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Publisher: Elsevier   (Total: 3159 journals)

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Showing 1 - 200 of 3159 Journals sorted alphabetically
A Practical Logic of Cognitive Systems     Full-text available via subscription   (Followers: 9)
AASRI Procedia     Open Access   (Followers: 15)
Academic Pediatrics     Hybrid Journal   (Followers: 32, SJR: 1.655, CiteScore: 2)
Academic Radiology     Hybrid Journal   (Followers: 22, SJR: 1.015, CiteScore: 2)
Accident Analysis & Prevention     Partially Free   (Followers: 90, SJR: 1.462, CiteScore: 3)
Accounting Forum     Hybrid Journal   (Followers: 25, SJR: 0.932, CiteScore: 2)
Accounting, Organizations and Society     Hybrid Journal   (Followers: 34, SJR: 1.771, CiteScore: 3)
Achievements in the Life Sciences     Open Access   (Followers: 5)
Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 7)
Acta Astronautica     Hybrid Journal   (Followers: 408, SJR: 0.758, CiteScore: 2)
Acta Automatica Sinica     Full-text available via subscription   (Followers: 2)
Acta Biomaterialia     Hybrid Journal   (Followers: 27, SJR: 1.967, CiteScore: 7)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription   (Followers: 2)
Acta de Investigación Psicológica     Open Access   (Followers: 3)
Acta Ecologica Sinica     Open Access   (Followers: 8, SJR: 0.18, CiteScore: 1)
Acta Haematologica Polonica     Free   (Followers: 1, SJR: 0.128, CiteScore: 0)
Acta Histochemica     Hybrid Journal   (Followers: 3, SJR: 0.661, CiteScore: 2)
Acta Materialia     Hybrid Journal   (Followers: 245, SJR: 3.263, CiteScore: 6)
Acta Mathematica Scientia     Full-text available via subscription   (Followers: 5, SJR: 0.504, CiteScore: 1)
Acta Mechanica Solida Sinica     Full-text available via subscription   (Followers: 9, SJR: 0.542, CiteScore: 1)
Acta Oecologica     Hybrid Journal   (Followers: 10, SJR: 0.834, CiteScore: 2)
Acta Otorrinolaringologica (English Edition)     Full-text available via subscription  
Acta Otorrinolaringológica Española     Full-text available via subscription   (Followers: 2, SJR: 0.307, CiteScore: 0)
Acta Pharmaceutica Sinica B     Open Access   (Followers: 1, SJR: 1.793, CiteScore: 6)
Acta Poética     Open Access   (Followers: 4, SJR: 0.101, CiteScore: 0)
Acta Psychologica     Hybrid Journal   (Followers: 27, SJR: 1.331, CiteScore: 2)
Acta Sociológica     Open Access   (Followers: 1)
Acta Tropica     Hybrid Journal   (Followers: 6, SJR: 1.052, CiteScore: 2)
Acta Urológica Portuguesa     Open Access  
Actas Dermo-Sifiliograficas     Full-text available via subscription   (Followers: 3, SJR: 0.374, CiteScore: 1)
Actas Dermo-Sifiliográficas (English Edition)     Full-text available via subscription   (Followers: 2)
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 3, SJR: 0.344, CiteScore: 1)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 1)
Actualites Pharmaceutiques     Full-text available via subscription   (Followers: 6, SJR: 0.19, CiteScore: 0)
Actualites Pharmaceutiques Hospitalieres     Full-text available via subscription   (Followers: 3)
Acupuncture and Related Therapies     Hybrid Journal   (Followers: 6)
Acute Pain     Full-text available via subscription   (Followers: 15, SJR: 2.671, CiteScore: 5)
Ad Hoc Networks     Hybrid Journal   (Followers: 11, SJR: 0.53, CiteScore: 4)
Addictive Behaviors     Hybrid Journal   (Followers: 16, SJR: 1.29, CiteScore: 3)
Addictive Behaviors Reports     Open Access   (Followers: 8, SJR: 0.755, CiteScore: 2)
Additive Manufacturing     Hybrid Journal   (Followers: 9, SJR: 2.611, CiteScore: 8)
Additives for Polymers     Full-text available via subscription   (Followers: 22)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 142, SJR: 4.09, CiteScore: 13)
Advanced Engineering Informatics     Hybrid Journal   (Followers: 11, SJR: 1.167, CiteScore: 4)
Advanced Powder Technology     Hybrid Journal   (Followers: 16, SJR: 0.694, CiteScore: 3)
Advances in Accounting     Hybrid Journal   (Followers: 8, SJR: 0.277, CiteScore: 1)
Advances in Agronomy     Full-text available via subscription   (Followers: 12, SJR: 2.384, CiteScore: 5)
Advances in Anesthesia     Full-text available via subscription   (Followers: 28, SJR: 0.126, CiteScore: 0)
Advances in Antiviral Drug Design     Full-text available via subscription   (Followers: 2)
Advances in Applied Mathematics     Full-text available via subscription   (Followers: 10, SJR: 0.992, CiteScore: 1)
Advances in Applied Mechanics     Full-text available via subscription   (Followers: 11, SJR: 1.551, CiteScore: 4)
Advances in Applied Microbiology     Full-text available via subscription   (Followers: 22, SJR: 2.089, CiteScore: 5)
Advances In Atomic, Molecular, and Optical Physics     Full-text available via subscription   (Followers: 14, SJR: 0.572, CiteScore: 2)
Advances in Biological Regulation     Hybrid Journal   (Followers: 4, SJR: 2.61, CiteScore: 7)
Advances in Botanical Research     Full-text available via subscription   (Followers: 2, SJR: 0.686, CiteScore: 2)
Advances in Cancer Research     Full-text available via subscription   (Followers: 30, SJR: 3.043, CiteScore: 6)
Advances in Carbohydrate Chemistry and Biochemistry     Full-text available via subscription   (Followers: 7, SJR: 1.453, CiteScore: 2)
Advances in Catalysis     Full-text available via subscription   (Followers: 5, SJR: 1.992, CiteScore: 5)
Advances in Cell Aging and Gerontology     Full-text available via subscription   (Followers: 3)
Advances in Cellular and Molecular Biology of Membranes and Organelles     Full-text available via subscription   (Followers: 12)
Advances in Chemical Engineering     Full-text available via subscription   (Followers: 27, SJR: 0.156, CiteScore: 1)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10, SJR: 0.713, CiteScore: 1)
Advances in Chronic Kidney Disease     Full-text available via subscription   (Followers: 10, SJR: 1.316, CiteScore: 2)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 28, SJR: 1.562, CiteScore: 3)
Advances in Colloid and Interface Science     Full-text available via subscription   (Followers: 19, SJR: 1.977, CiteScore: 8)
Advances in Computers     Full-text available via subscription   (Followers: 14, SJR: 0.205, CiteScore: 1)
