A PROSPECTIVE OBSERVATIONAL STUDY OF AIRWAY MANAGEMENT TECHNIQUES IN CERVICAL SPINE TRAUMA PATIENTS
Main Article Content
Keywords
hypoventilation, oropharyngeal, subluxation
Abstract
This prospective observational study aimed to compare various airway management techniques in patients with cervical spine trauma to determine the most effective and safe method. The study was conducted on patients with confirmed cervical spine injuries who required airway management in a tertiary care hospital over a period of 12 months. Airway management methods included direct laryngoscopy, fiberoptic bronchoscopy, and video laryngoscopy. The primary outcome was the success rate of intubation, while secondary outcomes included complications, time to intubation, and the need for additional maneuvers. Results showed that fiberoptic bronchoscopy had the highest success rate with the least cervical spine movement, followed by video laryngoscopy and direct laryngoscopy. Video laryngoscopy provided better visualization but required more time compared to direct laryngoscopy. Complications such as hypoxia, esophageal intubation, and trauma to the airway were minimal with fiberoptic bronchoscopy. The study concludes that while fiberoptic bronchoscopy remains the gold standard for airway management in cervical spine trauma, video laryngoscopy is a viable alternative when fiberoptic tools are unavailable. These findings suggest that tailored airway management strategies are essential for optimizing outcomes in cervical spine trauma patients.
References
1. Austin N, Krishnamoorthy V, Dagal A. Airway management in cervical spine injury.
International Journal of Critical Illness and Injury Science. 2014;4(1):50-56.
2. Pal R, Chauhan S, Ved BK, Lad SR. Evaluation of laryngoscopic view, intubation
difficulty and sympathetic response during direct laryngoscopy in sniffing position
and simple head extension: A prospective and randomized comparative study. Int J
Res Med Sci 2015;3:1895-901.
3. Magill IW. Endotracheal anaesthesia. American Journal of Surgery 1936; 34:450 –
5.
4. Jain D, Bala I, Gandhi K. Comparative effectiveness of McCoy laryngoscope and
CMAC(®) videolaryngoscope in simulated cervical spine injuries. J
AnaesthesiolClinPharmacol. 2016 Jan;32(1):59-64.
5. Joseph J, Sequeira T, Upadya M. Comparison of the use of McCoy and TruView
EVO2 laryngoscopes in patients with cervical spine immobilization. Saudi J Anaesth.
2012;6:248–53.
6. Bharti N, Arora S, Panda NB. A comparison of McCoy, TruView, and Macintosh
laryngoscopes for tracheal intubation in patients with immobilized cervical spine.
Saudi Journal of Anaesthesia. 2014;8(2):188-192. doi:10.4103/1658-354X.130705.
7. Laurent SC, de Melo AE, Alexander-Williams JM. The use of the McCoy
laryngoscope in patients with simulated cervical spine injuries. Anaesthesia.
1996;51:74–5.
8. Sabry LA, Shaarawy SS, Ellakany MH, Elmasry AA. Comparison between C-MAC
D-blade and McCoy laryngoscopes in intubating patients during cervical
immobilization. Res OpinAnesth Intensive Care 2016;3:122-8.
9. Kilicaslan, A. Topal, A. Tavlan, A. Erol, and S. Otelcioglu, “Effectiveness of the CMAC video laryngoscope in the management of unexpected failed intubations,”
Brazilian Journal of Anesthesiology, vol. 64, no. 1, pp. 62–65, 2014.
10. Standring S. Gray's Anatomy - The Anatomical basis of clinical practice. 41st ed
p718-724. Elsevier; 2016.
11. Crosby ET: Airway management in adults after cervical spine trauma.
Anesthesiology 2006; 104:1293–1318.
12. Baydur A, Adkins RH, Milic-Emili J. Lung mechanics in individuals with spinal
cord injury: effects of injury level and posture. J Appl Physiol 2001; 90:405-411
13. Mower WR, Hoffman JR, Pollack CV, et al. NEXUS Group. Use of plain
radiography to screen for cervical spine injuries. Ann Emerg Med 2001; 38:1-7
14. Demetriades D, Charalambides K, Chawan S, et al. Nonskeletal cervical spine
injuries: epidemiology and diagnostic pitfalls. J Trauma 2000; 48:724-724715. Goldberg W, Mueller C, Panacek E, Tigges S, Hoffman J, Mower WR:
Distribution and pattern of blunt traumatic cervical spine injury. Ann Emerg Med
2001; 38:17–21.
