Jasvinder Kaur - Academia.edu (original) (raw)

Papers by Jasvinder Kaur

Research paper thumbnail of The case of a theatrical spill – Should volatile anesthetic glass bottles be encased?

Acta Anaesthesiologica Taiwanica, 2011

Acta Anaesthesiologica Taiwanica, Volume 49, Issue 1, Pages 35-36, March 2011, Authors:Goneppanav... more Acta Anaesthesiologica Taiwanica, Volume 49, Issue 1, Pages 35-36, March 2011, Authors:Goneppanavar Umesh; Kaur Jasvinder; Shetty Nanda.

Research paper thumbnail of Solutions to Some of the Existing Problems With Breathing Equipment Type

Acta Anaesthesiologica Taiwanica, 2010

Despite the stringent guidelines laid down by the American Society of Anesthesiologists for equip... more Despite the stringent guidelines laid down by the American Society of Anesthesiologists for equipment checks, there are occasional reports of problems related to the equipment used to administer anesthesia. In this article, we discuss two important, albeit rare, problems associated with breathing equipment that have been reported in the literature. The rarity of these problems in itself may hinder early diagnosis because anesthesiologists do not usually consider these problems to be the cause of an ongoing patient morbidity. The first problem discussed here is the presence of a foreign body within the breathing system used to administer anesthesia. The second problem discussed is a kink in the breathing circuits that can precipitate lifethreatening problems if it is not detected early enough.

Research paper thumbnail of Nasopharyngeal airway as a diagnostic and therapeutic tool in difficult airway

Indian Journal of Anaesthesia, 2014

Research paper thumbnail of Should the arrhythmias that occur upon return of spontaneous circulation be treated?

Research paper thumbnail of Two-person paediatric resuscitation (basic life support)—Defining the role of the second rescuer

Resuscitation, 2008

RefDoc Bienvenue - Welcome. Refdoc est un service / is powered by. ...

Research paper thumbnail of Management of laryngospasm - our concerns and suggestions

Pediatric Anesthesia, 2008

... Management of laryngospasm – our concerns and suggestions. Goneppanavar Umesh,;Kaur Jasvinder... more ... Management of laryngospasm – our concerns and suggestions. Goneppanavar Umesh,;Kaur Jasvinder,; Venkateswaran Ramkumar. Article first published online: 2 SEP 2008. DOI: 10.1111/j.1460-9592.2008.02650.x. © 2008 The Authors. ...

Research paper thumbnail of Lightwand for confirming tracheal intubation in the presence of severe postintubation bronchospasm

Pediatric Anesthesia, 2012

Research paper thumbnail of Improvement in oxygenation with return of spontaneous ventilation during repair of congenital diaphragmatic hernia

Pediatric Anesthesia, 2008

Research paper thumbnail of Airway Management Technique for Vascular Mass in the Oral Cavity

Journal of Neurosurgical Anesthesiology, 2009

... Airway Management Technique for Vascular Mass in the Oral Cavity. Umesh, Goneppanavar MD; Dee... more ... Airway Management Technique for Vascular Mass in the Oral Cavity. Umesh, Goneppanavar MD; Deepak, Kavaraganahalli MD; Jasvinder, Kaur MD. ... Kaur Jasvinder, MD. Department of Anaesthesiology, Kasturba Medical College, Manipal Karnataka, India. ...

Research paper thumbnail of Umesh’s intubation detector (UID) for rapid and reliable identification of tracheal intubation by novices in anaesthetised, paralysed adult patients

Journal of Clinical Monitoring and Computing, 2013

Oesophageal intubation can lead to life threatening complications if left undetected. Several dev... more Oesophageal intubation can lead to life threatening complications if left undetected. Several devices and techniques are available to confirm tracheal intubation and for early detection of oesophageal intubation. This study was carried out to evaluate the utility of the Umesh's intubation detector device for rapid and reliable differentiation of tracheal from oesophageal intubation by novice users. In this prospective, double blind and randomised study, 100 healthy patients undergoing general anaesthesia with endotracheal intubation received two identical size endotracheal tubes; one inserted into trachea and the other into the oesophagus. The Umesh's intubation detector was connected to one of the tubes randomly and a novice was asked to observe for inflation of the reservoir bag of the device while two chest compressions of approximately one inch each were given to the patient. Out of the total 100 tracheal intubations, 96 were correctly identified while the observers could not clearly conclude whether the tube was in trachea or oesophagus in the other four patients. Out of the total 100 oesophageal intubations, 99 were correctly identified. There were no complications related to the study. Umesh's intubation detector device can be used by novices for rapid and reliable differentiation of tracheal from oesophageal intubation in healthy adult patients.