Advances in Dermatology     Full-text available via subscription   (Followers: 15)
Advances in Developmental Biology     Full-text available via subscription   (Followers: 11)
Advances in Digestive Medicine     Open Access   (Followers: 9)
Advances in DNA Sequence-Specific Agents     Full-text available via subscription   (Followers: 5)
Advances in Drug Research     Full-text available via subscription   (Followers: 24)
Advances in Ecological Research     Full-text available via subscription   (Followers: 43, SJR: 2.524, CiteScore: 4)
Advances in Engineering Software     Hybrid Journal   (Followers: 27, SJR: 1.159, CiteScore: 4)
Advances in Experimental Biology     Full-text available via subscription   (Followers: 7)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 44, SJR: 5.39, CiteScore: 8)
Advances in Exploration Geophysics     Full-text available via subscription   (Followers: 1)
Advances in Fluorine Science     Full-text available via subscription   (Followers: 9)
Advances in Food and Nutrition Research     Full-text available via subscription   (Followers: 54, SJR: 0.591, CiteScore: 2)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 16)
Advances in Genetics     Full-text available via subscription   (Followers: 16, SJR: 1.354, CiteScore: 4)
Advances in Genome Biology     Full-text available via subscription   (Followers: 8, SJR: 12.74, CiteScore: 13)
Advances in Geophysics     Full-text available via subscription   (Followers: 6, SJR: 1.193, CiteScore: 3)
Advances in Heat Transfer     Full-text available via subscription   (Followers: 21, SJR: 0.368, CiteScore: 1)
Advances in Heterocyclic Chemistry     Full-text available via subscription   (Followers: 11, SJR: 0.749, CiteScore: 3)
Advances in Human Factors/Ergonomics     Full-text available via subscription   (Followers: 22)
Advances in Imaging and Electron Physics     Full-text available via subscription   (Followers: 2, SJR: 0.193, CiteScore: 0)
Advances in Immunology     Full-text available via subscription   (Followers: 36, SJR: 4.433, CiteScore: 6)
Advances in Inorganic Chemistry     Full-text available via subscription   (Followers: 8, SJR: 1.163, CiteScore: 2)
Advances in Insect Physiology     Full-text available via subscription   (Followers: 2, SJR: 1.938, CiteScore: 3)
Advances in Integrative Medicine     Hybrid Journal   (Followers: 6, SJR: 0.176, CiteScore: 0)
Advances in Intl. Accounting     Full-text available via subscription   (Followers: 3)
Advances in Life Course Research     Hybrid Journal   (Followers: 8, SJR: 0.682, CiteScore: 2)
Advances in Lipobiology     Full-text available via subscription   (Followers: 1)
Advances in Magnetic and Optical Resonance     Full-text available via subscription   (Followers: 9)
Advances in Marine Biology     Full-text available via subscription   (Followers: 14, SJR: 0.88, CiteScore: 2)
Advances in Mathematics     Full-text available via subscription   (Followers: 11, SJR: 3.027, CiteScore: 2)
Advances in Medical Sciences     Hybrid Journal   (Followers: 6, SJR: 0.694, CiteScore: 2)
Advances in Medicinal Chemistry     Full-text available via subscription   (Followers: 5)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 4, SJR: 1.158, CiteScore: 3)
Advances in Molecular and Cell Biology     Full-text available via subscription   (Followers: 21)
Advances in Molecular and Cellular Endocrinology     Full-text available via subscription   (Followers: 8)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 7, SJR: 0.182, CiteScore: 0)
Advances in Nanoporous Materials     Full-text available via subscription   (Followers: 3)
Advances in Oncobiology     Full-text available via subscription   (Followers: 1)
Advances in Organ Biology     Full-text available via subscription   (Followers: 1)
Advances in Organometallic Chemistry     Full-text available via subscription   (Followers: 16, SJR: 1.875, CiteScore: 4)
Advances in Parallel Computing     Full-text available via subscription   (Followers: 7, SJR: 0.174, CiteScore: 0)
Advances in Parasitology     Full-text available via subscription   (Followers: 5, SJR: 1.579, CiteScore: 4)
Advances in Pediatrics     Full-text available via subscription   (Followers: 24, SJR: 0.461, CiteScore: 1)
Advances in Pharmaceutical Sciences     Full-text available via subscription   (Followers: 10)
Advances in Pharmacology     Full-text available via subscription   (Followers: 16, SJR: 1.536, CiteScore: 3)
Advances in Physical Organic Chemistry     Full-text available via subscription   (Followers: 8, SJR: 0.574, CiteScore: 1)
Advances in Phytomedicine     Full-text available via subscription  
Advances in Planar Lipid Bilayers and Liposomes     Full-text available via subscription   (Followers: 3, SJR: 0.109, CiteScore: 1)
Advances in Plant Biochemistry and Molecular Biology     Full-text available via subscription   (Followers: 8)
Advances in Plant Pathology     Full-text available via subscription   (Followers: 5)
Advances in Porous Media     Full-text available via subscription   (Followers: 5)
Advances in Protein Chemistry     Full-text available via subscription   (Followers: 18)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 20, SJR: 0.791, CiteScore: 2)
Advances in Psychology     Full-text available via subscription   (Followers: 62)
Advances in Quantum Chemistry     Full-text available via subscription   (Followers: 6, SJR: 0.371, CiteScore: 1)
Advances in Radiation Oncology     Open Access   (SJR: 0.263, CiteScore: 1)
Advances in Small Animal Medicine and Surgery     Hybrid Journal   (Followers: 3, SJR: 0.101, CiteScore: 0)
Advances in Space Biology and Medicine     Full-text available via subscription   (Followers: 5)
Advances in Space Research     Full-text available via subscription   (Followers: 395, SJR: 0.569, CiteScore: 2)
Advances in Structural Biology     Full-text available via subscription   (Followers: 5)
Advances in Surgery     Full-text available via subscription   (Followers: 10, SJR: 0.555, CiteScore: 2)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 31, SJR: 2.208, CiteScore: 4)
Advances in Veterinary Medicine     Full-text available via subscription   (Followers: 18)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 13)