16. Stiell IG, Wells GA, Vandemheen KL, Clement CM, Lesiuk H, De Maio VJ,
Laupacis A, Schull M, McKnight RD, Verbeek R, Brison R, Cass D, Dreyer J,
Eisenhauer MA, Greenberg GH, MacPhail I, Morrison L, Reardon M, Worthington J:
The Canadian C-spine rule for radiography in alert and stable trauma patients. JAMA
2001; 286:1841–8.
17. Tator CH: Update on the pathophysiology and pathology of acute spinal cord
injury. Brain Pathol 1995; 5:407–13.
18. Kwon BK, Tetzlaff W, Grauer JN, Beiner J, Vaccaro AR: Pathophysiology and
pharmacologic treatment of acute spinal cord injury. Spine J 2004; 4:451–64.
19. Panjabi M, White A III: Biomechanics of nonacute cervical spinal cord trauma.
Spine(Phila Pa 1976). 1988 Jul;13(7):838-42
20. Wang AY, Jaeger RJ, Yarkony GM, et al. Cough in spinal cord injured patients;
the relationship between motor level and peak expiratory flow. Spinal Cord 1997;
35:299-302
21.Almenoff PL, Spungen AM, Lesser M, et al. Pulmonary function survey in spinal
cord injury: influence of smoking andlevel and completeness of injury. Lung
1995;173:297-306
22.Fiacchino F, Bricchi M, Lasio G. Monitoring of curarisation in patients with
tetraparesis. Anaesthesia 1990;45:128-31
23. Silver JR, Randall WC, Guttman L. Spinal mediation of thermally induced
sweating. J Neurol Neurosurg Psychiatry1995;54:297-304
24. Campaglono DI, Bartett JA, Keller SE. The influence of neurological level on
immune function following spinal cord injury: A review. Spinal Cord Med 2000;
23:121-128
25. Mollinger LA, Spurr GB, Ghatit AZ, et al. Daily energy expenditure and basal
metabolic rates of patients with spinal cord injury. Arch Phys Med Rehabil
1985;66:420-426
26. Wilmot CB, Cope N, Hall KM, Acker Ml. Occult head injury; its incidence in spinal
cord injury. Arch Phys Med Rehabil 1985;66:227
27. Esposito TJ, Sanddal ND, Hansen JD, Reynolds S. Analysis of preventable
trauma deaths and inappropriate trauma care in a rural state. J Trauma.
1995;39:955–62.
28. Hussain LM, Redmond AD. Are pre-hospital deaths from accidental injury
preventable? BMJ. 1994;308:1077–80.Page | 99
29. Shorten GD, Opie NJ, Graziotti P, et al. Assessment of upper airway anatomy in
awake, sedated and anaesthetised patients using magnetic resonance imaging.
Anaesth Intensive Care. 1994;22:165–9.
30. Mathru M, Esch O, Lang J, et al. Magnetic resonance imaging of the upper
airway. Effects of propofol anesthesia and nasal continuous positive airway pressure
in humans. Anesthesiology.1996;84:273–9.
31. Guildner CW. Resuscitation-opening the airway. A comparative study of
techniques for opening an airway obstructed by the tongue. JACEP. 1976;5(8):588–
90.
32. Uzun L, Ugur MB, Altunkaya H, et al. Effectiveness of the jawthrust maneuver in
opening the airway: a flexible fiberoptic endoscopic study. ORL J Otorhinolaryngol
Relat Spec. 2005;67:39–44.
33. Hauswald M, Sklar DP, Tandberg D, Garcia JF. Cervical spine movement during
airway management: cinefluoroscopic appraisal in human cadavers.Am J Emerg
Med. 1991;9:535-8.
34. Brimacombe J, Keller C, Kunzel KH, et al. Cervical spine motion during airway
management: a cinefluoroscopic study of the posteriorly destabilized third cervical
vertebrae in human cadavers. Anesth Analg. 2000;91:1274–8
35. Davey A, Diba A. Ward’s Anaesthetic Equipment. 6thed p179-80. Saunders
Elsevier; 2012.
36. Dorsch J, Dorsch S. Understanding Anaesthesia Equipment. 5thed p521-24,
550-51. Wolters Kluwer; 2008.
