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Emergent intubation

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https://www.readbyqxmd.com/read/28549578/pediatric-out-of-hospital-cardiac-arrest-caused-by-left-coronary-artery-agenesis-with-primary-shockable-rhythm-a-brief-report
#1
Moritz Weigeldt, Sabine Lahmann, Konstantin Krieger, Sebastian Buttenberg, Volker Stephan, Brigitte Stiller, Dirk Stengel
BACKGROUND: To illustrate a rare cause of out-of-hospital cardiac arrest in children, its differential diagnoses, emergency and subsequent treatment at various steps in the rescue chain, and potential outcomes. CASE PRESENTATION: A 4-year-old boy with unknown agenesis of the left coronary ostium sustained out-of-hospital cardiac arrest. Bystander cardio-pulmonary resuscitation was initiated and defibrillation was performed via an automated external defibrillator (AED) shortly after paramedics arrived at the scene, restoring sinus rhythm and spontaneous circulation...
May 11, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28546373/noninvasive-respiratory-support-in-infants-and-children
#2
Katherine L Fedor
CPAP and noninvasive ventilation (NIV) offer an alternative to intubation and mechanical ventilation in the treatment of acute and chronic respiratory disorders commonly encountered in infants and children. There are many distinct challenges associated with the application, management, and safety of CPAP and NIV in the pediatric population. This review attempts to identify indications, contraindications, management strategies, and safety measures associated with the application of CPAP or NIV delivery in children...
June 2017: Respiratory Care
https://www.readbyqxmd.com/read/28542045/massive-hemoptysis-through-endotracheal-tube-during-emergency-cesarean-delivery-a-case-report-and-literature-review
#3
Von Vee Ng, Mukesh Kumar Shah, Ting Ting Oh, Abirami Ramanathan, Thangavelautham Suhitharan
Severe pulmonary hemorrhage occurred through the endotracheal tube during an emergency cesarean delivery. Intubation trauma was excluded with fiberoptic bronchoscopy. Episodes of hemoptysis continued for 48 hours. The patient was subsequently diagnosed with diffuse alveolar hemorrhage because of systemic lupus erythematosus. The diagnostic workup, successful management, and literature review are presented.
May 24, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28540092/anti-musk-positive-myasthenic-crisis-in-a-7-year-old-female
#4
Harrison J Matthews, Apisadaporn Thambundit, Brandon R Allen
A seven-year-old African American female with anti-MuSK-positive Juvenile Myasthenia Gravis collapsed while at school from progressively worsening weakness and dyspnea. On initial emergency department presentation, she required 15 liters per minute of supplemental oxygen to maintain oxygen saturation above 92%. Initial pulmonary function tests and venous blood gas led to the decision to place her on noninvasive positive pressure ventilation (NPPV) with BiPAP in the emergency department. Due to worsening hypercarbia, she later required mechanical intubation in the PICU and underwent IVIG therapy followed by plasmapheresis in order to achieve a stable discharge from the hospital...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28538645/increased-mortality-in-trauma-patients-who-develop-post-intubation-hypotension
#5
Robert S Green, Michael B Butler, Mete Erdogan
BACKGROUND: Post-intubation hypotension (PIH) is common and associated with poor outcomes in critically ill patient populations requiring emergency endotracheal intubation (ETI). The importance of PIH in the trauma population remains unclear. The objective of this study was to determine the prevalence of PIH in trauma patients and assess the association of PIH with patient outcomes. METHODS: Retrospective case series of adult (≥16 years) patients who were intubated on arrival at a tertiary trauma center in Halifax, Nova Scotia, Canada between 2000 and 2015...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538609/critical-care-interventions-for-asthmatic-patients-admitted-from-the-emergency-department-to-the-pediatric-intensive-care-unit
#6
Kristen Michelle Cundiff, James M Gerard, Robert G Flood
OBJECTIVES: The aim of this study was to assess the frequency and predictors of critical interventions in asthmatic patients admitted to the pediatric intensive care unit (PICU) at a tertiary-care pediatric hospital. METHODS: We conducted a retrospective chart review of patients admitted from our emergency department (ED) to the PICU for treatment of status asthmaticus between January 1, 2008, and March 31, 2013. Patients with concomitant medical conditions and those who received a critical intervention, other than continuously aerosolized albuterol, in the ED before admission were excluded...
May 23, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28537937/dexmedetomidine-the-new-all-in-one-drug-in-paediatric-anaesthesia
#7
Cedric E Sottas, Brian J Anderson
PURPOSE OF REVIEW: Dexmedetomidine is a drug with sedative, anxiolytic, sympatholytic and analgesic properties, which is finding widespread practice in paediatric anaesthesia and related practices. The present review summarizes its pharmacology and current experience with the drug. RECENT FINDINGS: Dexmedetomidine is proving useful in many diverse areas in paediatric anaesthesia where its sedative properties are useful for premedication, fibreoptic intubation and radiologic procedures...