Advances in Virus Research     Full-text available via subscription   (Followers: 5, SJR: 2.262, CiteScore: 5)
Advances in Water Resources     Hybrid Journal   (Followers: 46, SJR: 1.551, CiteScore: 3)
Aeolian Research     Hybrid Journal   (Followers: 6, SJR: 1.117, CiteScore: 3)
Aerospace Science and Technology     Hybrid Journal   (Followers: 337, SJR: 0.796, CiteScore: 3)
AEU - Intl. J. of Electronics and Communications     Hybrid Journal   (Followers: 8, SJR: 0.42, CiteScore: 2)
African J. of Emergency Medicine     Open Access   (Followers: 6, SJR: 0.296, CiteScore: 0)
Ageing Research Reviews     Hybrid Journal   (Followers: 11, SJR: 3.671, CiteScore: 9)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 443, SJR: 1.238, CiteScore: 3)
Agri Gene     Hybrid Journal   (SJR: 0.13, CiteScore: 0)
Agricultural and Forest Meteorology     Hybrid Journal   (Followers: 16, SJR: 1.818, CiteScore: 5)
Agricultural Systems     Hybrid Journal   (Followers: 32, SJR: 1.156, CiteScore: 4)
Agricultural Water Management     Hybrid Journal   (Followers: 43, SJR: 1.272, CiteScore: 3)
Agriculture and Agricultural Science Procedia     Open Access   (Followers: 1)
Agriculture and Natural Resources     Open Access   (Followers: 2)
Agriculture, Ecosystems & Environment     Hybrid Journal   (Followers: 57, SJR: 1.747, CiteScore: 4)
Ain Shams Engineering J.     Open Access   (Followers: 5, SJR: 0.589, CiteScore: 3)
Air Medical J.     Hybrid Journal   (Followers: 6, SJR: 0.26, CiteScore: 0)
AKCE Intl. J. of Graphs and Combinatorics     Open Access   (SJR: 0.19, CiteScore: 0)
Alcohol     Hybrid Journal   (Followers: 11, SJR: 1.153, CiteScore: 3)
Alcoholism and Drug Addiction     Open Access   (Followers: 9)
Alergologia Polska : Polish J. of Allergology     Full-text available via subscription   (Followers: 1)
Alexandria Engineering J.     Open Access   (Followers: 1, SJR: 0.604, CiteScore: 3)
Alexandria J. of Medicine     Open Access   (Followers: 1, SJR: 0.191, CiteScore: 1)
Algal Research     Partially Free   (Followers: 10, SJR: 1.142, CiteScore: 4)
Alkaloids: Chemical and Biological Perspectives     Full-text available via subscription   (Followers: 2)
Allergologia et Immunopathologia     Full-text available via subscription   (Followers: 1, SJR: 0.504, CiteScore: 1)
Allergology Intl.     Open Access   (Followers: 5, SJR: 1.148, CiteScore: 2)
Alpha Omegan     Full-text available via subscription   (SJR: 3.521, CiteScore: 6)
ALTER - European J. of Disability Research / Revue Européenne de Recherche sur le Handicap     Full-text available via subscription   (Followers: 9, SJR: 0.201, CiteScore: 1)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 50, SJR: 4.66, CiteScore: 10)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 4, SJR: 1.796, CiteScore: 4)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 4, SJR: 1.108, CiteScore: 3)
Ambulatory Pediatrics     Hybrid Journal   (Followers: 6)
American Heart J.     Hybrid Journal   (Followers: 50, SJR: 3.267, CiteScore: 4)
American J. of Cardiology     Hybrid Journal   (Followers: 54, SJR: 1.93, CiteScore: 3)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 44, SJR: 0.604, CiteScore: 1)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 10)
American J. of Geriatric Psychiatry     Hybrid Journal   (Followers: 14, SJR: 1.524, CiteScore: 3)
American J. of Human Genetics     Hybrid Journal   (Followers: 34, SJR: 7.45, CiteScore: 8)
American J. of Infection Control     Hybrid Journal   (Followers: 28, SJR: 1.062, CiteScore: 2)
American J. of Kidney Diseases     Hybrid Journal   (Followers: 34, SJR: 2.973, CiteScore: 4)
American J. of Medicine     Hybrid Journal   (Followers: 45)
American J. of Medicine Supplements     Full-text available via subscription   (Followers: 3, SJR: 1.967, CiteScore: 2)
American J. of Obstetrics and Gynecology     Hybrid Journal   (Followers: 202, SJR: 2.7, CiteScore: 4)
American J. of Ophthalmology     Hybrid Journal   (Followers: 63, SJR: 3.184, CiteScore: 4)
American J. of Ophthalmology Case Reports     Open Access   (Followers: 5, SJR: 0.265, CiteScore: 0)
American J. of Orthodontics and Dentofacial Orthopedics     Full-text available via subscription   (Followers: 6, SJR: 1.289, CiteScore: 1)
American J. of Otolaryngology     Hybrid Journal   (Followers: 25, SJR: 0.59, CiteScore: 1)
American J. of Pathology     Hybrid Journal   (Followers: 27, SJR: 2.139, CiteScore: 4)
American J. of Preventive Medicine     Hybrid Journal   (Followers: 28, SJR: 2.164, CiteScore: 4)
American J. of Surgery     Hybrid Journal   (Followers: 37, SJR: 1.141, CiteScore: 2)
American J. of the Medical Sciences     Hybrid Journal   (Followers: 12, SJR: 0.767, CiteScore: 1)
Ampersand : An Intl. J. of General and Applied Linguistics     Open Access   (Followers: 6)
Anaerobe     Hybrid Journal   (Followers: 4, SJR: 1.144, CiteScore: 3)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 62, SJR: 0.138, CiteScore: 0)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 16, SJR: 0.411, CiteScore: 1)
Anales de Cirugia Vascular     Full-text available via subscription  
Anales de Pediatría     Full-text available via subscription   (Followers: 3, SJR: 0.277, CiteScore: 0)
Anales de Pediatría (English Edition)     Full-text available via subscription  
Anales de Pediatría Continuada     Full-text available via subscription  
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 5, SJR: 4.849, CiteScore: 10)
Analytica Chimica Acta     Hybrid Journal   (Followers: 40, SJR: 1.512, CiteScore: 5)
Analytical Biochemistry     Hybrid Journal   (Followers: 172, SJR: 0.633, CiteScore: 2)
Analytical Chemistry Research     Open Access   (Followers: 10, SJR: 0.411, CiteScore: 2)
Analytical Spectroscopy Library     Full-text available via subscription   (Followers: 11)
Anesthésie & Réanimation     Full-text available via subscription   (Followers: 2)
Anesthesiology Clinics     Full-text available via subscription   (Followers: 23, SJR: 0.683, CiteScore: 2)
Angiología     Full-text available via subscription   (SJR: 0.121, CiteScore: 0)
Angiologia e Cirurgia Vascular     Open Access   (Followers: 1, SJR: 0.111, CiteScore: 0)
Animal Behaviour     Hybrid Journal   (Followers: 191, SJR: 1.58, CiteScore: 3)

