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First attempt intubation success rate

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https://www.readbyqxmd.com/read/28818854/nasal-midazolam-vs-ketamine-for-neonatal-intubation-in-the-delivery-room-a-randomised-trial
#1
Christophe Milési, Julien Baleine, Thibault Mura, Fernando Benito-Castro, Félicie Ferragu, Gérard Thiriez, Pierre Thévenot, Clémentine Combes, Ricardo Carbajal, Gilles Cambonie
OBJECTIVE: To compare the effectiveness of sedation by intranasal administration of midazolam (nMDZ) or ketamine (nKTM) for neonatal intubation. DESIGN: A multicentre, prospective, randomised, double-blind study. SETTING: Delivery rooms at four tertiary perinatal centres in France. PATIENTS: Preterm neonates with respiratory distress requiring non-emergent endotracheal intubation for surfactant instillation. INTERVENTIONS: Treatment was randomly allocated, with each neonate receiving a bolus of 0...
August 17, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28816881/the-shikani-optical-stylet-as-an-alternative-to-awake-fiberoptic-intubation-in-patients-at-risk-of-secondary-cervical-spine-injury-a-randomized-controlled-trial
#2
Rabab S S Mahrous, Aly M M Ahmed
BACKGROUND: Conventional intubation of the trachea and consequent prone positioning of anesthetized patients with cervical spine instability may result in secondary neurological injury. Historically, flexible fiberoptics used to be the chief choice for patients presenting with cervical spine instability surgery with difficult airway. Recently, the rigid optical stylets have shown promise in assisting difficult intubations. PURPOSE: The aim of the present study was to compare the efficacy of Shikani optical stylet (SOS) with the flexible fiberscope for awake intubation in patients with cervical spine instability...
August 14, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28807073/a-comparison-of-paramedic-first-pass-endotracheal-intubation-success-rate-of-the-vividtrac-vt-a-100-glidescope-ranger-and-direct-laryngoscopy-under-simulated-prehospital-cervical-spinal-immobilization-conditions-in-a-cadaveric-model
#3
Ryan Hodnick, Tony Zitek, Kellen Galster, Stephen Johnson, Bryan Bledsoe, Daniel Ebbs
OBJECTIVE: The primary goal of this study was to compare paramedic first pass success rate between two different video laryngoscopes and direct laryngoscopy (DL) under simulated prehospital conditions in a cadaveric model. METHODS: This was a non-randomized, group-controlled trial in which five non-embalmed, non-frozen cadavers were intubated under prehospital spinal immobilization conditions using DL and with both the GlideScope Ranger (GL; Verathon Inc, Bothell, Washington USA) and the VividTrac VT-A100 (VT; Vivid Medical, Palo Alto, California USA)...
August 15, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28757827/digital-assistance-of-nasogastric-tube-insertion-in-intubated-patients-under-general-anesthesia-a-single-blinded-prospective-randomized-study
#4
Alrefaey Kandeel, Mohammed Elmorhedi, Usama Abdalla
BACKGROUND: Nasogastric tube (NGT) insertion may pose a special problem in patients under general anesthesia with first attempt failure rates up to 50%. To increase insertion success rate and decreases related complications, several techniques have been developed. In this study, digital assistance technique is compared to the classic insertion technique in neck flexion. MATERIALS AND METHODS: In this prospective randomized study, 160 patients were randomly allocated into two groups; control group (Group C, n = 80) where NGT tube will be inserted with the neck in flexion position and digital facilitation group (Group D, n = 80)...
