Invasive techniques such as cricothyrotomy must also be available in the event of inability to intubate the trachea by conventional techniques. RSI is mainly used to intubate patients at high risk of aspiration, mostly due to a full stomach as commonly seen in a trauma setting. Bag ventilation causes distention of stomach which can induce vomiting, so this phase must be quick. The patient is given a sedative and paralytic agent, usually midazolam / suxamethonium / propofol and intubation is quickly attempted with minimal or no manual ventilation. The patient is assessed for predictable intubation difficulties. Laryngoscope blades and endotracheal tubes smaller than would be used in a non-emergency setting are selected. If the patient on initial assessment is found to have a difficult airway, RSI is contraindicated since a failed RSI attempt will leave no option but to ventilate the patient on bag and mask which can lead to vomiting. For these challenging cases, awake fiberoptic intubation is usually preferred. Controversy
Since the introduction of RSI, there has been controversy regarding virtually every aspect of this technique, including:
choice of intravenous hypnotic agents as well as their dosage and timing of administration
dosage and timing of administration of neuromuscular blocking agents
avoidance of manual ventilation before tracheal intubation
optimal position and whether the head-up, head-down, or horizontal supine position is the safest for induction of anesthesia in full-stomach patients
application of cricoid pressure, which is also referred to as the Sellick maneuver. References
External links
Rapid Sequence Intubation at eMedicine
In offering a range of clinical treatments to ‘correct’ a persons ability to produce an erection, biomedical institutions encourage the public to strive for prolonged sexual function. Anthropologists argue that a biomedical focus places emphasis on the biological processes of fixing the body thereby disregarding holistic ideals of health and aging. By relying on a wholly medical approach, Western biomedicine can become blindsided by bodily dysfunctions which can be understood as appropriate functions of age, and not as a medical problem. Anthropologists understand that a biosocial approach to ED considers a persons decision to undergo clinical treatment more likely a result of "society, political economy, history, and culture" than a matter of personal choice. In rejecting biomedical treatment for ED, men can challenge common forms of medicalized social control by deviating from what is considered the normal approach to dysfunction. Lexicology
The Latin term impotentia coeundi describes simple inability to insert the penis into the vagina; it is now mostly replaced by more precise terms, such as erectile dysfunction (ED). The study of ED within medicine is covered by andrology, a sub-field within urology. Research indicates that ED is common, and it is suggested that approximately 40% of males experience symptoms compatible with ED, at least occasionally. The condition is also on occasion called phallic impotence. Its antonym, or opposite condition, is priapism. References
Further reading
Carson, Culley; Faria, Geraldo; Hellstrom, Wayne J. G.; Krishnamurti, Sudhakar; Minhas, Suks; Moncada, Ignacio; Montague, Drogo K. (1 January 2010). "Implants, Mechanical Devices, and Vascular Surgery for Erectile Dysfunction". Journal of Sexual Medicine.