Research paper thumbnail of Low minimum alveolar concentration alarm: a standard for prevention of awareness during general anaesthesia maintained by inhalational anaesthetics

Journal of Clinical Monitoring and Computing, 2009

Awareness during general anaesthesia is a rare but significant problem that can be frightening to... more Awareness during general anaesthesia is a rare but significant problem that can be frightening to the patients. We suggest that newer generation monitors should include this facility to provide a low alarm limit to MAC settings so as to improve the quality of patient care. Also we suggest that a ''near empty'' alarm be incorporated into vaporizers which can warn the anaesthesiologist prior to development of possible light plane of anaesthesia. We hope that adopting these two features can help enhance patient safety and can further aid in quality assurance.

Research paper thumbnail of Tight reservoir bag: the bag itself may be the culprit

Journal of Clinical Monitoring and Computing, 2010

Numerous possibilities exist which may cause obstruction to ventilation under anesthesia resultin... more Numerous possibilities exist which may cause obstruction to ventilation under anesthesia resulting in a tight reservoir bag with low compliance. We report an interesting case where a reservoir bag twisted around its own neck and resulted in a tight bag situation. The neck portion of the reservoir bag would be hidden from the view of anesthesiologists in head and neck surgery and hence it is easier to miss early recognition of the twist. We caution all anesthesiologists using the disposable modified Jackson-Rees breathing system to be aware of such an eventuality. We also urge the manufacturer to consider strengthening the neck of the reservoir bag by improving the quality of the material used for its construction.

Research paper thumbnail of Arterial line for monitoring SpO2 in patients with ischemic peripheries

Journal of Clinical Monitoring and Computing, 2010

Monitoring the oxygenation status of patients with poor peripheral perfusion or ischemic peripher... more Monitoring the oxygenation status of patients with poor peripheral perfusion or ischemic peripheries is challenging in view of unreliable or unrecordable pulse oximeter data. In this article we describe a very simple and innovative technique of using the arterial line for reliable recording of arterial oxygen saturation (SpO 2 ) in such patients. We conclude that the arterial line can be used as an extension of the artery and SpO 2 may be reliably measured using the arterial line in such patients as long as the blood in the arterial tubing is pulsatile and a good contact is ensured between the arterial tubing and the sensor of the pulse oximeter.

Research paper thumbnail of A well centered chest X ray is a must for studying the relation between central line and trachea

Journal of Clinical Monitoring and Computing, 2012

We appreciate the interest shown by Lin and Tseng [1, 2] in our article. We understand the proble... more We appreciate the interest shown by Lin and Tseng [1, 2] in our article. We understand the problems faced by the authors in distinguishing the placement (artery or vein) of the left sided central venous catheter (CVC). A well centered chest X ray (CXR) is the most ...

Research paper thumbnail of Validation of the new intubation detector device: a manikin study

Journal of Clinical Monitoring and Computing, 2012

This study was done to validate the utility of Umesh&... more This study was done to validate the utility of Umesh's intubation detector in detection of tracheal or oesophageal intubation in manikin using volunteers with different levels of experience in tracheal intubation (including novices). The Sim Man II, (Laerdal Medical AS, Norway) manikin was used. Two cuffed tracheal tubes of size 6.5 mm ID were used. One was passed into the trachea and the other into oesophagus. The device was connected to one of the two tubes as per randomisation table and three high quality chest compressions were performed. Each volunteer participated in the study twice. Their opinion regarding the tube position (in trachea or oesophagus or could not determine) was noted. A total of 50 volunteers participated in the study. Eleven of them had not observed intubation (novice), 29 had either only observed or had experience of <10 tracheal intubations (less experienced) and 10 had experience of >10 intubations or >1 year experience in tracheal intubation (experienced). Out of a total 100 performances, 99 were correctly identified. On one instance, a tube placed in trachea was incorrectly interpreted to be in the oesophagus by a novice. Umesh's intubation detector helps in rapid and reliable confirmation of tracheal intubation in manikin irrespective of the experience level of the assessor in tracheal intubation.