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Journal Cover
Anaesthesia & Intensive Care Medicine
Journal Prestige (SJR): 0.138
Number of Followers: 62  
 
  Full-text available via subscription Subscription journal
ISSN (Print) 1472-0299
Published by Elsevier Homepage  [3159 journals]
  • Prevention of deep vein thrombosis and pulmonary embolism
    • Abstract: Publication date: Available online 7 August 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): Ravindra Cooray, Caroline LakeAbstractVenous thromboembolism is a major cause of perioperative morbidity and mortality. Immobilized medical patients are also at risk. Long-term sequelae represent a significant chronic health burden. Hospitalized patients should be assessed for their risk of thromboembolism and bleeding at regular intervals. Risk stratification using recommended models can be used to guide the choice of thromboprophylaxis. Both mechanical and pharmacological interventions reduce the incidence of venous thromboembolism. Extended prophylaxis is now recommended following high-risk orthopaedic and cancer surgeries and a number of newer oral antithrombotic agents are now available for this. Anaesthesia should be tailored to minimize the risk of venous stasis and maximize early postoperative mobilization.
       
  • Physiology of human fluid balance
    • Abstract: Publication date: Available online 3 August 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): F Watson, P AustinAbstractThe physiology of fluid balance in humans should be understood and applied in clinical practice. Fluid balance, when managed accurately and safely, can prevent significant morbidity and mortality. Anaesthesia and critical care patients are often fasted and under physiological stress. Therefore, homoeostatic regulation of fluid balance is impaired. A disturbance in normal fluid balance induces a physiological ‘stress’ response via metabolic, neuroendocrine and immune-mediated systems. Critically unwell patients may suffer morbidity secondary to high-volume fluid losses or oedema. There are three fluid compartments discussed in relation to human fluid balance. The intracellular space is surrounded by extracellular fluid, separated by the water permeable cell membrane. Extracellular fluid (ECF) compartment volume and electrolyte concentration, majorly sodium, must be tightly regulated to avoid osmosis and cell damage. The renal system maintains ECF volume by regulating sodium and osmotic concentration by retaining or excreting water.
       
  • Postoperative nausea and vomiting
    • Abstract: Publication date: Available online 3 August 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): Yolande Squire, Ruth SpencerAbstractPostoperative nausea and vomiting (PONV) remains a common clinical problem that increases patient morbidity, healthcare costs and affects patient satisfaction. This article outlines the physiology, reviews the available drugs and suggests a structure using risk stratification that helps to plan sensible clinical management.
       
  • Physiology and pharmacology of nausea and vomiting
    • Abstract: Publication date: Available online 2 August 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): Louise Denholm, Geraldine GallagherAbstractNausea and vomiting are both very unpleasant experiences. The physiology is poorly understood; however, understanding what we do know is key to tailoring a preventative or therapeutic antiemetic regime. There are two key sites in the central nervous system implicated in the organization of the vomiting reflex: the vomiting centre and the chemoreceptor trigger zone. There are five key neurotransmitters involved in afferent feedback to these areas. These are histamine (H1 receptors), dopamine (D2), serotonin (5-HT3), acetyl choline (muscarinic) and neurokinin (substance P). Postoperative nausea and vomiting will occur in around one-third of elective patients who have no prophylaxis. This can result in many detrimental effects including patient dissatisfaction, unplanned admission and prolonged recovery. It is therefore essential that clinicians understand how they can prevent and treat nausea and vomiting using either a single agent or a combination of antiemetics to target relevant receptors. Commonly used drugs include antihistamines, dopamine antagonists, serotonin antagonists and steroids. More novel agents are being developed such as aprepitant, a neurokinin receptor antagonist, palonosetron, a 5HT3 receptor antagonist and nabilone, a synthetic cannabinoid.
       