May 22, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28536701/endotracheal-intubation-using-a-direct-laryngoscope-and-the-protective-performances-of-respirators-a-randomized-trial
#8
Taeho Lim, Sanghyun Lee, Jaehoon Oh, Hyunggoo Kang, Chiwon Ahn, Yeongtak Song, Juncheol Lee, Hyungoo Shin
Purpose. Emergency physicians are at risk for infection during invasive procedures, and the respirators can reduce this risk. This study aimed to determine whether endotracheal intubation using direct laryngoscopes affected protection performances of respirators. Methods. A randomized crossover study of 24 emergency physicians was performed. We performed quantitative fit tests using respirators (cup type, fold type without a valve, and fold type with a valve) before and during intubation. The primary outcome was respirators' fit factors (FF), and secondary outcomes were acceptable protection (percentage of scores above 100 FF [FF%])...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28535961/emergency-intubation-in-prehospital-care
#9
Tomasz Klosiewicz, Radoslaw Zalewski, Agata Dabrowska, Adrian Maciejewski
No abstract text is available yet for this article.
May 15, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28530140/associations-of-nasopharyngeal-metabolome-and-microbiome-with-severity-among-infants-with-bronchiolitis-a-multi-omic-analysis
#10
Christopher J Stewart, Jonathan M Mansbach, Matthew C Wong, Nadim J Ajami, Joseph F Petrosino, Carlos A Camargo, Kohei Hasegawa
RATIONALE: Bronchiolitis is the most common lower respiratory infection in infants; however, it remains unclear which infants with bronchiolitis will develop severe illness. In addition, while emerging evidence indicates associations of the upper-airway microbiome with bronchiolitis severity, little is known about the mechanisms linking airway microbes and host response to disease severity. OBJECTIVES: To determine the relations among the nasopharyngeal airway metabolome profiles, microbiome profiles, and severity in infants with bronchiolitis...
May 21, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28527874/pressor-support-during-a-jarisch-herxheimer-reaction-after-initiation-of-treatment-for-weil-s-disease
#11
Randi Connor-Schuler, Anee Khan, Nikhil Goyal, Erin Zimny
We present a case of Weil's disease complicated by a Jarisch-Herxheimer reaction (JHR) after initiation of antibiotics while in the emergency department requiring invasive monitoring and vasopressor support. The case is followed by a brief review of the JHR which is rarely observed with treatment of leptospirosis. A healthy 28-year-old female who recently returned from the Caribbean presented to the emergency department with flu-like symptoms. The patient appeared jaundiced with conjunctival suffusion and was ultimately treated with the appropriate antibiotics for leptospirosis in the ED...
April 27, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28522914/one-year-experience-with-computer-assisted-propofol-sedation-for-colonoscopy
#12
Otto S Lin, Danielle La Selva, Richard A Kozarek, Deborah Tombs, Wade Weigel, Ryan Beecher, Johannes Koch, Susan McCormick, Michael Chiorean, Fred Drennan, Michael Gluck, Nanda Venu, Michael Larsen, Andrew Ross
AIM: To report our one-year experience with computer assisted propofol sedation (CAPS) for colonoscopy as the first United States Medical Center to adopt CAPS technology for routine clinical use. METHODS: Between September 2014 and August 2015, 2677 patients underwent elective outpatient colonoscopy with CAPS at our center. All colonoscopies were performed by 1 of 17 gastroenterologists certified in the use of the CAPS system, with the assistance of a specially trained nurse...
April 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28515954/a-prospective-cohort-study-of-thoracic-ultrasound-in-acute-respiratory-failure-the-c3po-protocol
#13
Peter D Wallbridge, Simon A Joosten, Liam M Hannan, Daniel P Steinfort, L Irving, J Goldin, Mark Hew
OBJECTIVES: This study was performed to assess the clinical utility of a standardised thoracic ultrasound examination when added to standard care in patients with acute respiratory failure admitted to an intermediate care unit. This study aimed to assess the impact on clinical diagnosis, clinician confidence and management. Ultrasound has been shown to have utility in patients admitted to intensive care and emergency; however, utility in a ward setting is unknown. DESIGN: Prospective cohort study...
May 2017: JRSM Open
https://www.readbyqxmd.com/read/28504622/-severe-cervical-kyphosis-causing-sudden-inspiratory-stridor
#14
Karen Lise Dahl Andersen, Allan Bach, Rikke Haahr Iversen, Søren Helbo Skaarup
An 85-year-old woman was brought to an accident and emergency department with breathing difficulties accompanied by inspiratory stridor. She was being treated for hypertension and severe osteoporosis which had caused thoracal and cervical fractures of the columna. Intubation was initiated as she desaturated and deteriorated despite maximum oxygen therapy. The intubation revealed a subglottic stenosis as a consequence of a recent osteoporotic fracture in the cervical columna. This represents a rare cause of respiratory failure as all other cardial, pulmonary and allergic aetiologies had been eliminated...
