\\n\\n
Released this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\\n\\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
\\n"}]',published:!0,mainMedia:null},components:[{type:"htmlEditorComponent",content:'IntechOpen is proud to announce that 191 of our authors have made the Clarivate™ Highly Cited Researchers List for 2020, ranking them among the top 1% most-cited.
\n\nThroughout the years, the list has named a total of 261 IntechOpen authors as Highly Cited. Of those researchers, 69 have been featured on the list multiple times.
\n\n\n\nReleased this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\n\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
\n'}],latestNews:[{slug:"intechopen-signs-new-contract-with-cepiec-china-for-distribution-of-open-access-books-20210319",title:"IntechOpen Signs New Contract with CEPIEC, China for Distribution of Open Access Books"},{slug:"150-million-downloads-and-counting-20210316",title:"150 Million Downloads and Counting"},{slug:"intechopen-secures-indefinite-content-preservation-with-clockss-20210309",title:"IntechOpen Secures Indefinite Content Preservation with CLOCKSS"},{slug:"intechopen-expands-to-all-global-amazon-channels-with-full-catalog-of-books-20210308",title:"IntechOpen Expands to All Global Amazon Channels with Full Catalog of Books"},{slug:"stanford-university-identifies-top-2-scientists-over-1-000-are-intechopen-authors-and-editors-20210122",title:"Stanford University Identifies Top 2% Scientists, Over 1,000 are IntechOpen Authors and Editors"},{slug:"intechopen-authors-included-in-the-highly-cited-researchers-list-for-2020-20210121",title:"IntechOpen Authors Included in the Highly Cited Researchers List for 2020"},{slug:"intechopen-maintains-position-as-the-world-s-largest-oa-book-publisher-20201218",title:"IntechOpen Maintains Position as the World’s Largest OA Book Publisher"},{slug:"all-intechopen-books-available-on-perlego-20201215",title:"All IntechOpen Books Available on Perlego"}]},book:{item:{type:"book",id:"1904",leadTitle:null,fullTitle:"Automation",title:"Automation",subtitle:null,reviewType:"peer-reviewed",abstract:'This is how Dr. Kongoli views the role of Automation in the modern world: \nAutomation is closely related to the modern need for sustainable development in the 21st century. One of the principles of sustainability is "Doing More with Less" which in other words, is also one of the goals of automation. By replacing the routine part of human labor with the use of machines, automation not only increases productivity and the quality of products beyond what can be achieved by humans but also frees space, time and energy for humans to deal with the new, non-routine challenge of developing innovative and more advanced technologies. This magnificent cycle in which established developments are automated and the free resources achieved by this automation are used to develop newer technologies that are subsequently automated is one of the most successful recipes for the human race towards the goal of sustainable development.',isbn:null,printIsbn:"978-953-51-0685-2",pdfIsbn:"978-953-51-6220-9",doi:"10.5772/2327",price:159,priceEur:175,priceUsd:205,slug:"automation",numberOfPages:562,isOpenForSubmission:!1,isInWos:1,hash:"5c36455d273d4c06b17a2ff1f239b9b9",bookSignature:"Florian Kongoli",publishedDate:"July 25th 2012",coverURL:"https://cdn.intechopen.com/books/images_new/1904.jpg",numberOfDownloads:76127,numberOfWosCitations:29,numberOfCrossrefCitations:48,numberOfDimensionsCitations:60,hasAltmetrics:0,numberOfTotalCitations:137,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"May 26th 2011",dateEndSecondStepPublish:"June 23rd 2011",dateEndThirdStepPublish:"October 28th 2011",dateEndFourthStepPublish:"November 27th 2011",dateEndFifthStepPublish:"March 26th 2012",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6,7",editedByType:"Edited by",kuFlag:!1,editors:[{id:"109973",title:"Dr.",name:"Florian",middleName:null,surname:"Kongoli",slug:"florian-kongoli",fullName:"Florian Kongoli",profilePictureURL:"https://mts.intechopen.com/storage/users/109973/images/2145_n.jpg",biography:"Dr. Florian Kongoli – Short Biography\n\nDr. Florian Kongoli, [BSc (Honors), MScA (Canada), PhD (Japan)/ MTMS, MGDMB, MCIM, MSME, MAIST,MISIJ, MSigmaXi, MIFAC, MACS, MASM, MMRS, MACerS, MECS] is CEO of FLOGEN Technologies Inc. (www.flogen.com), a high-tech technology company independently incorporated in Canada and USA, specializing among others in process control, optimization and automation as well as the development of new sustainable technologies for metallurgical, chemical and environmental industries in both non-ferrous (Ni, Cu, Zn, Pb, Fe-Ni, Fe-Cr, PGMs, etc.) extraction and processing as well as in iron and steel making and processing. \n \nHe has about 20 years of industrial research and development and academic (lecturer) experience spread across many invited engagements in Asia, Australia, Europe, North America and South America. He has a rich background in both industrial projects and pure scientific ones dealing with control, optimization and automation of processes and flowsheets; physical and thermochemical modeling; physicochemical properties mattes, slags, metals, gases, oxysulfides etc. He has worked and successfully carried out many industrial projects for more than 47 well-known metallurgical and chemical companies such as Mitsubishi Materials Corporation and Sumitomo Metal Mining (Japan), Falconbridge (now Xstrata-Canada), Western Mining