Research paper thumbnail of Yet another cause for blocked sidestream capnogram––beware of the non-threaded cap mount in heat and moisture exchangers

Journal of Clinical Monitoring and Computing, 2009

N. Yet another cause for blocked sidestream capnogram--beware of the non-threaded cap mount in he... more N. Yet another cause for blocked sidestream capnogram--beware of the non-threaded cap mount in heat and moisture exchangers. J Clin Monit Comput 2009; 23:207-208 ABSTRACT. Heat and moisture exchangers (HME) are commonly used during general anaesthesia and intensive care of patients on mechanical ventilators. Some of the HME manufacturers provide HMEs with a Luer lock fitting for connecting side stream CO 2 monitoring line, Luer lock cap, and a non-threaded cap mount. However, HMEs from different manufacturers and HMEs meant for use in children and for adults from the same manufacturer vary in the presence/absence of non-threaded cap mount. This can create confusion to the clinicians and can result in inadvertent connection of the CO 2 monitoring line to the non-threaded cap mount resulting in blocked CO 2 monitoring line and leak in the circuit. We caution all the anaesthesiologists and intensivists regarding this possibility while using HMEs from different manufacturers.

Research paper thumbnail of Immediate postoperative airway obstruction secondary to airway edema following tumor excision from the neck

Journal of Anesthesia, 2009

A 46-year-old woman was scheduled for excision of a malignant peripheral nerve sheath tumor from ... more A 46-year-old woman was scheduled for excision of a malignant peripheral nerve sheath tumor from the neck. The tumor had caused deviation of the trachea to the left and partial obstruction of the superior vena cava. Her upper airway at laryngoscopy after induction of anesthesia was normal. During tumor resection there were transient phases characterized by the complete disappearance of the peripheral oxygen saturation (Sp(O2)) and radial artery tracings. At the end of the operation, the trachea was extubated after ensuring adequate antagonization of neuromuscular blockade. However, immediately post-extubation, she showed signs of acute airway obstruction that necessitated reintubation of the trachea. Laryngoscopy revealed significant edema of the upper airway and vocal cords, requiring a smaller size tracheal tube. Many reports suggest the development of significant airway edema 24 h after such surgery. Our report highlights the fact that this can happen in the immediate postoperative period also. Some authors suggest that, in such surgery, extubation should routinely be done over pediatric tube exchangers. Routine leak testing and direct laryngoscopic/fiberoptic evaluation of the upper airway prior to extubation may also help. While our report reaffirms these points, it also stresses the importance of intraoperative monitoring for the compression of the great vessels, which may serve as a useful indicator of the early development of airway edema.

Research paper thumbnail of A technique to overcome inability to advance a tracheal tube over a fiberscope during nasotracheal intubation

Journal of Anesthesia, 2010

Research paper thumbnail of Anesthetic management of a patient with prosthetic heart valve for non-cardiac surgery: A case report

Cases Journal, 2008

Background: Patients with prosthetic heart valves are a challenge to any anesthesiologist due to ... more Background: Patients with prosthetic heart valves are a challenge to any anesthesiologist due to the risk of infective endocarditis, bleeding and thrombosis.

Research paper thumbnail of Laryngeal injuries and tracheal intubating conditions with or without muscle relaxation I

Canadian Journal of Anesthesia/Journal canadien d'anesthésie, 2009

We read with avid interest the recently published study regarding laryngeal injuries and tracheal... more We read with avid interest the recently published study regarding laryngeal injuries and tracheal intubating conditions with or without the use of muscle relaxants. 1 While we are intrigued by the findings, we have several concerns regarding the study design. The study reports that, at time T 0 ? 50 s, the study drug 0.15 ml kg -1 (cisatracurium 1 mg ml -1 or saline iv) was administered over 10 s. Next, at T 0 ? 100 s, propofol 2.5 mg kg -1 iv was administered over 50 s. Ventilation via facemask was initiated upon loss of eyelash reflex. Assuming the onset of propofol's action was coincidental with the completion of its administration, there remained an approximate time lag of 90 s from completion of the administration of cisatracurium and completion of the administration of propofol. The report does not indicate which anesthetic agents were administered during bag-mask ventilation prior to attempting laryngoscopy. This aspect concerns us, as patients might have experienced ''inability to breathe or discomfort'' prior to their loss of consciousness.