July 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28740393/current-evidence-for-the-use-of-c-mac-videolaryngoscope-in-adult-airway-management-a-review-of-the-literature
#5
REVIEW
Fu-Shan Xue, Hui-Xian Li, Ya-Yang Liu, Gui-Zhen Yang
The C-MAC videolaryngoscope is the first Macintosh-typed videolaryngoscope. Since the advent of its original version video Macintosh system in 1999, this device has been modified several times. A unique feature of C-MAC device is its ability to provide the 2 options of direct and video laryngoscopy with the same device. The available evidence shows that in patients with normal airways, C-MAC videolaryngoscope compared with direct laryngoscopy can provide comparable or better laryngeal views and exerts less force on maxillary incisors, but does not offer conclusive benefits with regard to intubation time, intubation success, number of intubation attempts, the use of adjuncts, and hemodynamic responses to intubation...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28676443/a-modified-tongue-depressor-facilitates-the-insertion-of-proseal-laryngeal-mask-airway-comparison-with-digital-and-introducer-techniques
#6
Yao-Chia Liu, Chen-Hwan Cherng
BACKGROUND: The larger and softer cuff of the ProSeal laryngeal mask airway (LMA) may cause difficulty in insertion. We introduced a novel technique using a modified tongue depressor to aid the ProSeal LMA insertion. METHODS: A total of 150 patients were randomly allocated into three groups of 50 each, digital (D), introducer (I), and tongue depressor (TD). The ProSeal LMA was inserted by the aid of digit, introducer and a modified tongue depressor, respectively...
July 1, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/28650415/videolaryngoscopy-versus-fiber-optic-intubation-through-a-supraglottic-airway-in-children-with-a-difficult-airway-an-analysis-from-the-multicenter-pediatric-difficult-intubation-registry
#7
Nicholas E Burjek, Akira Nishisaki, John E Fiadjoe, H Daniel Adams, Kenneth N Peeples, Vidya T Raman, Patrick N Olomu, Pete G Kovatsis, Narasimhan Jagannathan
BACKGROUND: The success rates and related complications of various techniques for intubation in children with difficult airways remain unknown. The primary aim of this study is to compare the success rates of fiber-optic intubation via supraglottic airway to videolaryngoscopy in children with difficult airways. Our secondary aim is to compare the complication rates of these techniques. METHODS: Observational data were collected from 14 sites after management of difficult pediatric airways...
June 23, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28640930/orotracheal-intubation-in-infants-performed-with-a-stylet-versus-without-a-stylet
#8
REVIEW
Joyce E O'Shea, Jennifer O'Gorman, Aakriti Gupta, Sanjay Sinhal, Jann P Foster, Liam Af O'Connell, C Omar F Kamlin, Peter G Davis
BACKGROUND: Neonatal endotracheal intubation is a common and potentially life-saving intervention. It is a mandatory skill for neonatal trainees, but one that is difficult to master and maintain. Intubation opportunities for trainees are decreasing and success rates are subsequently falling. Use of a stylet may aid intubation and improve success. However, the potential for associated harm must be considered. OBJECTIVES: To compare the benefits and harms of neonatal orotracheal intubation with a stylet versus neonatal orotracheal intubation without a stylet...
June 22, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28629915/video-laryngoscopy-for-endotracheal-intubation-of-critically-ill-adults-a-systemic-review-and-meta-analysis
#9
Hui-Bin Huang, Jin-Min Peng, Biao Xu, Guang-Yun Liu, Bin Du
BACKGROUND: Endotracheal intubation (EI) in ICU patients is associated with an increased risk of life-threatening adverse events due to unstable conditions, rapid deterioration, limited preparation time, and variability in the expertise of operators. The goal of this study was to compare the effect of video laryngoscopy (VL) and direct laryngoscopy (DL) in ICU patients requiring EI. METHODS: We searched for relevant studies in PubMed, Embase, and the Cochrane database from inception through January 30, 2017...
June 16, 2017: Chest
https://www.readbyqxmd.com/read/28582801/emergency-airway-management-in-australian-and-new-zealand-emergency-departments-a-multicentre-descriptive-study-of-3710-emergency-intubations
#10
Hatem Alkhouri, John Vassiliadis, Matthew Murray, John Mackenzie, Alex Tzannes, Sally McCarthy, Toby Fogg
OBJECTIVE: The aim of this study was to describe the practice of endotracheal intubation across a range of Australasian EDs. METHODS: We established a multicentre airway registry (The Australian and New Zealand Emergency Department Airway Registry [ANZEDAR]) prospectively capturing intubations from 43 Australian and New Zealand EDs over 24 months using the ANZEDAR form. Information recorded included patient demographics, intubation indications, predicted difficulty, rapid sequence induction and endotracheal intubation preparation technique, induction drugs, airway adjuncts and complications...