Corporation (now BHP Billiton-Australia), to mention just a few. In his work he has cooperated with several well-known universities around the world such as Tohoku University (Japan), Curtin University (Australia) and University of Montreal (Canada), amongst others . \n\nDr. Kongoli has published/edited 31 books and about 90 scientific articles in the last 5 years in peer review journals and other publications dealing with process control, optimization and automation, development of novel sustainable technologies, modeling of various properties of industrial mattes, slags, metals, effect of minor components, fluxing strategies, etc. He has delivered in 20 countries around the world about 130 plenary, keynote and invited presentations as well as articles, technical reports and research presentations. The results of his work and FLOGEN’s control and automation systems have been used by several companies around the world. He has also taught several continuing education courses including “Sulfide Smelting: Principles, Technologies and Environmental Considerations” held in San Diego, CA, 2003 and “Modern Technologies in Non-Ferrous Smelting & Recycling: Efficiency, Control, Energy and Environmental Issues”, held in Cancun, Mexico, November 27th to December 1st 2011. \n\nHe has served in many leadership positions in national and international organizations. He has been and actually is Chair/Vice-Chair/member of about 20 professional society committees and has been a chair of about 25 technical sessions. He is Editorial/Scientific Board member of several Professional Journals including: The Minerals and Metallurgical Processing Journal (USA), Mineral Processing and Extractive Metallurgy (UK/Australia), Erzmetall (Germany), European Journal of Mineral Processing and Environmental Protection (Turkey/Europe), Journal of Metallurgy (USA/Egypt), Journal of International Environmental Application & Science (Turkey/Europe), Journal of Mining and Metallurgy (Serbia/Europe), Journal of Industrial Engineering (USA/Egypt, InTech (Croatia/Europe and Shanghai/China). He is also a peer reviewer in various professional journals. He has been member of Organizing Committees or Scientific Committees of about 50 Professional International conferences in all continents. \n\nHe is also chairman of FLOGEN STAR OUTREACH (www.flogen.org), a non-profit international organization dedicated to giving STAR power to scientists, technologists and engineers and their supporters who help them towards realizing the goal of a sustainable future . In this framework he has successfully organized and chaired several record-bearing International Symposiums dedicated to famous personalities in science and technology. Among those are: \n \nYazawa International Symposium on Metallurgical and Materials Processing: Principles and Technologies (www.flogen.org/conferences.php?spage=3) held in San Diego California, USA, March 2003 with 31 sessions and more than 3000 pages of publications from authors from 36 countries around the world - the biggest International Symposium at the time in its class.\n\nSohn International Symposium on Advanced Processing of Metals and Materials: Principles, Technologies and Industrial Practice (www.flogen.org/conferences.php?spage=2), held in San Diego California, USA, in August 2006, a new record in its class over passing the magnitude of the previous symposium with about 500 papers from authors from 80 countries and about 6000 pages of publications. \n\nFray International Symposium on Metals and Materials Processing in a Clean Environment (www.flogen.org/conferences.php?spage=1), held in Cancun, Mexico, in November-December, 2011, another record symposium in many aspects in its class with about 500 abstracts from authors from 85 countries around the world, 230 sponsoring societies and organizations worldwide, 10 Major Industrial Corporations and 3 governments financial sponsors and 7 volumes of Publications of more than 4000 pages\n\nHe was also organized and chaired other theme-based International Symposium such as “Process Control and Optimization in Ferrous and Non-Ferrous Industry” held in Chicago, Illinois, USA in November 2003 (www.flogen.com/ControlSymposium) as well as the American Automatic Control Council/IFAC symposium of Automation in Mining, Mineral and Metals to be held in San Diego, California in 2013\n\nHe has excellent business management and organizations skills which have been instrumental in steering his company toward new ground breaking technologies.",institutionString:null,position:"CEO",outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"1",institution:null}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"715",title:"Automotive Technology and Engineering",slug:"automotive-technology-and-engineering"}],chapters:[{id:"37986",title:"Optimization of IPV6 over 802.16e WiMAX Network Using Policy Based Routing Protocol",doi:"10.5772/50592",slug:"optimization-of-ipv6-over-802-16e-wimax-network-using-policy-based-routing-protocol",totalDownloads:1901,totalCrossrefCites:0,totalDimensionsCites:0,signatures:"David Oluwashola Adeniji",downloadPdfUrl:"/chapter/pdf-download/37986",previewPdfUrl:"/chapter/pdf-preview/37986",authors:[{id:"115636",title:"Mr.",name:"Oluwashola",surname:"Adeniji",slug:"oluwashola-adeniji",fullName:"Oluwashola 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The advancement of pre-hospital airway control procedures and equipment represents the evolution of pre-hospital triage and emergency care.