Research paper thumbnail of The case of a theatrical spill – Should volatile anesthetic glass bottles be encased?

Acta Anaesthesiologica Taiwanica, 2011

Acta Anaesthesiologica Taiwanica, Volume 49, Issue 1, Pages 35-36, March 2011, Authors:Goneppanav... more Acta Anaesthesiologica Taiwanica, Volume 49, Issue 1, Pages 35-36, March 2011, Authors:Goneppanavar Umesh; Kaur Jasvinder; Shetty Nanda.

Research paper thumbnail of Solutions to Some of the Existing Problems With Breathing Equipment Type

Acta Anaesthesiologica Taiwanica, 2010

Despite the stringent guidelines laid down by the American Society of Anesthesiologists for equip... more Despite the stringent guidelines laid down by the American Society of Anesthesiologists for equipment checks, there are occasional reports of problems related to the equipment used to administer anesthesia. In this article, we discuss two important, albeit rare, problems associated with breathing equipment that have been reported in the literature. The rarity of these problems in itself may hinder early diagnosis because anesthesiologists do not usually consider these problems to be the cause of an ongoing patient morbidity. The first problem discussed here is the presence of a foreign body within the breathing system used to administer anesthesia. The second problem discussed is a kink in the breathing circuits that can precipitate lifethreatening problems if it is not detected early enough.

Research paper thumbnail of Nasopharyngeal airway as a diagnostic and therapeutic tool in difficult airway

Indian Journal of Anaesthesia, 2014

Research paper thumbnail of Should the arrhythmias that occur upon return of spontaneous circulation be treated?

Research paper thumbnail of Two-person paediatric resuscitation (basic life support)—Defining the role of the second rescuer

Resuscitation, 2008

RefDoc Bienvenue - Welcome. Refdoc est un service / is powered by. ...

Research paper thumbnail of Management of laryngospasm - our concerns and suggestions

Pediatric Anesthesia, 2008

... Management of laryngospasm – our concerns and suggestions. Goneppanavar Umesh,;Kaur Jasvinder... more ... Management of laryngospasm – our concerns and suggestions. Goneppanavar Umesh,;Kaur Jasvinder,; Venkateswaran Ramkumar. Article first published online: 2 SEP 2008. DOI: 10.1111/j.1460-9592.2008.02650.x. © 2008 The Authors. ...

Research paper thumbnail of Lightwand for confirming tracheal intubation in the presence of severe postintubation bronchospasm

Pediatric Anesthesia, 2012

Research paper thumbnail of Improvement in oxygenation with return of spontaneous ventilation during repair of congenital diaphragmatic hernia

Pediatric Anesthesia, 2008

Research paper thumbnail of Airway Management Technique for Vascular Mass in the Oral Cavity

Journal of Neurosurgical Anesthesiology, 2009

... Airway Management Technique for Vascular Mass in the Oral Cavity. Umesh, Goneppanavar MD; Dee... more ... Airway Management Technique for Vascular Mass in the Oral Cavity. Umesh, Goneppanavar MD; Deepak, Kavaraganahalli MD; Jasvinder, Kaur MD. ... Kaur Jasvinder, MD. Department of Anaesthesiology, Kasturba Medical College, Manipal Karnataka, India. ...

Research paper thumbnail of Umesh’s intubation detector (UID) for rapid and reliable identification of tracheal intubation by novices in anaesthetised, paralysed adult patients

Journal of Clinical Monitoring and Computing, 2013

Oesophageal intubation can lead to life threatening complications if left undetected. Several dev... more Oesophageal intubation can lead to life threatening complications if left undetected. Several devices and techniques are available to confirm tracheal intubation and for early detection of oesophageal intubation. This study was carried out to evaluate the utility of the Umesh's intubation detector device for rapid and reliable differentiation of tracheal from oesophageal intubation by novice users. In this prospective, double blind and randomised study, 100 healthy patients undergoing general anaesthesia with endotracheal intubation received two identical size endotracheal tubes; one inserted into trachea and the other into the oesophagus. The Umesh's intubation detector was connected to one of the tubes randomly and a novice was asked to observe for inflation of the reservoir bag of the device while two chest compressions of approximately one inch each were given to the patient. Out of the total 100 tracheal intubations, 96 were correctly identified while the observers could not clearly conclude whether the tube was in trachea or oesophagus in the other four patients. Out of the total 100 oesophageal intubations, 99 were correctly identified. There were no complications related to the study. Umesh's intubation detector device can be used by novices for rapid and reliable differentiation of tracheal from oesophageal intubation in healthy adult patients.