  • Patient recovery and the post-anaesthesia care unit (PACU)
    • Abstract: Publication date: Available online 1 August 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): Marie Davidson, Kerry LitchfieldAbstractPatient recovery is a period of active patient monitoring and management during which time return of airway reflexes and respiratory and cardiovascular stability should be achieved. The post-anaesthetic care unit is the specially designed clinical area in which staff trained in the recognition and management of the potential complications arising during this time care for patients. National guidance on the responsibilities and training of staff, the monitoring required during the recovery period and criteria for discharge serves to ensure patient safety and efficient theatre throughput.
       
  • Preoperative assessment in patients presenting for elective surgery
    • Abstract: Publication date: Available online 1 August 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): Carol E. Gray, Julie Baruah-Young, Christopher PayneAbstractPreoperative assessment of patients undergoing elective surgery is vital to ensure patients have underlying comorbidities identified, appropriate investigations performed and are optimized prior to the day of surgery. Anaesthetic pre-assessment is usually initiated at the pre-assessment clinic. A thorough assessment should include a careful history and examination as well as assessment of both the airway and functional capacity. This article provides a systematic approach to the assessment process.
       
  • Extubation and emergence
    • Abstract: Publication date: Available online 31 July 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): Lynsey Foulds, Andrew DaltonAbstractEmergence and extubation are a time of increased risk in all anaesthetics, with more complications occurring then than at induction and intubation. The majority of problems are airway related due to airway obstruction, hypoxia, aspiration, airway trauma or post-obstructive pulmonary oedema. Other problems include a delayed recovery of consciousness, cardiovascular instability and delirium. Prompt identification and treatment of the underlying cause is essential to prevent serious morbidity and mortality. The Difficult Airway Society published extubation guidelines in 2012. These guidelines provide a step-wise approach to extubation in a four-stage approach encompassing planning, preparation, performing and then post-extubation care. The planning phase is aimed at identifying the patients in whom extubation is a higher risk procedure, based on the presence or absence of risk factors and clinical assessment. Preparation includes optimization of the patient and the environment prior to extubation. The performing stage is a guide to maximize the success of the extubation process, while the post-extubation care is aimed at ensuring that safe and appropriate care is ongoing.
       
  • Body temperature and its regulation
    • Abstract: Publication date: Available online 31 July 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): James Kuht, Andrew D FarmeryAbstractHumans are homeotherms, i.e. they fix their temperature regardless of their environment. This is vital for normal cellular function and for metabolism to be independent of external temperature. The body has a warm ‘core’ and a cooler peripheral ‘shell’ whose role is to regulate heat transfer in and out of the core. Body temperature is controlled by a feedback system with both peripheral and central sensors, and an integrator located in the hypothalamus. Anaesthesia exposes patients to thermoregulatory challenges due to enhanced heat loss from the core to the shell to the environment, and interference with the hypothalamic temperature ‘set-point’. In extreme circumstances, deliberate hypothermia may provide benefits that outweigh the risks.
       
  • Perioperative fluid therapy for anaesthetists and intensivists
    • Abstract: Publication date: Available online 31 July 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): Claire McCue, Kathryn PuxtyAbstractUnderstanding fluid physiology in homeostasis and disease is a key part of anaesthesia and intensive care. Decision making in perioperative fluid therapy is guided by knowledge of fluid compartments, shifts in illness and surgery and the composition of commonly used intravenous fluids. The implication of poor fluid management has significant outcomes for the patient, with both under-resuscitation and over administration of fluids leading to organ dysfunction and postoperative morbidity and mortality. Increasing use of haemodynamic monitoring within a guideline framework is advised. The evidence base for type of fluid, timing, and volume remain areas of investigation and ongoing clinical debate and it is vital as clinicians involved in perioperative care to continually update our knowledge of this area. Research is currently ongoing to determine whether restrictive, liberal or goal-directed fluid therapy is optimal to guide our practice. In the meantime, advice is to both individualize management to the patient condition and develop local protocols where possible.
       
  • Osmolarity and partitioning of fluids
    • Abstract: Publication date: Available online 31 July 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): Ben R. Waterhouse, Andrew D. FarmeryAbstractThis article first outlines definitions and descriptions of key terms that will be used in the discussions that follow, including osmolarity, osmolality, osmotic and oncotic pressure. The physicochemical properties of water, ions and organic molecules are discussed in terms of their biological roles. Similarly, the interactions of amphipathic molecules and their three-dimensional structures in aqueous and non-aqueous environments are then explored. The movement of solutes and solvents across semipermeable membranes is considered and an assessment is made of the contribution of such mechanisms to normal physiology. Firstly, simple diffusion is described, followed by comparisons with facilitated diffusion and energy-dependent active transport focusing on the differences in kinetics and rate-limiting factors arising as a result. The mechanisms underlying Gibbs–Donnan equilibria are discussed, with particular emphasis as to how they arise across a selectively permeable membrane by way of a worked example. The equilibrium of forces influencing fluid movements across the capillary endothelium, known as Starling forces, is then described. Comparisons are made between the classic model as first proposed by Starling in 1896 and the modified glycocalyx model, which has developed over the past 25 years. Finally, the impact of these differences on our understanding of trans-capillary fluid flux is discussed.
       
  • Regurgitation and aspiration
    • Abstract: Publication date: Available online 31 July 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): Sarah Jackson, Tracey Eastaugh-WaringAbstractRegurgitation and aspiration remains one of the major complications of general anaesthesia. Aspiration is defined as oropharyngeal or gastric content entering the airway below the level of the vocal cords. This can cause morbidity and mortality by direct effects of the particulate, acid-related damage and bacterial pneumonia. It occurs largely in patients with risk factors, although occasionally in patients that are low risk. Anaesthetic technique should be adjusted depending on the patient's risk of aspiration with rapid sequence induction considered in high-risk patients. Recognition and appropriate management of aspiration is essential.
       