37. McCoy EP, Mirakhur RK. The levering laryngoscope. Anaesthesia 1993; 48:
516–9.
38. Robitaille A, Williams SR, Tremblay M-H, Guilbert F, Thériault M, Drolet P.
Cervical Spine Motion During Tracheal Intubation with Manual In-Line Stabilization:
Direct Laryngoscopy versus GlideScope® Videolaryngoscopy: Anesth Analg. 2008
Mar;106(3):935–41.
39. Aziz M. Airway Management in Neuroanesthesiology. Anesthesiol Clin. 2012
Jun;30(2):229–40.
40. Keller C, Brimacombe J, Keller K. Pressures exerted against the cervical
vertebrae by the standard and intubating laryngeal mask airways: a randomized,
controlled, cross-over study in fresh cadavers. Anesth Analg. 1999;89:1296–3000.
41. Kihara S, Watanabe S, Brimacombe J, Taguchi N, Yaguchi Y, Yamasaki Y.
Segmental cervical spine movement with the intubating laryngeal mask during
manual in-line stabilization in patients with cervical pathology undergoing
cervical spine surgery. Anesth Analg. 2000 Jul;91(1):195–200.Page | 101
42. Panjabi MM, White AA 3rd. Basic biomechanics of the spine. Neurosurgery.
1980 Jul;7(1):76-93.
43. Podolsky S, Baraff LJ, Simon RR, Hoffman JR, Larmon B, Ablon W. Efficacy of
cervical spine immobilization methods. J Trauma. 1983 Jun;23(6):461-5.
44. Suderman VS, Crosby ET, Lui A. Elective oral tracheal intubation in cervical
spine-injured adults. Can J Anaesth. 1991 Sep;38(6):785-9.
45. Langeron O, Riou B, Lambert Y, Viars P. Intubation trachéale des traumatisés du
rachis cervical à l'aide d'un laryngoscope à fibres optiques [Tracheal intubation in
patients with cervical spine injuries using a fiber optic laryngoscope]. Ann Fr Anesth
Reanim. 1992;11(3):388-91. French.
46 Meschino, A., Devitt, J.H., Koch, JP. et al. The safety of awake tracheal intubation
in cervical spine injury. Can J Anaesth 39, 114–117 (1992).
47. Heath KJ. The effect of laryngoscopy of different cervical spine immobilisation
techniques. Anaesthesia. 1994 Oct;49(10):843-5.
48. Sawin PD, Todd MM, Traynelis VC, Farrell SB, Nader A, Sato Y, Clausen JD,
Goel VK. Cervical spine motion with direct laryngoscopy and orotracheal intubation.
An in vivo cinefluoroscopic study of subjects without cervical abnormality.
Anesthesiology. 1996 Jul;85(1):26-36.
49. Gerling MC, Davis DP, Hamilton RS, Morris GF, Vilke GM, Garfin SR, Hayden
SR. Effect of surgical cricothyrotomy on the unstable cervical spine in a cadaver
model of intubation. J Emerg Med. 2001 Jan;20(1):1-5.Page | 102
50. Goutcher CM, Lochhead V: Reduction in mouth opening with semi-rigid cervical
collars. Br J Anaesth 2005; 95:344–8.
51. Maharaj CH, Buckley E, Harte BH, Laffey JG. Endotracheal intubation in patients
with cervical spine immobilization: a comparison of macintosh and airtraq
laryngoscopes. Anesthesiology. 2007 Jul;107(1):53-9.
52. Vlatten A, Litz S, MacManus B, Launcelott S, Soder C. A comparison of the
GlideScope video laryngoscope and standard direct laryngoscopy in children with
immobilized cervical spine. Pediatr Emerg Care. 2012 Dec;28(12):1317-20.
53. Malcharek MJ, Rogos B, Watzlawek S, Sorge O, Sablotzki A, Gille J, Larson CP
Jr. Awake fiberoptic intubation and self-positioning in patients at risk of secondary
cervical injury: a pilot study. J Neurosurg Anesthesiol. 2012 Jul;24(3):217-21.
54. Prasarn ML, Horodyski M, Scott NE, Konopka G, Conrad B, Rechtine GR.
Motion generated in the unstable upper cervical spine during head tilt-chin lift and
jaw thrust maneuvers. Spine J. 2014 Apr;14(4):609-14.