June 5, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28546013/-comparison-of-different-methods-of-nasogastric-tube-insertion-in-anesthetized-and-intubated-patients
#11
Ali Sait Kavakli, Nilgun Kavrut Ozturk, Arzu Karaveli, Asuman Arslan Onuk, Lutfi Ozyurek, Kerem Inanoglu
BACKGROUND: Nasogastric tube insertion may be difficult in anesthetized and intubated patients with head in the neutral position. Several techniques are available for the successful insertion of nasogastric tube. The primary aim of this study was to investigate the difference in the first attempt success rate of different techniques for insertion of nasogastric tube. Secondary aim was to investigate the difference of the duration of insertion using the selected technique, complications during insertion such as kinking and mucosal bleeding...
May 22, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28539007/videolaryngoscopy-versus-direct-laryngoscopy-for-tracheal-intubation-in-children-excluding-neonates
#12
REVIEW
Ibtihal S Abdelgadir, Robert S Phillips, Davinder Singh, Michael P Moncreiff, Joanne L Lumsden
BACKGROUND: Direct laryngoscopy is the method currently used for tracheal intubation in children. It occasionally offers unexpectedly poor laryngeal views. Indirect laryngoscopy involves visualizing the vocal cords by means other than obtaining a direct sight, with the potential to improve outcomes. We reviewed the current available literature and performed a meta-analysis to compare direct versus indirect laryngoscopy, or videolaryngoscopy, with regards to efficacy and adverse effects...
May 24, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28525401/glidescope-versus-airtraq-dl-for-double-lumen-tracheal-tube-insertion-in-patients-with-a-predicted-or-known-difficult-airway-a-randomised-study
#13
Olivier Belze, Evan Lepage, Yvan Bazin, Pierre Kerourin, Jacques Fusciardi, Francis Remérand, Fabien Espitalier
BACKGROUND: Double-lumen tracheal tube (DLT) insertion can be managed with videolaryngoscopes such as the Glidescope or indirect laryngoscopes like the Airtraq DL. No study has compared both devices when a difficult intubation is predicted. OBJECTIVE: Our hypothesis was that the Glidescope is superior to the Airtraq for double-lumen tube insertion in patients with a predicted or known difficult airway. DESIGN: Randomised study. PATIENTS: Adults scheduled for thoracic elective surgery, requiring one-lung ventilation with a predicted difficult intubation score of at least 7 (Arné risk index)...
July 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28489804/comparison-of-learning-performance-of-2-intubating-laryngeal-mask-airways-in-novice-a-randomized-crossover-manikin-study
#14
RANDOMIZED CONTROLLED TRIAL
Zi-Jia Liu, Jie Yi, Wei-Yun Chen, Xiu-Hua Zhang, Yu-Guang Huang
BACKGROUND: Intubating laryngeal mask airways (LMAs) such as i-gel and Aura-i could serve as rescue devices in resuscitation and further ensure the airway by facilitating trachea intubation without ventilation interruption. But data regarding intubating LMAs in novice are limited and skill degeneration without regular training has not been evaluated. So we designed this prospective randomized crossover manikin study to compare the learning performance of 2 intubating LMAs (i-gel and Aura-i)...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28487139/a-multicenter-randomized-trial-of-ramped%C3%A2-position-vs%C3%A2-sniffing-position-during%C3%A2-endotracheal-intubation-of-critically%C3%A2-ill-adults
#15
Matthew W Semler, David R Janz, Derek W Russell, Jonathan D Casey, Robert J Lentz, Aline N Zouk, Bennett P deBoisblanc, Jairo I Santanilla, Yasin A Khan, Aaron M Joffe, William S Stigler, Todd W Rice
BACKGROUND: Hypoxemia is the most common complication during endotracheal intubation of critically ill adults. Intubation in the ramped position has been hypothesized to prevent hypoxemia by increasing functional residual capacity and decreasing the duration of intubation, but has never been studied outside of the operating room. METHODS: Multicenter, randomized trial comparing the ramped position (head of the bed elevated to 25°) with the sniffing position (torso supine, neck flexed, and head extended) among 260 adults undergoing endotracheal intubation by pulmonary and critical care medicine fellows in four ICUs between July 22, 2015, and July 19, 2016...