  • Self-assessment
    • Abstract: Publication date: Available online 31 July 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): Vijayanand Nadella
       
  • Assessment of the emergency surgical patient
    • Abstract: Publication date: Available online 31 July 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): Caroline LakeAbstractIt is well known that emergency surgical patients have a higher risk of postoperative morbidity and mortality than those having elective procedures. A systematic preoperative assessment forms an important part of identifying risk factors and reducing their impact. Patients may require simultaneous resuscitation and assessment. Further deterioration in the patient's condition must not occur as a result of delays in decision making or awaiting results of investigations. A risk assessment score is useful for both surgeons and patients to provide information on possible postoperative outcomes. It will aid discussion for informed consent and guide planning of staffing for surgery and postoperative care location.
       
  • Characteristics of special circulations
    • Abstract: Publication date: Available online 30 July 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): John Chalmers, Jamie MacdonaldAbstractBlood flow through vascular beds is usually determined by the pressure gradient and the diameter of the precapillary resistance vessels. Special circulations have additional features of intrinsic blood flow control, allowing autoregulation. Coronary blood flow is linked to myocardial oxygen consumption by a metabolic mechanism, where increased metabolism releases vasodilator metabolites. Cerebral blood flow is primarily regulated by a myogenic mechanism whereby increases in transmural pressure stretch the vascular smooth muscle, which responds by contracting. Renal blood flow is regulated by myogenic mechanisms and tubuloglomerular feedback. Hepatic blood flow is delivered via the portal vein and hepatic artery, and flow varies in these vessels reciprocally to maintain constant total flow. The pulmonary circulation receives the entire cardiac output, and blood flow is regulated both passively and actively to allow increases in flow without significant increases in pressure.
       
  • Associated medical conditions in children
    • Abstract: Publication date: Available online 7 July 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): Elena FernandezAbstractChildren with acute and chronic associated medical conditions often present for surgical and radiological procedures. An understanding of the implications of these conditions for anaesthesia is important in preventing perioperative adverse events. In this article, we outline the relevant clinical features of some of the commonly encountered associated medical conditions and provide guidance on the current evidence for the perioperative anaesthetic management of these children.
       
  • Self-assessment
    • Abstract: Publication date: July 2018Source: Anaesthesia & Intensive Care Medicine, Volume 19, Issue 7Author(s): Vijayanand Nadella
       
  • Drugs acting on the heart: antihypertensive drugs
    • Abstract: Publication date: July 2018Source: Anaesthesia & Intensive Care Medicine, Volume 19, Issue 7Author(s): Matthew Charlton, Jonathan ThompsonAbstractAntihypertensive drugs are used commonly in anaesthesia and intensive care medicine. Patients might require antihypertensive drugs before surgery for the treatment of essential hypertension, pre-eclampsia or, occasionally for conditions such as phaeochromocytoma; during surgery as part of a deliberate hypotensive anaesthetic technique; or to reduce postoperative cardiovascular complications. Here, we discuss the physiology of blood pressure control, the pharmacology of antihypertensive drugs, current guidelines, and practical applications of antihypertensive therapy.
       
  • Mechanical support of the heart
    • Abstract: Publication date: July 2018Source: Anaesthesia & Intensive Care Medicine, Volume 19, Issue 7Author(s): Guarang Vaidya, Barbora Parizkova, Emma J BirksAbstractMechanical support of the heart can be offered to patients who are refractory to pharmacological treatment, therapy for coronary or valvular disease or resynchronization therapy. Ventricular assist devices enable end-organ perfusion in the setting of heart failure. This can be temporary (as a bridge to recovery or transplantation) or permanent (destination therapy). Devices can be extracorporeal or implanted, and generated flows can be pulsatile or non-pulsatile. Implantation usually requires sternotomy with or without cardiopulmonary bypass, but percutaneous devices exist. Cardiostable anaesthesia with inotropic support is vital. Problems include bleeding versus thrombosis, right heart failure and late infections. Transoesophageal echocardiography can be used to detect potential right-to-left atrial shunts, aortic regurgitation and cannula malposition, and to monitor filling and right ventricular function after implantation. In the future, total implantability of the devices, including the power source, is likely to occur. Eventually, they are likely to become a widespread alternative to transplantation.
       
  • Cardiopulmonary bypass
    • Abstract: Publication date: July 2018Source: Anaesthesia & Intensive Care Medicine, Volume 19, Issue 7Author(s): Hannah Kiziltug, Guillermo MartinezAbstractThe primary function of the cardiopulmonary bypass (CPB) machine is to provide oxygenated blood flow to the systemic circulation while providing the surgeon with a motionless, bloodless surgical field. The CPB circuit consists of a reservoir, blood pump, oxygenator, heat exchanger, arterial filter, cardioplegia delivery device and cannulae, interconnected by various sized tubing. The venous cannula directs blood away from the heart and lungs via the CBP circuit and the arterial cannula returns the oxygenated blood to the systemic circulation. A blood pump propels the blood volume forward through a membrane oxygenator and allows rapid transfusion of oxygenated blood back into the systemic circulation. The CPB flow needs to be enough to maintain an adequate cardiac output, therefore a flow of 1.8–2.2 litres/minute/m2 is recommended when at normothermia, although these flows can be reduced if the temperature is less than 28°C. The mortality and neurological complications after cardiac surgery are similar using either normothermic or hypothermic CPB. Maintenance of anaesthesia on CPB is often achieved with a propofol infusion (sometimes with the addition of remifentanil), but the use of volatile anaesthetic is also possible through the CPB machine. A vaporizer can be attached to the CPB circuit and volatile anaesthetic delivered into the sweep gas passing through the oxygenator. A safety checklist before separation from bypass is essential, and it may include: optimal temperature, heart rhythm, de-airing, acid-base status, ventilation, electrolytes and patient position. If heparin was used to maintain anticoagulation, it should be reversed with protamine after the patient is stable off-CPB. Some patients require inotropic or mechanical support to facilitate ‘weaning’ from CPB.
       