55. . Durga P, Yendrapati C, Kaniti G, Padhy N, Anne KK, Ramachandran G. Effect
of rigid cervical collar on tracheal intubation using Airtraq(®). Indian J Anaesth. 2014
Jul;58(4):416-22.
56. Holmes MG, Dagal A, Feinstein BA, Joffe AM. Airway Management Practice in
Adults With an Unstable Cervical Spine: The Harborview Medical Center Experience.
Anesth Analg. 2018 Aug;127(2):450-454.Page | 103
57. Lee J, Kim JS, Kang S, Shin YS, Doo AR. Prediction of difficult airway
management in traumatic cervical spine injury: influence of retropharyngeal space
extension. Ther Clin Risk Manag. 2019 May 17;15:669-675.
58. Patel N, Desai DJ. Tracheal intubation with King Vision video laryngoscope in
patients with cervical spine instability-Comparison of straight versus curved
reinforced endotracheal tubes. Indian J Anaesth. 2021 Sep;65(9):650-655.
59. Kim YJ, Hur C, Yoon HK, Lee HC, Park HP, Oh H. Effects of External Laryngeal
Manipulation on Cervical Spine Motion during Videolaryngoscopic Intubation under
Manual In-Line Stabilization: A Randomized Crossover Trial. J Clin Med. 2021 Jun
30;10(13):2931.
60. Diedrich, D.A., Rose, P.S. & Brown, D.R. Airway Management in
Cervical Spine Injury. Curr Anesthesiol Rep 3, 197–204 (2013).
61. Majernick TG, Bienek R, Houston JB, Hughes HG: Cervical spine movement
during orotracheal intubation. Ann Emerg Med 1986; 15:417–20.
62. Watts ADJ, Gelb AW, Bach DB, Pelz DM: Comparison of Bullard and Macintosh
laryngoscopes for endotracheal intubation of patients with a potential cervical spine
injury. Anesthesiology 1997; 87:1335–42.
63. Lennarson PJ, Smith D, Todd MM, Carras D, Sawin PD, Brayton J, Sato Y,
Traynelis VC: Segmental cervical spine motion during orotracheal intubation of the
intact and injured spine with and without external stabilization. J Neurosurg (Spine 2)
2000; 92:201–6
International Journal of Critical Illness and Injury Science. 2014;4(1):50-56.
2. Pal R, Chauhan S, Ved BK, Lad SR. Evaluation of laryngoscopic view, intubation
difficulty and sympathetic response during direct laryngoscopy in sniffing position
and simple head extension: A prospective and randomized comparative study. Int J
Res Med Sci 2015;3:1895-901.
3. Magill IW. Endotracheal anaesthesia. American Journal of Surgery 1936; 34:450 –
5.
4. Jain D, Bala I, Gandhi K. Comparative effectiveness of McCoy laryngoscope and
CMAC(®) videolaryngoscope in simulated cervical spine injuries. J
AnaesthesiolClinPharmacol. 2016 Jan;32(1):59-64.
5. Joseph J, Sequeira T, Upadya M. Comparison of the use of McCoy and TruView
EVO2 laryngoscopes in patients with cervical spine immobilization. Saudi J Anaesth.
2012;6:248–53.
6. Bharti N, Arora S, Panda NB. A comparison of McCoy, TruView, and Macintosh
laryngoscopes for tracheal intubation in patients with immobilized cervical spine.
Saudi Journal of Anaesthesia. 2014;8(2):188-192. doi:10.4103/1658-354X.130705.
7. Laurent SC, de Melo AE, Alexander-Williams JM. The use of the McCoy
laryngoscope in patients with simulated cervical spine injuries. Anaesthesia.
1996;51:74–5.
8. Sabry LA, Shaarawy SS, Ellakany MH, Elmasry AA. Comparison between C-MAC
D-blade and McCoy laryngoscopes in intubating patients during cervical
immobilization. Res OpinAnesth Intensive Care 2016;3:122-8.
9. Kilicaslan, A. Topal, A. Tavlan, A. Erol, and S. Otelcioglu, “Effectiveness of the CMAC video laryngoscope in the management of unexpected failed intubations,”
Brazilian Journal of Anesthesiology, vol. 64, no. 1, pp. 62–65, 2014.
10. Standring S. Gray's Anatomy - The Anatomical basis of clinical practice. 41st ed
p718-724. Elsevier; 2016.