The spectrum of airway management outside of the hospital involves a wide array of skills and techniques, starting with basic airway skills that are included in basic life support training (BLS) such as mouth to mouth or mouth to nose ventilation and use of the simple oxygen face masks, moving to intermediate airway management techniques like bag mask ventilation or use of oral and nasal airway devices, ending with advanced airway management techniques like use of supraglottic devices, endotracheal intubation or surgical airway techniques.
Prehospital airway management services are provided by a spectrum of providers who have different levels of training and skills. For example, basic airway skills can be provided by a lay person since it has been taught to the public for decades now. Intermediate and advanced skills are performed by emergency medical service responders, who also have a variable level of training. The majority of the Emergency Medical Service (EMS) systems around the world utilize non-physician providers, while in other countries they do operate with a physician staffed EMS.
Airway management in the prehospital setting has major challenges. Achieving a successful airway management requires a collection of adjustments that involve equipment, personnel and medication in a simultaneous fashion. In addition to the logistic challenges an effort in identifying the patient who need urgent advanced airway management techniques from those whom basic airway maneuvers are adequate. Over the years prehospital airway management has become progressively formalized, local and international associations in different countries has put in place guidelines to improve patient safety and standardize the process. Although there are noticeable differences in EMS infrastructure in different countries which are reflected in those different guidelines, needless to say the purpose of those guidelines is the same, with the main focus being the patient safety.
In general, most of the protocols suggest that advanced airway management techniques should only be carried out by appropriately skilled personnel, at the same time attention should focus on performing high quality basic airway maneuvers when personnel with advanced airway skills aren’t immediately available.
In certain circumstances, when other airway equipment’s aren’t available this technique can be used initially to maintain oxygenation and ventilation. A barrier should be used to avoid infection transmission [1].
Adults:
Head-tilt/chin-lift to open the airway while pinching the person’s nose closed and the hand over his head. The lips have to surround the mouth to create a seal. Start to blow into the person’s mouth for one second and watch the chest rise. This maneuver is contraindicated when cervical spine injuries are suspected.
Pediatrics:
Head-tilt/chin-lift to open the airway. The lips have to surround the mouth and nose of the child to create a seal. Blow gently the child’s nose mouth for one second. Note that the infant’s lungs need a smaller volume of air than an adult., Watch the chest rise while blowing.
It is performed when the rescuer is dealing with a spontaneously breathing patient assisting him to maintain adequate oxygenation and ventilation, with the aid of simple of equipment such as oral or nasal airway devices that can maintain upper airway patency.
Oxygenation can be maintained via simple face mask, nasal cannula or non-rebreathing face mask. Continuous positive pressure ventilation (CPAP) by applying a fitting mask to allow CPAP with spontaneous ventilation can also be implemented in special circumstances when deemed appropriate. This method is found to decrease rates of intubation and mortality [2].
It is a standard maneuver for initial airway management, the mask applied to the patient’s mouth and nose with a properly tight seal being formed between the patient’s mouth and the mask to improve oxygenation and ventilation.
It can also be used if endotracheal intubation is planned to avoid oxygen desaturation during the process of intubation.
BMV can be applied by one person using one hand bag mask ventilation technique or by two providers using two hand bag mask ventilation technique in cases were mainting proper seal and proper ventilation becomes difficult.
They are used frequently by prehospital rescuers for spontaneous and assisted breathing to improve both oxygenation and ventilation. They should be avoided in patients suffering from facial and head injuries.
The oropharyngeal airway device is ideal for use in unresponsive or unconscious patients who have depressed airway reflexes. Keeping in mind that patient with intact gag reflex might not be able to tolerate the device. On the other hand, The nasopharyngeal airway is usually better tolerated by conscious patients, it is useful also in patients having trauma to oral structures. The proper size should be carefully selected.