  • Transoesophageal echocardiography in cardiac anaesthesia
    • Abstract: Publication date: July 2018Source: Anaesthesia & Intensive Care Medicine, Volume 19, Issue 7Author(s): Christine Herr, Andrew RoscoeAbstractEchocardiography is the most widely used minimally invasive investigation to diagnose heart disease. Transoesophageal echocardiography (TOE) was first introduced perioperatively in the 1980s and is now an important monitoring tool for patients undergoing cardiac surgery. Because of the close proximity of the oesophagus to the heart, TOE facilitates the acquisition of high-resolution images. The TOE probe is a multiplane transducer. This means that the image planes can be rotated from 0° to 180°, enabling three-dimensional (3D) assessment of the structure of interest. Intraoperative TOE has been shown to improve outcome in a variety of cardiac surgeries. The introduction of real-time 3D TOE has provided better diagnosis of the mechanism of certain valve pathologies. TOE has become an important investigation in the assessment of haemodynamic instability in the perioperative period because it allows rapid and accurate diagnosis.
       
  • Preoperative assessment for cardiac surgery
    • Abstract: Publication date: July 2018Source: Anaesthesia & Intensive Care Medicine, Volume 19, Issue 7Author(s): Shilpa Sannakki, Deepa Sannakki, Juan Jose Echebarria, Mathew PatterilAbstractAnaesthetic challenges in cardiac surgery are multifaceted. Since patients present with compromised cardiovascular reserve and multiple co-morbidities, a thorough preoperative assessment and meticulous anaesthetic plan is essential. This targets anaesthetic history, physical examination and analysis of investigations, routine and specific to the cardiovascular system. Special models exist for risk stratification to aid perioperative planning, surgical decision making, benchmarking and quality assurance. This article provides an overview of history, examination and preoperative management of patients undergoing cardiac surgery. Scoring systems and practical investigations are reviewed.
       
  • The principles of cardiac anaesthesia
    • Abstract: Publication date: July 2018Source: Anaesthesia & Intensive Care Medicine, Volume 19, Issue 7Author(s): Michael Charlesworth, Petr MartinovskyAbstractDespite the origins of cardiac surgery and anaesthesia involving experimentation and danger, modern practice has evolved to dramatically reduce risk and increase patient safety. Outcomes from cardiac surgery in the UK are consistently improving despite an aging population, increasing clinical complexity and an increasing incidence of chronic conditions such as anaemia and frailty. The management of bleeding is a great challenge to the surgeon and anaesthetist; knowledge of novel near-patient tests, blood products and their transfusion, blood conservation strategies and haemostatic agents is of paramount importance.
       
  • Drugs acting on the heart: antiarrhythmics
    • Abstract: Publication date: July 2018Source: Anaesthesia & Intensive Care Medicine, Volume 19, Issue 7Author(s): Christopher Hebbes, Jonathan P. ThompsonAbstractArrhythmias are abnormalities of cardiac rate or rhythm occurring for a variety of reasons. They are common in the perioperative period and in intensive care. Causes may reflect an underlying heritable predisposition, the presence of new pathology either of the heart or conducting system, or as a result of systemic illness. Targets for antiarrhythmics include myocardial ion channels, muscarinic or nicotinic acetylcholine receptors, adrenergic or adenosine receptors. Arrhythmias may cause cardiac arrest and haemodynamic compromise, requiring rapid identification and corrective treatment either of rate or rhythm. Even where stable, arrhythmias present an increased risk of thromboembolic events requiring the use of anticoagulation. Treatment may be directed at controlling heart rate or rhythm to restore the circulation and tissue perfusion. Strategies may include prevention or correction of precipitating factors (such as electrolyte abnormalities or sepsis) and sometimes non-pharmacological treatments (cardioversion, surgical ablation or pacing). Antiarrhythmic drugs are often required. The targets, mechanisms and clinical guidelines are reviewed for common antiarrhythmic agents.
       
  • Drugs acting on the heart: heart failure and coronary insufficiency
    • Abstract: Publication date: July 2018Source: Anaesthesia & Intensive Care Medicine, Volume 19, Issue 7Author(s): Matthew Charlton, Jonathan P. ThompsonAbstractHeart failure (HF) and coronary insufficiency are common amongst surgical and critical care patients. Both are chronic conditions interrupted by acute episodes. HF activates neurohormonal mechanisms that worsen renal and cardiac function. Acute heart failure (AHF) commonly presents with dyspnoea as a consequence of systolic and/or diastolic dysfunction. Goals of treatment are symptom relief, to maintain tissue perfusion and optimize cardiac function. Diuretics and vasodilators are used early; positive inotropic drugs are reserved for when other treatment has failed. Chronic heart failure (CHF) is treated using changes in lifestyle and drugs to manage symptoms. ACE inhibitors and beta-blockers are effective in systolic heart failure and are associated with improved mortality. HF with preserved ejection fraction (HFPEF) is less responsive to drug therapy, though outcomes are better than for systolic HF. Coronary insufficiency occurs because of an imbalance of myocardial oxygen balance, leading to symptoms of ischaemic heart disease (IHD). Treatment goals are maintaining coronary blood flow and reducing myocardial oxygen demand. Beta-blockers and anti-platelet drugs improve outcomes; modern anti-platelets are more effective but are associated with risks of haemorrhage. Statins are effective for primary and secondary prevention of myocardial infarction; they have additional anti-inflammatory properties.
       
  • Preoperative assessment and preparation for safe paediatric anaesthesia
    • Abstract: Publication date: Available online 30 June 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): Matthew Harvey, Tim GearyAbstractThe delivery of anaesthesia to children and young people provides unique challenges. A careful, systematic approach to assessment and preparation can deliver a positive experience for the child, carers and staff while mitigating potential complications. Preparation for anaesthesia should encompass information gathering, assessment and planning for anatomical, physiological, social and behavioural elements specific to the child and the surgery. Delivery of appropriate information, consent and fasting are also key elements of ensuring positive perioperative outcomes. We consider the common components of preparation for the delivery of safe paediatric anaesthesia.
       