11. Crosby ET: Airway management in adults after cervical spine trauma.
Anesthesiology 2006; 104:1293–1318.
12. Baydur A, Adkins RH, Milic-Emili J. Lung mechanics in individuals with spinal
cord injury: effects of injury level and posture. J Appl Physiol 2001; 90:405-411
13. Mower WR, Hoffman JR, Pollack CV, et al. NEXUS Group. Use of plain
radiography to screen for cervical spine injuries. Ann Emerg Med 2001; 38:1-7
14. Demetriades D, Charalambides K, Chawan S, et al. Nonskeletal cervical spine
injuries: epidemiology and diagnostic pitfalls. J Trauma 2000; 48:724-724715. Goldberg W, Mueller C, Panacek E, Tigges S, Hoffman J, Mower WR:
Distribution and pattern of blunt traumatic cervical spine injury. Ann Emerg Med
2001; 38:17–21.
16. Stiell IG, Wells GA, Vandemheen KL, Clement CM, Lesiuk H, De Maio VJ,
Laupacis A, Schull M, McKnight RD, Verbeek R, Brison R, Cass D, Dreyer J,
Eisenhauer MA, Greenberg GH, MacPhail I, Morrison L, Reardon M, Worthington J:
The Canadian C-spine rule for radiography in alert and stable trauma patients. JAMA
2001; 286:1841–8.
17. Tator CH: Update on the pathophysiology and pathology of acute spinal cord
injury. Brain Pathol 1995; 5:407–13.
18. Kwon BK, Tetzlaff W, Grauer JN, Beiner J, Vaccaro AR: Pathophysiology and
pharmacologic treatment of acute spinal cord injury. Spine J 2004; 4:451–64.
19. Panjabi M, White A III: Biomechanics of nonacute cervical spinal cord trauma.
Spine(Phila Pa 1976). 1988 Jul;13(7):838-42
20. Wang AY, Jaeger RJ, Yarkony GM, et al. Cough in spinal cord injured patients;
the relationship between motor level and peak expiratory flow. Spinal Cord 1997;
35:299-302
21.Almenoff PL, Spungen AM, Lesser M, et al. Pulmonary function survey in spinal
cord injury: influence of smoking andlevel and completeness of injury. Lung
1995;173:297-306
22.Fiacchino F, Bricchi M, Lasio G. Monitoring of curarisation in patients with
tetraparesis. Anaesthesia 1990;45:128-31
23. Silver JR, Randall WC, Guttman L. Spinal mediation of thermally induced
sweating. J Neurol Neurosurg Psychiatry1995;54:297-304
24. Campaglono DI, Bartett JA, Keller SE. The influence of neurological level on
immune function following spinal cord injury: A review. Spinal Cord Med 2000;
23:121-128
25. Mollinger LA, Spurr GB, Ghatit AZ, et al. Daily energy expenditure and basal
metabolic rates of patients with spinal cord injury. Arch Phys Med Rehabil
1985;66:420-426
26. Wilmot CB, Cope N, Hall KM, Acker Ml. Occult head injury; its incidence in spinal
cord injury. Arch Phys Med Rehabil 1985;66:227
27. Esposito TJ, Sanddal ND, Hansen JD, Reynolds S. Analysis of preventable
trauma deaths and inappropriate trauma care in a rural state. J Trauma.
1995;39:955–62.
28. Hussain LM, Redmond AD. Are pre-hospital deaths from accidental injury
preventable? BMJ. 1994;308:1077–80.Page | 99
29. Shorten GD, Opie NJ, Graziotti P, et al. Assessment of upper airway anatomy in
awake, sedated and anaesthetised patients using magnetic resonance imaging.
Anaesth Intensive Care. 1994;22:165–9.
30. Mathru M, Esch O, Lang J, et al. Magnetic resonance imaging of the upper
airway. Effects of propofol anesthesia and nasal continuous positive airway pressure
in humans. Anesthesiology.1996;84:273–9.
31. Guildner CW. Resuscitation-opening the airway. A comparative study of
techniques for opening an airway obstructed by the tongue. JACEP. 1976;5(8):588–
90.
32. Uzun L, Ugur MB, Altunkaya H, et al. Effectiveness of the jawthrust maneuver in
opening the airway: a flexible fiberoptic endoscopic study. ORL J Otorhinolaryngol
Relat Spec. 2005;67:39–44.