SGA is a broad term for devices which sits above the glottic opening, examples includes laryngeal masks, Proseal LMA, Intubating LMA (ILMA, Fastrach), LMA Supreme, LMA Protector, i-gel (with non-inflatable cuff).
The ease of use for non-experienced personnel, makes those devices an appealing option for the use in the out of hospital environment or remote setup. SGA insertion does not require sophisticated skills, it provides proper means of ventilation and oxygenation in unconscious patients. Those features helped the adoption of such devices and increased their use worldwide. Moreover, SGA has become a backup tool in failed intubation in accordance with the difficult airway algorithm by the American Society of Anesthesia (ASA) [3]. Unfortunately, these devices do not protect from aspiration and may induce soft tissue trauma.
These devices have an extra advantage over the other SGA by having large pharyngeal tubes to seal the oropharynx or esophageal balloons to seal the esophagus so they can provide oxygenation and ventilation with reasonable protection from aspiration. They are easy to use and do not require advanced training.
A group of airways includes Laryngeal tube [4], Esophageal tracheal airway (Combitube) which be either inserted in the trachea or esophagus, King laryngeal tube (LT), Rusch EasyTube unlike the Combitube, Intubating Laryngeal Tube Suction Disposable (iLTS-D).
Endotracheal intubation is considered the gold standard method of airway management, which allows proper oxygenation, positive pressure ventilation, positive end-expiratory pressure (PEEP), and protection from gastric content aspiration. The performance of ETI requires advanced training and highly skilled personnel, keeping in mind that out of hospital ETI is carried out in suboptimal environment and unusual positions. First attempt ETI among EMS providers in an Australian cohort study was found to be around 80%, non the less, the paramedic experience was not associated with improved patient survival [5]. But in other studies the first-pass intubation was correlated with improved return of spontaneous circulation rate and survival [6]. Those conflicting result highlights the importance of the approach to airway management, experience in performing one specific procedure like ETI does not warrant a better outcome, moreover literature suggest that out of hospital ETI is not achieving the goals it intended for and that in some cases it might even cause harm [7].
The fundamental role of performing ETI in the Field is to improve patient outcome. There are multiple studies that have looked into the morbidity and mortality of field ETI compared to other airway management maneuvers like the use of supraglottic/extra-glottic devices or bag mask ventilation, most of the studies had an inconclusive results on survival or outcome. In a recent study of the national database of Thailand registry that looked into the return of spontaneous circulation (ROSC) in out of hospital cardiac arrest patients who received ETI vs. bag mask ventilation, both groups had comparable ROSC rate although the bag mask ventilation group had less severe condition and received faster treatment [8]. In a meta-analysis by Benoit and his colleagues that investigated the outcome of out of hospital ETI vs. SGA insertion in patients with cardiac arrest among more than 75,000 patients, they concluded that patients who arrested outside of the hospital had better outcome when they received ETI rather than SGA device by EMS providers, specifically speaking ROSC, survival to hospital admission and neurological outcome were all better in the ETI group [9]. Similar conclusion was demonstrated by a study of the Korean nationwide registry that studied the survival of out of hospital cardiac arrest in approximately 100,000 patients who received bag mask ventilation vs. ETI vs. SGA, ETI group had favorable outcomes compared to both other groups [10].
Out of hospital endotracheal intubation brings a lot of challenges to the provider, other than just performing the procedure itself, other complication can occur, like misplacement of the endotracheal tube, hemodynamic changes associated with the intervention and their pathophysiological impact on the disease process itself, intervention with the resuscitation efforts, airway trauma and others.
In an observational study at level trauma center the rate of endotracheal misplacement without the use of continuous end-tidal carbon dioxide (ETCO2) monitoring was around 23%, using ETCO2 continuous monitor reduced it to around zero [11].
Rapid Sequence Intubation (RSI) is an airway management technique that aims toward controlling the airway in the emergency setting in the fastest and safest means possible, that might require the use of anesthetic induction agents and neuromuscular blocking agents in order to minimize the possibility of gastric content aspiration during endotracheal intubation. Rapid sequence induction technique is further discussed in another chapter.
The debate over whether to use RSI vs. intubation without the use of medications to facilitate the process of intubation in the prehospital setting is still ongoing. Despite that the use of medications in RSI provides optimum conditions for successful endotracheal intubation but it does not goes without risks, mainly because of the significant hemodynamic changes associated with the use of anesthetic induction agents and the possibility of development of difficult airway scenario and loss of spontaneous ventilation after the use of muscle relaxants.
