WMN Editors

AIRWAY PART II: EMERGENCY AIRWAY MANAGEMENT

/in , , , , /by

WMN-Cover-26.6

ISSN-1059-6518

AIRWAY-PART II – EMERGENCY AIRWAY MANAGEMENT

By Frank Hubbell, DO

Illustrations by T.B.R. Walsh

The PURPOSE of Airway Adjuncts:

 

The purpose of airway adjuncts is to maintain a patent, open airway. This is accomplished primarily by preventing the tongue or other soft tissues from occluding the entrance to the airway at the larynx.

 

These airway adjuncts are divided into three categories.

1.     There are primary airways for immediate support of the airway

2.     Intermediate airways designed for longer-term use.

3.     Total airway control airways, which require endotracheal intubation that not only maintain an open, patent airway, but also help to prevent aspiration of fluids into the lungs.

 

REMEMBER: Primary and intermediate airway adjuncts do not necessarily prevent the aspiration of saliva, blood, vomitus, or other fluids from getting into the trachea and lungs.

 

IMMEDIATE TECHNIQUES for ESTABLISHING and  MAINTAINING an OPEN AIRWAY:

 

PRIMARY AIRWAYS:

 

The RECOVERY POSITION:            recovery-position

 

This is the quickest and simplest way to establish and maintain an open airway in an unconscious patient. You simply have to know how to properly safely logroll someone onto his or her side.

  Read more

WMN Editors

AIRWAY PART I: ANATOMY and PHYSIOLOGY of the RESPIRATORY SYSTEM

/in , , , , , /by

Cover

ISSN-1059-6518

 

The Challenges of Emergency Airway Management:

 By Frank Hubbell, DO

Illustrations by T.B.R. Walsh

First, let’s define the problem:

 

1.     When the need for emergency airway management arises, it is usually a scene that is already difficult, desperate, rapidly deteriorating. A scene that most likely requires critical care skills. One of those rare times where speed is of the essence.

2.     Your patient may be unruly, uncooperative, or even intoxicated.

3.     Your patient will most likely already be hypoxic with poor oxygenation and decreasing respiratory and ventilatory efforts. As a result they will not tolerate even short periods of apnea or hypoxia.

4.     Your patient may have recently eaten or drank, and these stomach contents dramatically increase the risk of vomiting and with the risk of aspiration.

5.     Their airway may already be compromised by blood, vomitus, secretions, or distorted anatomy from trauma.

6.     Your patient may be a cardiac arrest or a near-arrest situation.

 

OXYGEN: Let’s begin this discussion with oxygen.

 

When we talk about the importance of maintaining an open airway, what we are really talking about is the importance of a constant, uninterrupted flow of oxygen to every cell in the body. The cells with the greatest demand, and therefore the most sensitive tissues to oxygen supply, are the nerve cells that make up the brain. These neurological tissues can only survive intact for 4 – 6 minutes without oxygen; after 10 minutes without

O2 , irreversible brain damage occurs and most likely death.

 

The human brain makes up 2% of our total body weight, but it is hypermetabolic:

– it requires 15% of our cardiac output,

– 20% of total body oxygen consumption, and

– 25% of the total body utilization of glucose.

  Read more

WMN Editors

THE WORLD OF VENOMOUS SNAKES

/in , , , /by

ISSN-1059-6518

THE WORLD OF VENOMOUS SNAKES

By Frank Hubbell, D.O.

SNAKE BITE STATISTICS:

It is impossible to accurately count the number of venomous snakebites worldwide, simply because most occur in rural and remote areas where access to medical care is limited, statistics are not kept, and snakebites are not reported.

 Worldwide:

There are reportedly 421,000 envenomations per year with 20,000 deaths.

But, snakebites and deaths from snakebites are grossly underreported.

It is estimated that the real numbers could be as high as 1,841,000 envenomations with 94,000 deaths per year.

 United States:

Approximately 8000 venomous snakebites are reported each year with 5 – 10 deaths per year.

SNAKES ARE:

–       elongated

–       legless/limbless

–       carnivorous reptiles

–       lack eyelids

–       lack external ears

–       ectothermic (cold-blooded)

–       most are amniote vertebrates (lay eggs that contain amniotic fluid, suitable for the terrestrial environment), some snakes do have live births

–       covered in overlapping scales

–       most kill by swallowing their prey whole or death by constriction

–       of the 3,400 species, 300 are venomous and use their venom to kill, subdue, and digest their prey

 

Kingdom – Animalia

Phylum – Chordata

Class – Reptilia

Order – Squamata

Suborder – Serpentes

Family – 20 different families

4 families are venomous

Genera – 500 different Genera

Species – 3,400 different species

3,100 are nonvenomous

300 are venomous

 

Interestingly enough, venomous snakes can be divided into different families based on their dentition and types of fangs, not as you might suspect, by the type of venom they possess. The rest of snakes are fangless, aglyphous.

Read more

WMN Editors

TOXINS IN THE FOODS WE EAT and CYANIDE

/in , , , /by

Volume 26 Number 2

ISSN-1059-6518

 

By Frank Hubbell, DO

 

 

There are quite a few foods that we commonly eat that contain potentially lethal toxins. Fortunately, they are in trace quantities, and our liver is generally able to detoxify them before they can cause us any harm.

 

 

One particular toxin that is found in a variety of foods is amygdalin, a cyanogenic glycoside that is metabolized into hydrogen cyanide (HCN). Egads! CYANIDE– that could kill you!

 

 

 

Cyanide can be found in the following seeds and foods:

 

Apple seeds                            Cherry pits

 

Peach pits                              Apricot pits

 

Plums                                       Pears

 

Almonds                                Lima beans

 

Nectarines                            Barley

 

Cabbage                                Sorghum

 

Broccoli                                Cauliflower

 

Flaxseed                                Bamboo

 

White Clover

 

Cassava root = tapioca, manioc, yuca

 

 

The questions are where does the cyanide come from, and why it is in these seeds, fruits, or vegetables?

 

 

Some plants have the ability to fix nitrogen to carbon with a triple bond, making hydrogen cyanide = HCN, one hydrogen atom, one carbon atom, and one nitrogen atom.  Of course at this point, you’re wondering why aren’t all plants potentially cyanide carriers.  The plants have to have the enzymes necessary to carry out these chemical reactions and it has to be able to store the hydrogen cyanide without harming itself.

 

  Read more