33. Hauswald M, Sklar DP, Tandberg D, Garcia JF. Cervical spine movement during
airway management: cinefluoroscopic appraisal in human cadavers.Am J Emerg
Med. 1991;9:535-8.
34. Brimacombe J, Keller C, Kunzel KH, et al. Cervical spine motion during airway
management: a cinefluoroscopic study of the posteriorly destabilized third cervical
vertebrae in human cadavers. Anesth Analg. 2000;91:1274–8
35. Davey A, Diba A. Ward’s Anaesthetic Equipment. 6thed p179-80. Saunders
Elsevier; 2012.
36. Dorsch J, Dorsch S. Understanding Anaesthesia Equipment. 5thed p521-24,
550-51. Wolters Kluwer; 2008.
37. McCoy EP, Mirakhur RK. The levering laryngoscope. Anaesthesia 1993; 48:
516–9.
38. Robitaille A, Williams SR, Tremblay M-H, Guilbert F, Thériault M, Drolet P.
Cervical Spine Motion During Tracheal Intubation with Manual In-Line Stabilization:
Direct Laryngoscopy versus GlideScope® Videolaryngoscopy: Anesth Analg. 2008
Mar;106(3):935–41.
39. Aziz M. Airway Management in Neuroanesthesiology. Anesthesiol Clin. 2012
Jun;30(2):229–40.
40. Keller C, Brimacombe J, Keller K. Pressures exerted against the cervical
vertebrae by the standard and intubating laryngeal mask airways: a randomized,
controlled, cross-over study in fresh cadavers. Anesth Analg. 1999;89:1296–3000.
41. Kihara S, Watanabe S, Brimacombe J, Taguchi N, Yaguchi Y, Yamasaki Y.
Segmental cervical spine movement with the intubating laryngeal mask during
manual in-line stabilization in patients with cervical pathology undergoing
cervical spine surgery. Anesth Analg. 2000 Jul;91(1):195–200.Page | 101
42. Panjabi MM, White AA 3rd. Basic biomechanics of the spine. Neurosurgery.
1980 Jul;7(1):76-93.
43. Podolsky S, Baraff LJ, Simon RR, Hoffman JR, Larmon B, Ablon W. Efficacy of
cervical spine immobilization methods. J Trauma. 1983 Jun;23(6):461-5.
44. Suderman VS, Crosby ET, Lui A. Elective oral tracheal intubation in cervical
spine-injured adults. Can J Anaesth. 1991 Sep;38(6):785-9.
45. Langeron O, Riou B, Lambert Y, Viars P. Intubation trachéale des traumatisés du
rachis cervical à l'aide d'un laryngoscope à fibres optiques [Tracheal intubation in
patients with cervical spine injuries using a fiber optic laryngoscope]. Ann Fr Anesth
Reanim. 1992;11(3):388-91. French.
46 Meschino, A., Devitt, J.H., Koch, JP. et al. The safety of awake tracheal intubation
in cervical spine injury. Can J Anaesth 39, 114–117 (1992).
47. Heath KJ. The effect of laryngoscopy of different cervical spine immobilisation
techniques. Anaesthesia. 1994 Oct;49(10):843-5.
48. Sawin PD, Todd MM, Traynelis VC, Farrell SB, Nader A, Sato Y, Clausen JD,
Goel VK. Cervical spine motion with direct laryngoscopy and orotracheal intubation.
An in vivo cinefluoroscopic study of subjects without cervical abnormality.
Anesthesiology. 1996 Jul;85(1):26-36.
49. Gerling MC, Davis DP, Hamilton RS, Morris GF, Vilke GM, Garfin SR, Hayden
SR. Effect of surgical cricothyrotomy on the unstable cervical spine in a cadaver
model of intubation. J Emerg Med. 2001 Jan;20(1):1-5.Page | 102
50. Goutcher CM, Lochhead V: Reduction in mouth opening with semi-rigid cervical
collars. Br J Anaesth 2005; 95:344–8.
51. Maharaj CH, Buckley E, Harte BH, Laffey JG. Endotracheal intubation in patients
with cervical spine immobilization: a comparison of macintosh and airtraq
laryngoscopes. Anesthesiology. 2007 Jul;107(1):53-9.