The use of medications to assist endotracheal intubation provides conditions that properly optimize the procedure. Factors that might be associated with failure to intubate like inability to pass the tube through the vocal cords, inability to visualize the cords, trismus and presence of gag reflex, can all be resolved with the use of medications to assist the endotracheal tube insertion [12]. Bernard et al. in a randomized clinical trial concluded that the neurological outcome of patients with severe traumatic brain injury was better when out of hospital RSI is performed by paramedics compared with intubation in the hospital setting [13].
In a study that evaluated the outcome in patients with severe traumatic brain injury who received RSI by paramedics compared to matched non intubated historical controls, concluded that RSI group had increase in mortality [14]. Moreover RSI led to prolonged on scene time and thus delayed transfer to the hospital.
Therefor the decision whether to incorporate RSI vs. non medication intubation should be individualized based on the level of training of EMS providers as well as the level of resources provided by the health care system.
Management of hypoxia thus management of the airway is of a paramount importance for trauma victims, trauma is one of the leading causes of death among the young adult population, and number of potentially preventable prehospital death is high, reaching up to 43% according to a recent review [15], the majority are due to the missed opportunity of performing a proper basic airway management technique.
Airway management of trauma cases is challenging due to many factors, some are directly related to the type of trauma like trauma to the face or the respiratory tract, while others are related to the hypovolemia as a result of the trauma insult. Cervical spine injuries present a specific set of challenges that would render managing the airway in such population quite difficult and might need special equipment and techniques to maintain patient safety.
Since upper airway obstruction is one of most important factors of morbidity and mortality in trauma victims, identifying the factors that would lead to airway mismanagement is very important. Factor that would contribute to airway mismanagement include [16]:
Inability to recognize an inadequate airway |
Inability to establish a clear airway with or without airway device |
Inability to recognize a misplaced airway device |
Failure of maintenance of a previously established airway due to displacement of the airway device |
Inability to recognize the need for ventilation |
Aspiration of gastric content |
Special attention to patients who might have potential inadequate respiration such as patient with decreased level of consciousness due to head injury or intoxication, patients with direct trauma to the airway, facial and maxillary region, neck, larynx or throat, patient with significant blood loss and patients who might develop respiratory failure due to a blast, inhalational injury or exposure to chemical agent.
In most of the cases of trauma victims, simple maneuvers are usually sufficient to overcome upper airway obstruction, but in cases were simple techniques were ineffective the aim should be toward establishing a definitive airway technique. In an prospective observation study Lockery and his colleagues investigated the effectiveness prehospital advanced airway management in trauma patient, among the patient whom had received advanced airway management technique around 57% of them had airway compromise upon there arrival to the trauma centers, the success rate of ETI for non-physician paramedic was 64% and 11% reached a health care facility with unrecognized esophageal intubation. While physician-paramedic teams achieved definitive airway management for all patients [17]. Therefore, level of training, and availability of expertise are important in situations when advanced airway technique is warranted in trauma patient population group.
Advanced airway management techniques include ETI or a surgical airway. Below is a list of the most common indications for advanced airway technique in trauma victims.
Apneic patient |
Protect from aspiration of vomitous content or airway bleeding |
Reduced level of consciousness (Glasgow Coma Scale <8) |
Significant faciomaxillary fractures |
Patient who is at risk of upper airway obstruction: neck hematoma, laryngeal and tracheal injury |
Inhalational injury with impending or potential airway compromise |
Failure to maintain oxygenation using facemask or BiPAP/CPAP |
It is recommended to assume that patients with major trauma, head and facial injuries, decreased level of consciousness or with neck pain as having cervical spine injury thus warranting cervical immobilization techniques to prevent further damage. Cervical immobilization has been known to attribute to difficulties with laryngoscopic view and hence difficult airway management. In a prospective study by Heath, that investigated the effect of different cervical spine immobilization techniques on the ease of laryngoscopy, poor view on laryngoscopy (grade 3 or 4) was more encountered when the cervical spine immobilized using rigid collar, tapes and sandbags compared to in-line manual immobilization. Therefore, manual in-line stabilization of cervical spine is the method of choice during tracheal intubation [18].
Airway management in pediatrics is relatively difficult and requires highly skilled and professional personnel, this difficulty is based on the physiological, anatomical differences between infant, pediatric, and adult airways [19]. These differences included in the following table:
Large occiput |
Relatively larger tongue and small mouth |
High and anterior larynx |
Large and floppy epiglottis |
Subglottic narrowing at the cricoid cartilage |
Foreign body aspiration is a common problem in the pediatric population, it may cause severe airway obstruction and might mandates immediate intervention. Other causes that might mandate airway intervention in the pediatric group include epiglottitis, viral croup, trauma, seizures, hypoxia, and cardiac arrest.