Research paper thumbnail of Low minimum alveolar concentration alarm: a standard for prevention of awareness during general anaesthesia maintained by inhalational anaesthetics

Journal of Clinical Monitoring and Computing, 2009

Awareness during general anaesthesia is a rare but significant problem that can be frightening to... more Awareness during general anaesthesia is a rare but significant problem that can be frightening to the patients. We suggest that newer generation monitors should include this facility to provide a low alarm limit to MAC settings so as to improve the quality of patient care. Also we suggest that a ''near empty'' alarm be incorporated into vaporizers which can warn the anaesthesiologist prior to development of possible light plane of anaesthesia. We hope that adopting these two features can help enhance patient safety and can further aid in quality assurance.

Research paper thumbnail of Tight reservoir bag: the bag itself may be the culprit

Journal of Clinical Monitoring and Computing, 2010

Numerous possibilities exist which may cause obstruction to ventilation under anesthesia resultin... more Numerous possibilities exist which may cause obstruction to ventilation under anesthesia resulting in a tight reservoir bag with low compliance. We report an interesting case where a reservoir bag twisted around its own neck and resulted in a tight bag situation. The neck portion of the reservoir bag would be hidden from the view of anesthesiologists in head and neck surgery and hence it is easier to miss early recognition of the twist. We caution all anesthesiologists using the disposable modified Jackson-Rees breathing system to be aware of such an eventuality. We also urge the manufacturer to consider strengthening the neck of the reservoir bag by improving the quality of the material used for its construction.

Research paper thumbnail of Arterial line for monitoring SpO2 in patients with ischemic peripheries

Journal of Clinical Monitoring and Computing, 2010

Monitoring the oxygenation status of patients with poor peripheral perfusion or ischemic peripher... more Monitoring the oxygenation status of patients with poor peripheral perfusion or ischemic peripheries is challenging in view of unreliable or unrecordable pulse oximeter data. In this article we describe a very simple and innovative technique of using the arterial line for reliable recording of arterial oxygen saturation (SpO 2 ) in such patients. We conclude that the arterial line can be used as an extension of the artery and SpO 2 may be reliably measured using the arterial line in such patients as long as the blood in the arterial tubing is pulsatile and a good contact is ensured between the arterial tubing and the sensor of the pulse oximeter.

Research paper thumbnail of A well centered chest X ray is a must for studying the relation between central line and trachea

Journal of Clinical Monitoring and Computing, 2012

We appreciate the interest shown by Lin and Tseng [1, 2] in our article. We understand the proble... more We appreciate the interest shown by Lin and Tseng [1, 2] in our article. We understand the problems faced by the authors in distinguishing the placement (artery or vein) of the left sided central venous catheter (CVC). A well centered chest X ray (CXR) is the most ...

Research paper thumbnail of Validation of the new intubation detector device: a manikin study

Journal of Clinical Monitoring and Computing, 2012

This study was done to validate the utility of Umesh&... more This study was done to validate the utility of Umesh's intubation detector in detection of tracheal or oesophageal intubation in manikin using volunteers with different levels of experience in tracheal intubation (including novices). The Sim Man II, (Laerdal Medical AS, Norway) manikin was used. Two cuffed tracheal tubes of size 6.5 mm ID were used. One was passed into the trachea and the other into oesophagus. The device was connected to one of the two tubes as per randomisation table and three high quality chest compressions were performed. Each volunteer participated in the study twice. Their opinion regarding the tube position (in trachea or oesophagus or could not determine) was noted. A total of 50 volunteers participated in the study. Eleven of them had not observed intubation (novice), 29 had either only observed or had experience of <10 tracheal intubations (less experienced) and 10 had experience of >10 intubations or >1 year experience in tracheal intubation (experienced). Out of a total 100 performances, 99 were correctly identified. On one instance, a tube placed in trachea was incorrectly interpreted to be in the oesophagus by a novice. Umesh's intubation detector helps in rapid and reliable confirmation of tracheal intubation in manikin irrespective of the experience level of the assessor in tracheal intubation.