May 8, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28503749/a-prospective-evaluation-of-transverse-tracheal-sonography-during-emergent-intubation-by-emergency-medicine-resident-physicians
#15
Shadi Lahham, Jamie Baydoun, James Bailey, Sandra Sandoval, Sean P Wilson, John C Fox, David E Slattery
OBJECTIVES: Establishing a definitive airway is often the first step in emergency department treatment of critically ill patients. Currently, there is no agreed upon consensus as to the most efficacious method of airway confirmation. Our objective was to determine the diagnostic accuracy of real-time sonography performed by resident physicians to confirm placement of the endotracheal tube during emergent intubation. METHODS: We performed a prospective cohort study of adult patients in the emergency department undergoing emergent endotracheal intubation...
May 15, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28492404/trend-and-outcomes-of-video-laryngoscope-use-across-picus
#16
Jocelyn R Grunwell, Pradip P Kamat, Michael Miksa, Ashwin Krishna, Karen Walson, Dennis Simon, Conrad Krawiec, Ryan Breuer, Jan Hau Lee, Eleanor Gradidge, Keiko Tarquinio, Asha Shenoi, Justine Shults, Vinay Nadkarni, Akira Nishisaki
OBJECTIVE: Video (indirect) laryngoscopy is used as a primary tracheal intubation device for difficult airways in emergency departments and in adult ICUs. The use and outcomes of video laryngoscopy compared with direct laryngoscopy has not been quantified in PICUs or cardiac ICUs. DESIGN: Retrospective review of prospectively collected observational data from a multicenter tracheal intubation database (National Emergency Airway Registry for Children) from July 2010 to June 2015...
May 10, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28492403/pediatric-in-hospital-acute-respiratory-compromise-a-report-from-the-american-heart-association-s-get-with-the-guidelines-resuscitation-registry
#17
Lars W Andersen, Mikael Vognsen, Alexis Topjian, Linda Brown, Robert A Berg, Vinay M Nadkarni, Hans Kirkegaard, Michael W Donnino
OBJECTIVES: The main objectives of this study were to describe in-hospital acute respiratory compromise among children (< 18 yr old), and its association with cardiac arrest and in-hospital mortality. DESIGN: Observational study using prospectively collected data. SETTING: U.S. hospitals reporting data to the "Get With The Guidelines-Resuscitation" registry. PATIENTS: Pediatric patients (< 18 yr old) with acute respiratory compromise...
May 10, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28489506/prehospital-intubation-is-associated-with-favorable-outcomes-and-lower-mortality-in-protect-iii
#18
Kurt R Denninghoff, Tomas Nuño, Qi Pauls, Sharon D Yeatts, Robert Silbergleit, Yuko Y Palesch, Lisa H Merck, Geoff T Manley, David W Wright
OBJECTIVE: Traumatic brain injury (TBI) causes more than 2.5 million emergency department visits, hospitalizations, or deaths annually. Prehospital endotracheal intubation has been associated with poor outcomes in patients with TBI in several retrospective observational studies. We evaluated the relationship between prehospital intubation, functional outcomes, and mortality using high quality data on clinical practice collected prospectively during a randomized multicenter clinical trial...
May 10, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28487415/randomized-comparison-of-helmet-cpap-versus-high-flow-nasal-cannula-oxygen-in-pediatric-respiratory-distress
#19
Giovanna Vitaliti, Maria Concetta Vitaliti, Maria Carla Finocchiaro, Vita Antonella Di Stefano, Piero Pavone, Nassim Matin, Nazgol Motamed-Gorji, Riccardo Lubrano, Raffaele Falsaperla
BACKGROUND: The current study aimed to compare the efficacy and safety of 2 noninvasive respiratory support methods, which included helmet CPAP and high-flow nasal cannula (HFNC) in children with respiratory distress admitted to a pediatric intermediate care unit. METHODS: This study was a prospective observational study conducted on children with respiratory distress (age 1-24 months) who were admitted to our acute and emergency operative unit. All included subjects were randomly treated with helmet CPAP or HFNC in a 1:1 fashion until their clinical picture, oxygen saturation, and arterial blood gas (ABG) parameters resolved...
May 9, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28486385/validation-of-the-vasoactive-inotropic-score-in-pediatric-sepsis
#20
Amanda M McIntosh, Suhong Tong, Sara J Deakyne, Jesse A Davidson, Halden F Scott
OBJECTIVES: To assess the validity of Vasoactive-Inotropic Score as a scoring system for cardiovascular support and surrogate outcome in pediatric sepsis. DESIGN: Secondary retrospective analysis of a single-center sepsis registry. SETTING: Freestanding children's hospital and tertiary referral center. PATIENTS: Children greater than 60 days and less than 18 years with sepsis identified in the emergency department between January 2012 and June 2015 treated with at least one vasoactive medication within 48 hours of admission to the PICU...
May 8, 2017: Pediatric Critical Care Medicine
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