Central Journal of ISA

Rakesh Garg ¹, Meenu Chadha ¹, Uma Srivastava ¹, S. Moied Ahmed ¹

Affiliations
1 Dept. of Anaesthesiology & Critical Care, J N Medical College, AMU, Aligarh, IN

Abstract

Difficult airway happens in clinical practice and may lead to catastrophic outcome. The guidelines are promulgated to provide safe, evidence base practice for well-being of patients, physicians and health care system. This is in line with a paradigm shift towards evidence based medicine approach in clinical practice. Such document also helps in judging the standard of care at all levels, raise quality of care and maintain cost benefit. The guidelines and algorithms exists for various nations around the world. They have drafted the document based on the local need taking into considerations logistics, infrastructure and the cost, based on evidence.

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Rakesh Garg ¹, S. Moied Ahmed ², Uma Srivastav ³, Meenu Chadha ⁴

Affiliations
1 Department of Onco-Anaesthesiology and Palliative Medicine, Dr BRAIRCH, All India Institute of Medical Sciences, New Delhi, IN
2 Dept of Anaesthesiology, Jawahar Lal Nehru Medical College, Aligarh Muslim University, IN
3 Dept of Anaesthesiology, Sarojini Naidu Medical College, Agra, IN
4 Convenient Hospital Limited Hospital, Indore, IN

Abstract

The cardiopulmonary arrest can happen in many situations and places warranting immediate management. There are many guidelines promulgated around the world for management of such victims. The guidelines provide safe, evidence base practice for optimal outcome of the patients along with appropriate support to physicians and health care system. This is in current line with a paradigm shift towards evidence based medicine approach in clinical practice.

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Shahna Ali ¹, Manazir Athar ¹, S. Moied Ahmed ¹, Obaid Ahmad Siddiqui ¹

Affiliations
1 Department of Anaesthesiology, Jawaharlal Nehru Medical College, AMU, Aligarh, IN

Abstract

Encephalocoele consists of herniation of Cerebrospinal Fluid (CSF), meninges and brain tissue through a congenital bony defect in the cranium. Anaesthetic challenges associated with a huge occipital encephalocoele include difficult airway, prone positioning and its complications, and accurate assessment of CSF and blood loss. We describe a case of a 5-day male, first child from a non-consanguineous marriage who was admitted with a huge occipital encephalocoele with micrognathia. In view of anticipated difficult intubation, the baby was induced with sevoflurane and intubated in spontaneously breathing with the help of infant size 0 Airtraq optical laryngoscope device in lateral position after one failed intubation attempt with direct laryngoscopy in supine. The intraoperative course remained uneventful. Recovery from anaesthesia was satisfactory and postoperative course was uneventful. After monitoring in the Intensive Care Unit for a day, the patient was shifted to the ward and discharged on the 10^th post-operative day with advice for regular follow up.

Keywords

Amniotic Band Syndrome, High Arched Palate, Syndactyly.

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