Arch Guillotti
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Unfortunately I see kids in varying degrees of laryngospasm and obstruction post-extubation all the time. The nurses I work with cannot differentiate between the two, nor can they adequately determine the appropriate time to extubate.
Here is what it says in Cote:
Anterior and upward displacement of the jaw ("jaw thrust") longitudinally separates the base of the tongue, the epiglottis, and the aryepiglottic folds from the vocal folds, thereby helping to relieve laryngospasm.
Do you disagree?
Here is what it says in Cote:
Anterior and upward displacement of the jaw ("jaw thrust") longitudinally separates the base of the tongue, the epiglottis, and the aryepiglottic folds from the vocal folds, thereby helping to relieve laryngospasm.
Do you disagree?
So you think that a problem, caused by stimulating underanesthetized cords, should be treated with more stimulation? Or do you think that laryngospasm is caused by something else?
How does jaw thrust and oral airway treat laryngospasm? I would agree with both if what you are treating is in fact upper airway obstruction (90% of what is called laryngospasm is probably only upper airway obstruction anyway IMHO), but how will either help with true laryngospasm?
If their glottis is closed, where is your "gentle positive pressure" going to go, and how does this stimulation of the cords break the laryngospasm if it is indeed a stimulation induced phenomenon?
If you aren't convinced that this is the root cause, then you can make a logical argument for your interventions... except "gentle positive pressure." Filling the stomach with air is never a positive thing.
- pod