very much enjoy the lovely floaty feeling of going under! I hope that's of some little help to you.
@@doctoraoifebee Thanks! I've been studying anesthesia online for a few months and that's sorta helped, I'll see if i can meet me anesthesiologist a few months pre-op.
@@neurological1722 I don't know for sure how it is handled in other countries - but in Germany the practice of "premedication" is quite common; depending on regional protocol patients get an anxiolytic in the morning before the operation. For example midazolam or lorazepam, which really helps with being a lot calmer! You may try talking with the surgeon about it for example!
I have found that talking about your anesthesia fears with your anesthesiologist // nurse anesthetist can really help. Also, if you know you may have bad reactions with some anesthesia drugs, you can discuss what they use to put you to sleep prior to surgery. I have had a ton of corrective and diagnostic surgeries almost every year for the past 20 years. I developed fear that I conquered after awakening under anesthesia five times during surgery.
Hi Bahri. Thanks for the question. There are multiple ways to assess whether or not the tube is correctly placed. The presence of a steady end tidal CO2 trace is the gold standard method for confirming that you've correctly placed the tube in the trachea rather than the oesophagus. Additional methods include seeing bilateral, symmetrical chest rise as you bag ventilate the patient, seeing misting of the tube with water vapour and a 5-point auscultation with stethoscope. Auscultation isn't always done. Once we see the CO2 trace we're happy campers! Where auscultation becomes more important is when there's a concern that we've passed the tube too far resulting in an endobronchial intubation. When we auscultate in that scenario we can tell if we are indeed only ventilating one lung. I hope that helps!
Hi Frances! Thanks for your question. Kumar and Iarlaith are anaesthetists/anaesthesiologist (depending on the terminology wherever you are in the world) and Noreen is an anaesthesia nurse so assists with airways and other anaesthesia procedures in theatre. I hope that helps.
Thanks for your question Fatma. Unfortunately not as I would need to go through an ethics committee and get both ethical approval and patient approval. It's a lot easier to pretend with colleagues to show the basic sequence of things.
We are not allowed to do internships due to the epidemic. Unfortunately, we even take our hands-on classes online. I want it to remain in my memory visually by watching Dr.
i would bet the privacy laws wherever she is filing from has laws similar to the United States HIPAA (health information ptotection and accountability act) for patient privacy.
Hi Lisa! We actually don’t have nurse anaesthetists in Ireland. Anaesthesia is delivered exclusively by doctors, either consultants or a trainee under supervision of a consultant. Our training scheme is 6 years long and we dual train in anaesthesia and critical care as well as the usual paediatric anaesthesia, obstetrics anaesthesia, trauma anaesthesia, regional anaesthesia, acute and chronic pain, cardiothoracic etc.
This has really helped me. Wonderful video❤
Thank u , best vidoe i seen so far , love ur vidoea
Nice video & helpful for students.
Thanks.
Der Krikoiddruck/Sellick-Handgriff beschreibt die Kompression des Ösophagus über Druck (ca. 4,5 kg) auf das Krikoid. Dieses Manöver war lange Zeit fester Bestandteil einer klassischen RSI. Die Annahme war, dass die Hinterwand des Larynx die Speiseröhre okkludiert und damit einer Regurgitation sowie einer pulmonalen Aspiration vorgebeugt werden kann. Diese Annahme ist jedoch nicht belegt. Durch den Krikoiddruck kann die (Masken‑)Beatmung erschwert werden und am Ösophagus kann es zu Verletzungen bis zum Einriss kommen. Der Krikoiddruck ist daher nur als Option im Einzelfall zu erwägen, um eine Regurgitation bzw. Aspiration zu verhindern. Es sollte jedoch gelockert bzw. aufgehoben werden, wenn sich eine erschwerte Beatmung zeigt.
Bei der rsi machst du keine maskenbeatmung. In dem Moment wenn der Tubus durch die stimmritze ist und geblockt wurde ist ja ein Aspirationsschutz gegeben und der cricoiddruck hinfällig. Ist aber wohl eher was für den Straßengraben als das sichere Umfeld in der Klinik
Habe ich ja geschrieben
Do you have any tips for irrational anesthesia anxiety? I'm EXTREMELY scared of my next operation. The funny thing is, I'm very interested in anesthesiology and it seems like an interesting career path.
Side tangent away, I really need help with my anxiety because it's way too bad for what it is. I don't have any specific fear except of the anesthesia. I'm not afraid of my anesthesiologist or my surgeon, just the anesthesia itself.
