Combitube Rescue for Cesarean Delivery Followed by Ninth and Twelfth Cranial Nerve Dysfunction
Bibliographic record
Abstract
Purpose: The Combitube™ has been shown to be effective in many airway management scenarios. We describe its use as a rescue device in a “cannot intubate cannot ventilate” (CICV) situation that was encountered during a Cesarean delivery (CD) followed by transient cranial nerve dysfunction.Clinical features: A 24-yr-old gravida 4 para 1 (weight 112 kg, body mass index 44 kg·m−2) at 34 weeks gestation, with pregnancy induced hypertension and a prior history of uneventful airway management, presented for urgent CD. She refused regional anesthesia and attempts at awake laryngoscopy and intubation. Following rapid sequence induction, attempts at direct laryngoscopy and intubation failed. Ventilation via facemask and laryngeal mask also failed. A Combitube was inserted and inflated according to manufacturer’s instructions and resulted in successful ventilation of the patient. The Combitube was in place for approximately three hours and then removed uneventfully. The following day, the patient presented with signs and symptoms consistent with bilateral glossopharyngeal and unilateral hypoglossal nerve dysfunction. Three months later the patient’s nerve dysfunction had completely resolved.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".