Use of video laryngoscopes by inexperienced personnel in difficult intubations

The current gold standard in securing airway patency remains to be endotracheal intubation. It is the only method, which allows for nearly 100% protection of the bronchial tree from aspiration of gastric contents as well as providing the most ideal circumstances for control of ventilation parameters. Endotracheal intu- bation, although in many aspects superior to other methods of securing airways, can only be performed by skilled and experienced personnel in ideal conditions. An example of such conditions are in an operating room in the preoperative period when an anesthesiologist is able to proficiently perform the task with all of the tools and equipment needed at hand. However, in many situations, especially in emergencies, such ideal conditions are difficult or impossible to achieve. One of the many reasons behind this is often the lack of experienced personnel at the scene of an emergency. Another significant difficulty arises from trauma patients who must maintain an immobilized cervical spine, as well as those patients who are undergoing active cardiopulmonary resuscitation when providing high quality chest compressions is the highest priority. Therefore, it seems reasonable to look for the methods which on one hand will secure an airway with a tube inserted directly into the larynx, and on the other hand will make the procedure more accessible to less expe- rienced personnel by maintaining the proper patient safety throughout the whole procedure. A noteworthy method, which achieves this goal, is the use of the video laryngoscopes for endotracheal intubation. The participation in a short introductory training, regarding the use of the device itself, is sufficient to allow for the efficient intubation. The parameters which can be used to compare these different intubation methods include the ease of use, the rate of effectiveness of the first intubation trial as well as the total time needed for the procedure. The authors of this article attempt to compare classic laryngoscopes to video-assisted laryngoscopes. 

The clinical picture and the possibilities of conservative treatment of thoracic aortic aneurysms

Tętniaki aorty są drugą co do częstości chorobą aorty. Dzieli się je na dwie grupy: tętniaki aorty brzusznej oraz piersiowej. Te drugie stanowią do 8% rozpoznawanych tętniaków. Najczęściej wykrywany jest przypadkowo przy okazji wykonywania badania obrazowego. Tętniaka rozpoznajemy, gdy poszerzenie średnicy naczynia jest większe niż 55% normalnej wielkości. Częściej występuje u mężczyzn, jednak u kobiet jest bardziej niebezpieczny z powodu większego ryzyka pęknięcia. Głównym sposobem leczenia zachowawczego jest stosowanie beta-blokerów oraz leków obniżających ciśnienie krwi – głównie sartanów, bowiem ich działanie sprowadza się do spowolnienia przyrostu średnicy aorty.Aortic aneurysms are the second most common aortic disease. They can be divided into two groups: abdominal and thoracic aortic aneurisms. The latter group accounts for up to 8% of all diagnosed aneurysms. They are usually diagnosed incidentally during imaging examination. Aneurysm is diagnosed when the dilatation of the vessel diameter is bigger than 55% of its normal size. It is more common in males, but in females it is more dangerous because of a higher risk of rupture. The main conservative treatment is the use of beta-blockers and drugs that lower blood pressure, mainly sartans, as their effect comes down to slowing the increase in aortic diameter