RESUMO
Anatomically, the airway is ever changing in size, anteroposterior alignment, and point of most narrow dimension. Special considerations regarding obesity, chronic and acute illness, underlying developmental abnormalities, and age can all affect preparation and intervention toward securing a definitive airway. Mechanical ventilation strategies should focus on limiting peak inspiratory pressures and optimizing lung protective tidal volumes. Emergency physicians should work toward minimizing risk of peri-intubation hypoxemia and arrest. With review of anatomic and physiologic principles in the setting of a practical approach toward evaluating and managing distress and failure, emergency physicians can successfully manage critical pediatric airway encounters.
Assuntos
Síndrome do Desconforto Respiratório/terapia , Insuficiência Respiratória/terapia , Manuseio das Vias Aéreas , COVID-19/terapia , Criança , Anormalidades Craniofaciais/complicações , Cuidados Críticos , Desenho de Equipamento , Capacidade Residual Funcional , Parada Cardíaca/terapia , Humanos , Hipnóticos e Sedativos/uso terapêutico , Intubação Intratraqueal/métodos , Laringoscópios , Laringoscopia/métodos , Laringe/anatomia & histologia , Doenças Neuromusculares/terapia , Ventilação não Invasiva , Oxigenoterapia , Medicina de Emergência Pediátrica , Obesidade Infantil/complicações , Respiração com Pressão Positiva , Gravação em VídeoRESUMO
The diagnosis and management of neurologic conditions are more complex at the extremes of age than in the average adult. In the pediatric population, neurologic emergencies are somewhat rare and some may require emergent consultation. In older adults, geriatric physiologic changes with increased comorbidities leads to atypical presentations and worsened outcomes. The unique considerations regarding emergency department presentation and management of stroke and altered mental status in both age groups is discussed, in addition to seizures and intracranial hemorrhage in pediatrics, and Parkinson's disease and meningitis in the geriatric population.
Assuntos
Emergências , Doenças do Sistema Nervoso/diagnóstico , Doença Aguda , Fatores Etários , Idoso , Criança , Demência/diagnóstico , Demência/terapia , Serviço Hospitalar de Emergência , Humanos , Hemorragias Intracranianas/diagnóstico , Hemorragias Intracranianas/terapia , Meningite/diagnóstico , Meningite/terapia , Doenças do Sistema Nervoso/terapia , Doença de Parkinson/diagnóstico , Doença de Parkinson/terapia , Convulsões/diagnóstico , Convulsões/terapia , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/terapiaRESUMO
Models of addiction etiology and treatment emphasize the influence of family-of-origin experiences. Using two addiction-related coping behaviors (ARCBs) common among college women (i.e., problematic alcohol use, disordered eating), we examined whether ARCBs in parents related to matching ARCBs in college women offspring. We expected that matching parental ARCBs would relate more strongly to the ARCBs in offspring than more distal/general family factors. A total of 197 college women completed measures of family dynamics, parental difficulties with alcohol, family focus on appearance and weight, personal difficulties with alcohol use, and disordered eating. A significant indirect effect for family dysfunction on disordered eating and alcohol-related problems was found. That is, family relationship difficulties predicted parents' ARCBs, which predicted matching ARCBs in participants (e.g., parental alcohol problems predicted participant alcohol problems). Matched parental ARCBs were better predictors of participants' ARCBs than more general/distal family factors and non-matched ARCBs. Specifically, path analysis and testing of beta weights supported specificity of parental ARCBs for predicting matching offspring ARCBs. Implications of study findings for tailoring prevention efforts are discussed.