laryngealmaskairwayintheproneposition喉罩通气在易发部位学习教案

1、会计学1laryngealmaskairwayintheproneposition喉罩通气喉罩通气(tng q)在易发部位在易发部位第一页，共31页。non-anesthetized but still prone第1页/共30页第二页，共31页。4. Distribution of ventilation 第2页/共30页第三页，共31页。system3. Pressure injuries direct - indirect第3页/共30页第四页，共31页。Anaesthesia in the prone positionH. Edgcombe1, K. Carter1 and S. Ya

2、rrow2*1Royal Berkshire NHS Foundation Trust, London Road, Reading RG1 5AN, UK. 2John Radcliffe Hospital,Oxford, UK*Corresponding author: Nuffield Department of Anaesthesia, John Radcliffe Hospital, Oxford OX3 9DU, UK.British Journal of Anaesthesia 100 (2): 16583 (2008)第4页/共30页第五页，共31页。SOURCES OF POT

3、ENTIAL INJURY TO THE BRACHYAL PLEXUS AND ITS PERIPHERAL COMPONENTS WHEN THE PATIENT IS PRONEA. Neck rotation, stretching roots of the plexus. B. Compression of the plexus and vessels between the clavicle and first rib. C. Injury to the axillary neurovascular bundle from the head of the humerus. D. C

4、ompression of the ulnar nerve before, beyond, and within the cubital tunnel. E. Area of vulnerability of the radial nerve to lateral compression proximal to the elbow. (Reproduced from Martin JT, Warner MA Eds: Positioning in Anesthesia and Surgery, 3rd edition. Philadelphia, WB Saunders, 1997, p 18

5、5, with permission.) and permission from Prof. Barash.第5页/共30页第六页，共31页。第6页/共30页第七页，共31页。 and you can add whatever your experience and memory can bring第7页/共30页第八页，共31页。Some of the problems can be avoided if第8页/共30页第九页，共31页。 - provides visual appreciation on how he/she will be during surgery第9页/共30页第十

6、页，共31页。第10页/共30页第十一页，共31页。第11页/共30页第十二页，共31页。Complete access to the face第12页/共30页第十三页，共31页。Only one hand is needed第13页/共30页第十四页，共31页。第14页/共30页第十五页，共31页。 Original article: “Insertion of the LMA Supreme in the prone position” Anaesthesia, 2010, 65, 154-157第15页/共30页第十六页，共31页。第16页/共30页第十七页，共31页。Reproduc

7、ed with permission from “A Practical Guide to the Prone Position for SurgeryDr. Patrick Ross, Consultant Anaesthetist, Pennine Acute NHS TrustDr. Glyn Smurthwaite, Consultant Anaesthetist, Salford Royal NHS Foundation Trust第17页/共30页第十八页，共31页。Reproduced with permission from “A Practical Guide to the

8、Prone Position for SurgeryDr. Patrick Ross, Consultant Anaesthetist, Pennine Acute NHS TrustDr. Glyn Smurthwaite, Consultant Anaesthetist, Salford Royal NHS Foundation Trust第18页/共30页第十九页，共31页。The armrest is slightly lower than the table.第19页/共30页第二十页，共31页。The same armrest from a slightly different a

9、ngle.第20页/共30页第二十一页，共31页。Correct arm position, no tension in theshoulder, elbow and wrist articulations第21页/共30页第二十二页，共31页。Noting above 90 degrees第22页/共30页第二十三页，共31页。One assistant is holding the mouth openWhile the anesthetist is inserting the LMA第23页/共30页第二十四页，共31页。The LMA is in. The rest is as usu

10、al as it can be第24页/共30页第二十五页，共31页。MAAYANEY HAYESHUA MEDICAL CENTERBNEY BRAKISRAEL第25页/共30页第二十六页，共31页。Are you nuts?AstonishmentDistrustEnthusiasm第26页/共30页第二十七页，共31页。Use of the LMA as a primary adjunct is controversial, but it has been used effectively.“Anaesthesia in the prone position” - cited第27页/共30页第二十八页，共31页。KNOW, THE EYE D