52. Vlatten A, Litz S, MacManus B, Launcelott S, Soder C. A comparison of the
GlideScope video laryngoscope and standard direct laryngoscopy in children with
immobilized cervical spine. Pediatr Emerg Care. 2012 Dec;28(12):1317-20.
53. Malcharek MJ, Rogos B, Watzlawek S, Sorge O, Sablotzki A, Gille J, Larson CP
Jr. Awake fiberoptic intubation and self-positioning in patients at risk of secondary
cervical injury: a pilot study. J Neurosurg Anesthesiol. 2012 Jul;24(3):217-21.
54. Prasarn ML, Horodyski M, Scott NE, Konopka G, Conrad B, Rechtine GR.
Motion generated in the unstable upper cervical spine during head tilt-chin lift and
jaw thrust maneuvers. Spine J. 2014 Apr;14(4):609-14.
55. . Durga P, Yendrapati C, Kaniti G, Padhy N, Anne KK, Ramachandran G. Effect
of rigid cervical collar on tracheal intubation using Airtraq(®). Indian J Anaesth. 2014
Jul;58(4):416-22.
56. Holmes MG, Dagal A, Feinstein BA, Joffe AM. Airway Management Practice in
Adults With an Unstable Cervical Spine: The Harborview Medical Center Experience.
Anesth Analg. 2018 Aug;127(2):450-454.Page | 103
57. Lee J, Kim JS, Kang S, Shin YS, Doo AR. Prediction of difficult airway
management in traumatic cervical spine injury: influence of retropharyngeal space
extension. Ther Clin Risk Manag. 2019 May 17;15:669-675.
58. Patel N, Desai DJ. Tracheal intubation with King Vision video laryngoscope in
patients with cervical spine instability-Comparison of straight versus curved
reinforced endotracheal tubes. Indian J Anaesth. 2021 Sep;65(9):650-655.
59. Kim YJ, Hur C, Yoon HK, Lee HC, Park HP, Oh H. Effects of External Laryngeal
Manipulation on Cervical Spine Motion during Videolaryngoscopic Intubation under
Manual In-Line Stabilization: A Randomized Crossover Trial. J Clin Med. 2021 Jun
30;10(13):2931.
60. Diedrich, D.A., Rose, P.S. & Brown, D.R. Airway Management in
Cervical Spine Injury. Curr Anesthesiol Rep 3, 197–204 (2013).
61. Majernick TG, Bienek R, Houston JB, Hughes HG: Cervical spine movement
during orotracheal intubation. Ann Emerg Med 1986; 15:417–20.
62. Watts ADJ, Gelb AW, Bach DB, Pelz DM: Comparison of Bullard and Macintosh
laryngoscopes for endotracheal intubation of patients with a potential cervical spine
injury. Anesthesiology 1997; 87:1335–42.
63. Lennarson PJ, Smith D, Todd MM, Carras D, Sawin PD, Brayton J, Sato Y,
Traynelis VC: Segmental cervical spine motion during orotracheal intubation of the
intact and injured spine with and without external stabilization. J Neurosurg (Spine 2)
2000; 92:201–6
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Sep 16, 2024
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How to Cite
Dr Christina Mary Jose, Dr Smita S Lele, Dr Ranju Sebastian, & Dr Fauziya K. (2024). A PROSPECTIVE OBSERVATIONAL STUDY OF AIRWAY MANAGEMENT TECHNIQUES IN CERVICAL SPINE TRAUMA PATIENTS. Journal of Population Therapeutics and Clinical Pharmacology, 31(9), 1162-1164. https://doi.org/10.53555/0786ks55
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Author Biographies
Dr Christina Mary Jose
Senior Resident, Govt. Medical College, Ernakulam.
Dr Smita S Lele
Associate Professor, Lokmanya tilak municipal medical college hospital, Sion, Mumbai.
Dr Ranju Sebastian
Assistant Professor, Govt. Medical College, Ernakulam
Dr Fauziya K
Senior Resident, Govt. Medical College, Ernakulam.
How to Cite
Dr Christina Mary Jose, Dr Smita S Lele, Dr Ranju Sebastian, & Dr Fauziya K. (2024). A PROSPECTIVE OBSERVATIONAL STUDY OF AIRWAY MANAGEMENT TECHNIQUES IN CERVICAL SPINE TRAUMA PATIENTS. Journal of Population Therapeutics and Clinical Pharmacology, 31(9), 1162-1164. https://doi.org/10.53555/0786ks55