Research paper thumbnail of Yet another cause for blocked sidestream capnogram––beware of the non-threaded cap mount in heat and moisture exchangers

Journal of Clinical Monitoring and Computing, 2009

N. Yet another cause for blocked sidestream capnogram--beware of the non-threaded cap mount in he... more N. Yet another cause for blocked sidestream capnogram--beware of the non-threaded cap mount in heat and moisture exchangers. J Clin Monit Comput 2009; 23:207-208 ABSTRACT. Heat and moisture exchangers (HME) are commonly used during general anaesthesia and intensive care of patients on mechanical ventilators. Some of the HME manufacturers provide HMEs with a Luer lock fitting for connecting side stream CO 2 monitoring line, Luer lock cap, and a non-threaded cap mount. However, HMEs from different manufacturers and HMEs meant for use in children and for adults from the same manufacturer vary in the presence/absence of non-threaded cap mount. This can create confusion to the clinicians and can result in inadvertent connection of the CO 2 monitoring line to the non-threaded cap mount resulting in blocked CO 2 monitoring line and leak in the circuit. We caution all the anaesthesiologists and intensivists regarding this possibility while using HMEs from different manufacturers.

Research paper thumbnail of Immediate postoperative airway obstruction secondary to airway edema following tumor excision from the neck

Journal of Anesthesia, 2009

A 46-year-old woman was scheduled for excision of a malignant peripheral nerve sheath tumor from ... more A 46-year-old woman was scheduled for excision of a malignant peripheral nerve sheath tumor from the neck. The tumor had caused deviation of the trachea to the left and partial obstruction of the superior vena cava. Her upper airway at laryngoscopy after induction of anesthesia was normal. During tumor resection there were transient phases characterized by the complete disappearance of the peripheral oxygen saturation (Sp(O2)) and radial artery tracings. At the end of the operation, the trachea was extubated after ensuring adequate antagonization of neuromuscular blockade. However, immediately post-extubation, she showed signs of acute airway obstruction that necessitated reintubation of the trachea. Laryngoscopy revealed significant edema of the upper airway and vocal cords, requiring a smaller size tracheal tube. Many reports suggest the development of significant airway edema 24 h after such surgery. Our report highlights the fact that this can happen in the immediate postoperative period also. Some authors suggest that, in such surgery, extubation should routinely be done over pediatric tube exchangers. Routine leak testing and direct laryngoscopic/fiberoptic evaluation of the upper airway prior to extubation may also help. While our report reaffirms these points, it also stresses the importance of intraoperative monitoring for the compression of the great vessels, which may serve as a useful indicator of the early development of airway edema.

Research paper thumbnail of A technique to overcome inability to advance a tracheal tube over a fiberscope during nasotracheal intubation

Journal of Anesthesia, 2010

Research paper thumbnail of Anesthetic management of a patient with prosthetic heart valve for non-cardiac surgery: A case report

Cases Journal, 2008

Background: Patients with prosthetic heart valves are a challenge to any anesthesiologist due to ... more Background: Patients with prosthetic heart valves are a challenge to any anesthesiologist due to the risk of infective endocarditis, bleeding and thrombosis.

Research paper thumbnail of Laryngeal injuries and tracheal intubating conditions with or without muscle relaxation I

Canadian Journal of Anesthesia/Journal canadien d'anesthésie, 2009

We read with avid interest the recently published study regarding laryngeal injuries and tracheal... more We read with avid interest the recently published study regarding laryngeal injuries and tracheal intubating conditions with or without the use of muscle relaxants. 1 While we are intrigued by the findings, we have several concerns regarding the study design. The study reports that, at time T 0 ? 50 s, the study drug 0.15 ml kg -1 (cisatracurium 1 mg ml -1 or saline iv) was administered over 10 s. Next, at T 0 ? 100 s, propofol 2.5 mg kg -1 iv was administered over 50 s. Ventilation via facemask was initiated upon loss of eyelash reflex. Assuming the onset of propofol's action was coincidental with the completion of its administration, there remained an approximate time lag of 90 s from completion of the administration of cisatracurium and completion of the administration of propofol. The report does not indicate which anesthetic agents were administered during bag-mask ventilation prior to attempting laryngoscopy. This aspect concerns us, as patients might have experienced ''inability to breathe or discomfort'' prior to their loss of consciousness.