The use of prehospital advanced airway management techniques in the pediatric population have shown to have a conflicting result, in a recent nationwide cohort study, that looked into the outcome of out of hospital cardiac arrest in the pediatric population of japan, the use of advanced airway management technique including ETI and supraglottic devices did not demonstrate any improvement in 1-month survival or functional status when compared to the use of basic airway techniques [20].
Despite the conflicting results of the use of advanced airway management techniques, the use of supraglottic airway devices has been shown to easy, simple and with minimal complications in simulated pediatric cardiac arrest scenarios [21].
A useful tool to help guiding the sizes and dosages of the equipment and medications in the pediatric group is the Broselow Pediatric Emergency Tape, also known as the Broselow Tape, a color-coded tape that matches the measured height to the child’s expected weight and other needed information.
Inhalational injury is a broad non-specific term that encompasses damage inflicted by heat, smoke, or chemical irritants to the respiratory tract or lung tissue.
Inhalational injury is commonly associated with burn injuries, around 10–20% of burn victims also suffered from inhalational injury complications that increased morbidity and mortality [22], moreover inhalation injury is considered an independent predictor of mortality in burn victims.
All burn patients should receive humidified 100% oxygen though a facemask to displace carbon monoxide [23], Advanced Life support of the American burn association recommends early endotracheal intubation, if there is any of the following indicators:
Signs of Airway obstruction
Total burn surface area more than 40%
Extensive facial burns or involvement of the oral cavity
Significant facial edema.
Difficult swallowing
Signs of respiratory distress
Disturbed level of consciousness
In patient with large burns, absence of qualified personnel to perform intubation during transfer.
Current recommendations for the airway management of patient with respiratory failure due to novel Corona virus II infection are focusing on in-hospital health care providers. While neglecting to provide guidance for EMS providers in the pre-hospital setting.
The in-hospital airway management recommendations of COVID-19 patients can be summarized in the following points:
Always use proper personal protective equipment (PPE) during the contact with the patient.
A surgical mask should be placed over the patient face to reduce the risk of spreading the infection, it can be placed over a nasal canula as well.
Bag-mask-ventilation should be restricted to minimum if any to minimize aerosol generation.
Rapid sequence intubation technique with video laryngoscopy is highly recommended.
Regarding the pre-hospital airway management, EMS providers should be able to identify suspected COVID 19 patients. To screen the patients EMS providers should inquire about the following: Recent history of travel, close contact with a known COVID 19 case, or with a person with flu like symptoms, worsening dyspnea, myalgia, sore throat, dry cough and/or GI symptoms. All precautions should be taken when dealing with patients reporting difficulty in breathing, or flu like sickness.
When handling COVID 19 patients appropriate PPE should be worn. That includes N95 mask, gown, gloves, and eye protection. To prevent further contamination a surgical mask should be provided to the suspected patient as soon as possible.
Similar to the in-hospital airway management protocols, rapid sequence intubation with video laryngoscopy is highly recommended when endotracheal intubation is warranted in the prehospital setting. Providers should not attempt more than one endotracheal intubation trial, if it wasn’t successful the provider should proceed to SGA insertion. HEPA filter should be applied to avoid equipment contamination. Bag-mask ventilation should be restricted to minimum, but in scenarios where the bag-mask ventilation is inevitable two-person mask ventilation technique, and the use of airway adjuncts are recommended to improve the mask seal [24].
The use of video assisted devices for endotracheal intubation has been gaining solid ground over the past recent years, especially as the cost of the technology has become lower.
Several recent studies have concluded that the use of video assisted devices has significantly increased the first-pass success rate as well as the overall success rate compared to the use of direct laryngoscopy [25, 26, 27]. Moreover, the use of video assisted devices for intubation has shown a faster learning curve compared to direct laryngoscopy [28], such feature might increase the use of advanced airway techniques by the paramedics in the field over time.
One of the downsides of using video assisted devices in the field is the potential difficulty of visualizing the vocal cords in the presence of blood and vomitus specially in trauma patients, another downside is that direct sun light might interfere with the visualization of video monitor [29].
These Terms and Conditions outline the rules and regulations pertaining to the use of IntechOpen’s website www.intechopen.com and all the subdomains owned by IntechOpen located at 5 Princes Gate Court, London, SW7 2QJ, United Kingdom.
