Management of the Airway, An Issue of Atlas of the Oral and Maxillofacial Surgery Clinics

Dale A. Baur, Henry H. Rowshan

Description

Articles include: Causes of the Difficult Airway, Management of the Difficult Airway in Oral and Maxillofacial Surgery, Emergency Cricothyrotomy, Operative Tracheostomy, Percutaneous Dialation Tracheostomy, Pediatric Tracheostomy, and Alternative Techniques in Airway Management.

Sujets

• Oral Surgery
• Medical
• Médecine
• Dentistry

Informations

• Publié par: Saunders
• Date de parution: 25 mars 2010
• Nombre de lectures: 1
• EAN13: 9781455700165
• Langue: English
• Poids de l'ouvrage: 1 Mo

Extrait

Oral and Maxillofacial Surgery Clinics of North America
Perioperative Management of the Oral and Maxillofacial Surgery Patient, Part I
H. Dym
The Brooklyn Hospital Center, 121 DeKalb Avenue, Brooklyn, NY 11201
ISSN  1042-3699
Volume 18 • Number 1 • February 2006

Contents
Forthcoming Issues
Perioperative Management of the Oral and Maxillofacial Surgery Patient, Part I
Dedication
Perioperative Laboratory and Diagnostic Testing—What is Needed and When?
Fluid and Electrolyte Management and Blood Product Usage
Perioperative Risk Assessment in the Surgical Care of Geriatric Patients
Perioperative Considerations in the Management of Pediatric Surgical Patients
Postoperative Care of Oral and Maxillofacial Surgery Patients
Psychologic Considerations in the Management of Oral Surgical Patients
Fever Work-Up and Management in Postsurgical Oral and Maxillofacial Surgery Patients
Perioperative Management of Patients Who Have Pulmonary Disease
Prevention of Venous Thromboembolism
Wound Healing and Perioperative Care
Nutritional Aspects of Care
Index
Oral and Maxillofacial Surgery Clinics of North America , Vol. 18, No. 1, February 2006
ISSN: 1042-3699
doi: 10.1016/S1042-3699(06)00009-4

Forthcoming Issues
Oral and Maxillofacial Surgery Clinics of North America , Vol. 18, No. 1, February 2006
ISSN: 1042-3699
doi: 10.1016/j.coms.2005.11.001

Preface
Perioperative Management of the Oral and Maxillofacial Surgery Patient, Part I

Harry Dym, DDS
Guest Editor, [e-mail]
The Brooklyn Hospital Center, 121 DeKalb Avenue, Brooklyn, NY 11201, USA
Like many in our esteemed profession, I have spent my entire professional life (over 28 years) working almost exclusively in a hospital setting within an American Dental Association--approved Oral and Maxillofacial Surgery Residency Training Program. Much has changed during this time, mostly for the better.
As the national percentage of older (ie, over 65 years of age) Americans continues to grow and our profession's scope of services continues to increase, it is becoming quite evident that our patient practice demographics will also begin to shift. As a profession, we will begin performing more complex reconstructive procedures on patients who have compromised health histories.
It is with that thought in mind that this two-part issue was planned: to serve as a text and reference work for better management in the perioperative care of the medically compromised and hospitalized patient segment of our practices. We hope that the readership will find this two part series useful and valuable to their everyday clinical practice.
On a personal note, being involved with the Oral and Maxillofacial Surgery Clinics of North America is always a most rewarding and fulfilling experience, and I would like to thank John Vassallo, Editor, for his support and assistance. To the Senior Administration of The Brooklyn Hospital Center, Mr. Sam Lehrfeld, President and Chief Executive Officer, Mr. Paul Albertson, Senior VP Operation/Ambulatory Care, Mr. Rick Braun, Executive VP/CFO, and Dr. John Carroll, Chief Medical Officer, I offer my sincere thanks for their complete and uncompromising support of the Department of Dentistry and Oral & Maxillofacial Surgery, and of our department's dual mission of quality patient care and resident education.
I have been fortunate to have spent the past quarter of a century working under and with the following three people: Dr. Peter Sherman, Chairman of Dental/OMS at Woodhull Hospital Medical Center, who has been a valued colleague and cherished friend, along with Dr. Earl Clarkson, Director of Dentistry/Oral and Maxillofacial Surgery at the Brooklyn Hospital Center, and Dr. Orrett Ogle, Chief of OMS at Woodhull, who contributed to this issue. They are true stars of our profession, and I am fortunate to have had them by my side for constant support and encouragement these many years.
Equally rewarding when editing a two-part text such as this are the oral and maxillofacial surgery colleagues I've come to know and work with. I am privileged to have had Drs. Leslie Halpern, Peter Quinn, Larry Cunningham, Ryaz Ansari, Guillermo Chacon, Mark Steinberg, Andrés Herrera, Stanley Bodner, Desai Chirag, James Fang, Scott Reminick, Sanjeev Raj Bhatia, Ramesh Gulrajani, Hyon Yoo, Bethany Serafin, Tirbod Fattahi, Ladi Doonquah, Vivek Shetty, Harry Schwartz, Lee Carrasco, Leon Assael, and Remy H. Blanchaert, Jr., assisting me in this work. They have all successfully completed their mission, and I look forward to working with them again on future projects. Corinne Acevedo, my Executive Assistant, played a major role in coordinating the editorial material, and I thank her for her patience, diligence, and excellent work.
Finally, I must acknowledge my family for their consistent and steadfast support despite too many hours spent in the hospital and away from home: Freidy, my beautiful wife of 28 years, my oldest son Yehoshua, my daughter-in-law Chani, my other two boys, Daniel and Akiva, and my beautiful and talented daughter Hindy.
This issue is dedicated to my parents, Mollie Dym and Chaim Dym; to my mother-in-law, Hedy Rosner; and my late father-in-law, Sol Rosner, a wonderful person who is sorely missed. They all embody and represent what is noble, ethical, moral, and good and are a beacon of light that helps guide me in my journey through this life.
Oral and Maxillofacial Surgery Clinics of North America , Vol. 18, No. 1, February 2006
ISSN: 1042-3699
doi: 10.1016/j.coms.2006.01.001