Hi Neurologica. Fear around anaesthesia is very common and something that we as anaesthesiologists deal with all the time. Even with very complicated or invasive surgeries I often find that it is the anaesthesia that my patient is most afraid of. After all, it's not something we experience every day! I find that there are two main ways that people deal with this; some people want me to tell them very little as it scares them, others find that lots of information about all the steps puts them at ease. You may already know which would suit you better. Knowing and trusting your anaesthesiologist will also help. We do this thousands of times and with all our modern drugs and safety equipment anaesthesia has never been safer. If fact many people very much enjoy the lovely floaty feeling of going under! I hope that's of some little help to you.
@@doctoraoifebee Thanks! I've been studying anesthesia online for a few months and that's sorta helped, I'll see if i can meet me anesthesiologist a few months pre-op.
@@neurological1722 I don't know for sure how it is handled in other countries - but in Germany the practice of "premedication" is quite common; depending on regional protocol patients get an anxiolytic in the morning before the operation. For example midazolam or lorazepam, which really helps with being a lot calmer! You may try talking with the surgeon about it for example!
I have found that talking about your anesthesia fears with your anesthesiologist // nurse anesthetist can really help. Also, if you know you may have bad reactions with some anesthesia drugs, you can discuss what they use to put you to sleep prior to surgery.
I have had a ton of corrective and diagnostic surgeries almost every year for the past 20 years. I developed fear that I conquered after awakening under anesthesia five times during surgery.
@@kgrfirdjy can u expand on this please?? Youve woken up 5 times during surgery?
Thank you, KRNA student,following your educative videos.
Thank you Hamisi! Hope to add more soon :)
I'm wondering if general anesthesia is a type of taking a nap Jesus is with you sweetie
Thank you! I can be an anaesthesiologist now! Where do I apply? 🤣
We’ll sign you up immediately! The more the merrier 😃
Lindo "paciente" 😍😍
Thank you for this nice video.But I think after the saving tube should we hear lungs with stethoscope,isn't it ?
Hi Bahri. Thanks for the question. There are multiple ways to assess whether or not the tube is correctly placed. The presence of a steady end tidal CO2 trace is the gold standard method for confirming that you've correctly placed the tube in the trachea rather than the oesophagus. Additional methods include seeing bilateral, symmetrical chest rise as you bag ventilate the patient, seeing misting of the tube with water vapour and a 5-point auscultation with stethoscope. Auscultation isn't always done. Once we see the CO2 trace we're happy campers! Where auscultation becomes more important is when there's a concern that we've passed the tube too far resulting in an endobronchial intubation. When we auscultate in that scenario we can tell if we are indeed only ventilating one lung. I hope that helps!
Is Kumar an anaesthetist or anaesthetic nurse?
Hi Frances! Thanks for your question. Kumar and Iarlaith are anaesthetists/anaesthesiologist (depending on the terminology wherever you are in the world) and Noreen is an anaesthesia nurse so assists with airways and other anaesthesia procedures in theatre. I hope that helps.
❤❤❤❤❤❤
thank you
Thanks for watching!
Why Kumar is nervous 😅
He must have no trust in Iarlaith! 😁
😂
Il faut faire le fentanyle après l'intubation
😊
I thought they would really intubate him 😭
Can you show me real anesthesia applications?
Thanks for your question Fatma. Unfortunately not as I would need to go through an ethics committee and get both ethical approval and patient approval. It's a lot easier to pretend with colleagues to show the basic sequence of things.
Oh well, I am also an anesthesia student, but I understand you too. Thank you for your kindness and reply☺😇
We are not allowed to do internships due to the epidemic. Unfortunately, we even take our hands-on classes online. I want it to remain in my memory visually by watching Dr.
i would bet the privacy laws wherever she is filing from has laws similar to the United States HIPAA (health information ptotection and accountability act) for patient privacy.
@ooo mmm ovv mmm i see😄
فيمحمتؤشغمشذتليحهلؤظكيشجعليذهلفيشخفيظمؤسذكجليشهفيشقؤشمجيؤذغيايشظؤلسهفيسهلتيؤيسكجنيذشؤمهلذؤغشهؤؤذكجيؤظغشؤيذلعيشتعلشمغلاشظحيسةلؤذكهليكحغشبشيذفيشجكهلاسظتليذفسهلبيؤقسهغبشذفيشيشهغيشذيسهفيشمليؤشحعليذؤذمجميشغلينمؤا
Thank God for nurse anesthetists! *The person at the head of the bed*
Hi Lisa! We actually don’t have nurse anaesthetists in Ireland. Anaesthesia is delivered exclusively by doctors, either consultants or a trainee under supervision of a consultant. Our training scheme is 6 years long and we dual train in anaesthesia and critical care as well as the usual paediatric anaesthesia, obstetrics anaesthesia, trauma anaesthesia, regional anaesthesia, acute and chronic pain, cardiothoracic etc.
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Not interest
Nice video & helpful for students.
Thanks.