',metaTitle:"Terms and Conditions",metaDescription:"These terms and conditions outline the rules and regulations for the use of IntechOpen Website at https://intechopen.com and all its subdomains owned by Intech Limited located at 7th floor, 10 Lower Thames Street, London, EC3R 6AF, UK.",metaKeywords:null,canonicalURL:"/page/terms-and-conditions",contentRaw:'[{"type":"htmlEditorComponent","content":"By accessing the website at www.intechopen.com you are agreeing to be bound by these Terms of Service, all applicable laws and regulations, and agree that you are responsible for compliance with any applicable local laws. Use and/or access to this site is based on full agreement and compliance of these Terms. All materials contained on this website are protected by applicable copyright and trademark laws.
\\n\\nThe following terminology applies to these Terms and Conditions, Privacy Statement, Disclaimer Notice, and any or all Agreements:
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\\n\\nAll Terms refer to the offer, acceptance, and consideration of payment necessary to provide assistance to the Client in the most appropriate manner, whether by formal meetings of a fixed duration, or by any other agreed means, for the express purpose of meeting the Client’s needs in respect of provision of the Company’s stated services/products, and in accordance with, and subject to, the prevailing laws of the United Kingdom.
\\n\\nAny use of the above terminology, or other words in the singular, plural, capitalization and/or he/she or they, are taken as interchangeable.
\\n\\nUnless otherwise stated, IntechOpen and/or its licensors own the intellectual property rights for all materials on www.intechopen.com. All intellectual property rights are reserved. You may view, download, share, link and print pages from www.intechopen.com for your own personal use, subject to the restrictions set out in these Terms and Conditions.
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\\n\\nIntechopen.com website content and services are provided on an "AS IS" and an "AS AVAILABLE" basis. Material appearing on www.intechopen.com could include minor technical, typographical, or photographic errors. IntechOpen may make changes to any material contained on its website at any time without notice.
\\n\\nIntechOpen has no formal affiliation to any external sites that link to www.intechopen.com, unless otherwise specifically stated. As such, it is not responsible for content that appears on any such sites. The inclusion of any link to IntechOpen does not imply endorsement by IntechOpen. Use of any such linked website is done solely at the user's own discretion.
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\\n\\nIf you find any link on our website, or any linked website, objectionable for any reason, please Contact Us. We will consider all requests to remove links but will have no obligation to do so.
\\n\\nWithout prior approval and express written permission, you may not create frames around our web pages or use other techniques that alter in any way the visual presentation or appearance of our website.
\\n\\nIntechOpen may revise its Terms of Service for its website at any time without notice. By using this website, you are agreeing to be bound by the current version of all Terms at the time of use.
\\n\\nThese Terms and Conditions are governed by and construed in accordance with the laws of the United Kingdom and you irrevocably submit to the exclusive jurisdiction of the courts in London, United Kingdom.
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\\n"}]'},components:[{type:"htmlEditorComponent",content:'By accessing the website at www.intechopen.com you are agreeing to be bound by these Terms of Service, all applicable laws and regulations, and agree that you are responsible for compliance with any applicable local laws. Use and/or access to this site is based on full agreement and compliance of these Terms. All materials contained on this website are protected by applicable copyright and trademark laws.
\n\nThe following terminology applies to these Terms and Conditions, Privacy Statement, Disclaimer Notice, and any or all Agreements:
\n\n“Client”, “Customer”, “You” and “Your” refers to you, the person accessing this website and accepting the Company’s Terms and Conditions;
\n\n“The Company”, “Ourselves”, “We”, “Our” and “Us”, refers to our Company, IntechOpen;
\n\n“Party”, “Parties”, or “Us”, refers to both the Client and ourselves, or either the Client or ourselves.
\n\nAll Terms refer to the offer, acceptance, and consideration of payment necessary to provide assistance to the Client in the most appropriate manner, whether by formal meetings of a fixed duration, or by any other agreed means, for the express purpose of meeting the Client’s needs in respect of provision of the Company’s stated services/products, and in accordance with, and subject to, the prevailing laws of the United Kingdom.
\n\nAny use of the above terminology, or other words in the singular, plural, capitalization and/or he/she or they, are taken as interchangeable.
\n\nUnless otherwise stated, IntechOpen and/or its licensors own the intellectual property rights for all materials on www.intechopen.com. All intellectual property rights are reserved. You may view, download, share, link and print pages from www.intechopen.com for your own personal use, subject to the restrictions set out in these Terms and Conditions.