Dedication

Harry Dym, DDS
This issue is dedicated to the memory of my mother, Molly Dym, who passed away suddenly and departed from this world on Saturday, November 19, 2005. My mother came to America as an immigrant in 1950 having survived the raging flames and inferno of Nazi Europe. She arrived on these shores poor in worldly possessions but rich in spirit and dreams of a brighter future for her and my dear father.
My mother was a devoutly religious woman who believed firmly in God, family, and education. She fought valiantly against the ravages of Parkinson's disease and died, with her family at her side, having fulfilled her dream.
Oral and Maxillofacial Surgery Clinics of North America , Vol. 18, No. 1, February 2006
ISSN: 1042-3699
doi: 10.1016/j.coms.2005.09.012

Perioperative Laboratory and Diagnostic Testing—What is Needed and When?

Tirbod Fattahi, DDS, MD, FACS
E-mail address: [e-mail]
Division of Maxillofacial Surgery, University of Florida, 653-1 West 8th Street, Jacksonville, FL 32209, USA

Abstract
Preoperative patient evaluation is an essential component of any surgical practice. A complete history and physical, along with appropriate diagnostic tests, are performed routinely to ensure a safe and predictable delivery of care. Oral and maxillofacial surgeons use this principle in everyday practice. Regardless of type of surgery and practice (office-based dentoalveolar surgery, orthognathic surgery, trauma, elective aesthetic surgery), oral and maxillofacial surgeons must formulate a decision-making process and a treatment plan regarding the perioperative management of patients. The anesthetic plan and the surgical plan must be assessed preoperatively.
Preoperative patient evaluation is an essential component of any surgical practice. A complete history and physical, along with appropriate diagnostic tests, are performed routinely to ensure a safe and predictable delivery of care. Oral and maxillofacial surgeons use this principle in everyday practice. Regardless of type of surgery and practice (office-based dentoalveolar surgery, orthognathic surgery, trauma, elective aesthetic surgery, and so forth), oral and maxillofacial surgeons must formulate a decision-making process and a treatment plan regarding the perioperative management of patients. The anesthetic plan and the surgical plan must be assessed preoperatively.
Preoperative evaluation of surgical patients and the decisions regarding choosing the appropriate and specific presurgical laboratory tests can be a daunting task at times because often it is riddled with confusion and ambiguity. The dilemma facing health-care providers is twofold: one, there is the need to reduce or eliminate nonindicated preoperative tests; two, there is a responsibility to continue to order indicated tests to maximize and improve patient care. There is no doubt that there exist some limitations regarding preoperative testing of surgery patients. One of the first difficulties faced by clinicians is the definition of the word, “abnormal.” When ordering a test, clinicians are attempting to discriminate between patients who have normal values and those who have abnormal ones. This knowledge then is used to determine the possibility for the existence of a pathologic condition, which ultimately may have an impact on the proposed surgical and anesthetic plan. Unfortunately, most laboratory values are based on a 95% confidence limit; therefore, it is possible that 5% of “normal” patients who do have any pathologic condition have an “abnormal” test result [1] . This may lead to misinterpretation of a pathologic condition. It is just as important to consider not only if a laboratory value is abnormal but also if an abnormal value may affect the perioperative care of patients or is able to predict a complication [2] . It is estimated that only 0.22% of all “abnormal” preoperative tests done before elective surgery could influence the perioperative management of the surgical patients [3] .
It is estimated