  • Self-assessment
    • Abstract: Publication date: Available online 28 June 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): Viyayanand Nadella
       
  • Anaesthetic implications of congenital heart disease for children
           undergoing non-cardiac surgery
    • Abstract: Publication date: Available online 27 June 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): Sarah Smith, Alyson WalkerAbstractA diagnosis of congenital heart disease (CHD) increases perioperative risk for children having surgical procedures. Some will require anaesthesia at a specialist cardiac centre, while for others it is safe and appropriate to have their procedure in a local district general hospital (DGH). Children with complex CHD and poor physiological status carry the highest risk of cardiac arrest and mortality. Clinical features of cardiomyopathy, cyanosis, pulmonary hypertension, arrhythmia and cardiac failure are most likely to require specialist input and tertiary referral, whereas those with a preoperative stay of less than 10 days undergoing elective, minor surgery, who are older than 2 years of age and physiologically well may be safely anaesthetized in a DGH. In order to maximize safety, the anaesthetist must carry out a thorough preoperative assessment, have an understanding of the patient's individual physiology and be prepared for the potential effects of general anaesthesia. Systemic vascular resistance is reduced by most induction agents and volatile anaesthetics, pulmonary vascular resistance is affected by changes in ventilation and gas exchange. The anaesthetist should be alert to particular potential complications, such as arrhythmias, hypoxia, bleeding and cardiac arrest.
       
  • Developmental paediatric anaesthetic pharmacology
    • Abstract: Publication date: Available online 25 June 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): Tom G. HansenAbstractSafe and effective drug therapy in neonates, infants and children require detailed knowledge about the ontogeny of drug disposition and action as well how these interact with genetics and co-morbidity in children. Recent advances in developmental pharmacology in children follow the increased understanding of the impact of growth and development on drug disposition (absorption, distribution, metabolism and excretion–ADME). Numerous approaches have been used to determine optimal dosing of drugs in children, none of which are perfect. Human growth is a non-linear process and age-related changes in body composition and organ function are dynamic and often discordant during infancy. Major gaps of knowledge remain regarding the ontogeny of drug metabolizing enzymes and transporting proteins, and the paucity of pharmacodynamic and pharmacogenetic data in the paediatric population remains overwhelming.
       
  • Induction of anaesthesia
    • Abstract: Publication date: Available online 25 June 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): Charlotte Dean, Eleanor ChapmanAbstractGeneral anaesthesia is a temporary state of unconsciousness which is induced to facilitate a therapeutic procedure. Induction is the first stage of a sequential process. It commences with patient preparation and assessment away from theatre then continues in the safe and monitored environment of the anaesthetic room or operating theatre where the administration of drugs and airway interventions take place. The anaesthetic then transits through maintenance, emergence and recovery phases. The exact mechanism of induction, whether it be intravenous, inhalational or rapid sequence induction, depends on the needs of the patient and the procedure planned. As general anaesthesia is seldom a therapeutic intervention in itself, it is essential that inherent risks to the patient be minimized.
       
  • Equipment and monitoring in paediatric anaesthesia
    • Abstract: Publication date: Available online 25 June 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): Dannie Seddon, M. McLeodAbstractAdvances in paediatric anaesthetic equipment and monitoring continue to be made. While the mainstay of airway intubating equipment currently is the direct laryngoscope, video laryngoscopes and endoscopes are increasing in their use. These continue to evolve, generating better quality pictures, with more sophisticated yet easier to use equipment. Vascular access in paediatric anaesthesia can be challenging with an increasing number of patients presenting with difficult intravenous access. Ultrasound has become an integral piece of equipment in the management of these children. As the population increases in weight, so the management of the obese paediatric patient is now a reality. This requires thought and careful planning of their perioperative care. Newer techniques such as high-flow nasal oxygen are useful both to prevent hypoxia at induction, but also to facilitate open airway surgery. Neurological monitoring in the form of near infrared spectroscopy and bispectral index are discussed with evidence relevant to paediatric practice. This article will discuss all of these devices and techniques with particular emphasis on paediatric anaesthetic practice.
       
  • Safeguarding for anaesthetists: working to protect children
    • Abstract: Publication date: Available online 23 June 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): Kathy Wilkinson, Alistair J. CranstonAbstractAn awareness of what may constitute neglect or ill treatment to children and young people is important for all healthcare staff, and prevention of harm is everyone's business. While it is relatively unusual to see serious signs of abuse in a routine surgical context, anaesthetists also see children in many different settings and should be able to clearly communicate their concerns. While there are differences in both relevant law and statutory advice in the various parts of the UK, the message is basically the same. New recommendations potentially allow for a more meaningful and flexible approach to training.
       
  • Humidification devices
    • Abstract: Publication date: Available online 23 June 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): Stuart Gaffney, Andrew DaltonAbstractHumidification is concerned with the addition of water vapour to a gas and can be measured as either absolute or relative. Adequate humidification is a vital consideration in anaesthesia given that the anatomical source of natural gas humidification (the nasopharynx) is generally bypassed, which can lead to complications including hypothermia, thickening of respiratory secretions, mucus plugging and airway keratinization. Humidification may be passive or active. Equipment involved in passive humidification includes HME filters, soda lime and cold water baths, with these devices able to achieve varying efficiencies without extrinsic energy input. Active humidification devices (including hot water baths) are capable of delivering a higher relative humidity but are associated with higher cost and potential hazards. While not strictly classed as true humidification devices, nebulizers are considered in this article as they add water droplets into a gas flow using a Venturi system, spinning discs or ultrasound vibration technology.
       
  • Equipment for airway management
    • Abstract: Publication date: Available online 23 June 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): Andrew Laurie, Jamie MacdonaldAbstractAirway management provides gas exchange, protects the lungs from injury and permits treatment. This requires safe, effective and reliable use of equipment, often in combination. A management plan with backups is essential, but a sequence of logical plans forming an airway management strategy is better. Correct equipment use needs correct knowledge, skill and attitudes. There are five approaches to airway management in which equipment is used: facemask ventilation with adjuncts, use of supraglottic airway devices, tracheal intubation with a variety of laryngoscopes (including the flexible fibreoptic bronchoscope), front of neck (transtracheal) access using cricothyroidotomy or tracheostomy and airway clearance with suction or foreign body removal. Tracheal tubes and aids for placement are described.
       
 
 
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