\n\nWe employ the use of cookies. By using the IntechOpen website you consent to the use of cookies in accordance with IntechOpen’s Privacy Policy. Most modern day interactive websites use cookies to enable the retrieval of user details for each visit. On our site, cookies are predominantly used to enable functionality and ease of use for those visiting the site.
\n\nIn no circumstances shall IntechOpen or its suppliers be liable for any damages (including, without limitation, damages for loss of data or profit, or due to business interruption) arising out of the use, or inability to use, the materials on IntechOpen's websites, even if IntechOpen or an IntechOpen authorized representative has been notified orally or in writing of the possibility of such damage. Some jurisdictions do not allow limitations on implied warranties, or limitations of liability for consequential or incidental damages; consequently, these limitations may not apply to you.
\n\nIntechopen.com website content and services are provided on an "AS IS" and an "AS AVAILABLE" basis. Material appearing on www.intechopen.com could include minor technical, typographical, or photographic errors. IntechOpen may make changes to any material contained on its website at any time without notice.
\n\nIntechOpen has no formal affiliation to any external sites that link to www.intechopen.com, unless otherwise specifically stated. As such, it is not responsible for content that appears on any such sites. The inclusion of any link to IntechOpen does not imply endorsement by IntechOpen. Use of any such linked website is done solely at the user's own discretion.
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\n\nIf you find any link on our website, or any linked website, objectionable for any reason, please Contact Us. We will consider all requests to remove links but will have no obligation to do so.
\n\nWithout prior approval and express written permission, you may not create frames around our web pages or use other techniques that alter in any way the visual presentation or appearance of our website.
\n\nIntechOpen may revise its Terms of Service for its website at any time without notice. By using this website, you are agreeing to be bound by the current version of all Terms at the time of use.
\n\nThese Terms and Conditions are governed by and construed in accordance with the laws of the United Kingdom and you irrevocably submit to the exclusive jurisdiction of the courts in London, United Kingdom.
\n\nCroatian version of Terms and Conditions available here
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He is the member of many Pharmaceutical Associations and acts as a reviewer of scientific journals and European projects under different research areas such as: drug delivery systems, nanotechnology and pharmaceutical biotechnology. Dr. Sezer is the author of many scientific publications in peer-reviewed journals and poster communications. Focus of his research activity is drug delivery, physico-chemical characterization and biological evaluation of biopolymers micro and nanoparticles as modified drug delivery system, and colloidal drug carriers (liposomes, nanoparticles etc.).",institutionString:null,institution:{name:"Marmara University",country:{name:"Turkey"}}},{id:"61051",title:"Prof.",name:"Andrea",middleName:null,surname:"Natale",slug:"andrea-natale",fullName:"Andrea Natale",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"100762",title:"Prof.",name:"Andrea",middleName:null,surname:"Natale",slug:"andrea-natale",fullName:"Andrea Natale",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"St David's Medical Center",country:{name:"United States of America"}}},{id:"107416",title:"Dr.",name:"Andrea",middleName:null,surname:"Natale",slug:"andrea-natale",fullName:"Andrea Natale",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Texas Cardiac Arrhythmia",country:{name:"United States of America"}}},{id:"64434",title:"Dr.",name:"Angkoon",middleName:null,surname:"Phinyomark",slug:"angkoon-phinyomark",fullName:"Angkoon Phinyomark",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/64434/images/2619_n.jpg",biography:"My name is Angkoon Phinyomark. I received a B.Eng. degree in Computer Engineering with First Class Honors in 2008 from Prince of Songkla University, Songkhla, Thailand, where I received a Ph.D. degree in Electrical Engineering. My research interests are primarily in the area of biomedical signal processing and classification notably EMG (electromyography signal), EOG (electrooculography signal), and EEG (electroencephalography signal), image analysis notably breast cancer analysis and optical coherence tomography, and rehabilitation engineering. I became a student member of IEEE in 2008. During October 2011-March 2012, I had worked at School of Computer Science and Electronic Engineering, University of Essex, Colchester, Essex, United Kingdom. In addition, during a B.Eng. I had been a visiting research student at Faculty of Computer Science, University of Murcia, Murcia, Spain for three months.\n\nI have published over 40 papers during 5 years in refereed journals, books, and conference proceedings in the areas of electro-physiological signals processing and classification, notably EMG and EOG signals, fractal analysis, wavelet analysis, texture analysis, feature extraction and machine learning algorithms, and assistive and rehabilitative devices. I have several computer programming language certificates, i.e. Sun Certified Programmer for the Java 2 Platform 1.4 (SCJP), Microsoft Certified Professional Developer, Web Developer (MCPD), Microsoft Certified Technology Specialist, .NET Framework 2.0 Web (MCTS). 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