May 6, 2017: Chest
https://www.readbyqxmd.com/read/28460858/analysis-of-out-of-hospital-pediatric-intubation-by%C3%A2-an-australian-helicopter-emergency-medical%C3%A2-service
#16
Brian J Burns, Joanna B Watterson, Sandra Ware, Luke Regan, Cliff Reid
STUDY OBJECTIVE: We examine first-look success in emergency pediatric intubation by a physician-staffed helicopter emergency medical service (EMS). METHODS: A database analysis of all pediatric (<16 years) intubations during a 64-month period was undertaken, using data from a prospectively enrolled electronic airway registry form. Recorded findings included patient demographics, operator background, airway intervention including intubation attempts, complications, and critical timings...
April 28, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28441963/in-hospital-airway-management-training-for-non-anesthesiologist-ems-physicians-a-descriptive-quality-control-study
#17
Helmut Trimmel, Christoph Beywinkler, Sonja Hornung, Janett Kreutziger, Wolfgang G Voelckel
BACKGROUND: Pre-hospital airway management is a major challenge for emergency medical service (EMS) personnel. Despite convincing evidence that the rescuer's qualifications determine efficacy of tracheal intubation, in-hospital airway management training is not mandatory in Austria, and often neglected. Thus we sought to prove that airway management competence of EMS physicians can be established and maintained by a tailored training program. METHODS: In this descriptive quality control study we retrospectively evaluated all in- and pre-hospital airway cases managed by EMS physicians who underwent a structured in-hospital training program in anesthesia at General Hospital Wiener Neustadt...
April 26, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28429117/a-comparison-of-mcgrath-mac%C3%A2-and-standard-direct-laryngoscopy-in-simulated-immobilized-cervical-spine-pediatric-intubation-a-manikin-study
#18
Marcin Madziala, Jacek Smereka, Marek Dabrowski, Steve Leung, Kurt Ruetzler, Lukasz Szarpak
Emergency airway management in children is generally considered to be challenging, and endotracheal intubation requires a high level of personal skills and experience. Immobilization of the cervical spine is indicated in all patients with the risk of any cervical spine injury but significantly aggravates endotracheal intubation. The best airway device in this setting has not been established yet, although the use of videolaryngoscopes is generally promising. Seventy-five moderately experienced paramedics of the Emergency Medical Service of Poland performed endotracheal intubations in a pediatric manikin in three airway scenarios: (A) normal airway, (B) manual in-line cervical immobilization, and (C) cervical immobilization using a Patriot cervical extrication collar and using two airway techniques: (1) McGrath videolaryngoscope and (2) Macintosh blade in a randomized sequence...
June 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28409758/improving-neonatal-intubation-safety-a-journey-of-a-thousand-miles
#19
T Sawyer, E Foglia, L Dupree Hatch, A Moussa, A Ades, L Johnston, A Nishisaki
Neonatal intubation is one of the most common procedures performed by neonatologists, however, the procedure is difficult and high risk. Neonates who endure the procedure often experience adverse events, including bradycardia and severe oxygen desaturations. Because of low first attempt success rates, neonates are often subjected to multiple intubation attempts before the endotracheal tube is successfully placed. These factors conspire to make intubation one of the most dangerous procedures in neonatal medicine...
2017: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28341185/c-mac-compared-with-direct-laryngoscopy-for-intubation-in-patients-with-cervical-spine-immobilization-a-manikin-trial
#20
Jacek Smereka, Jerzy R Ladny, Amanda Naylor, Kurt Ruetzler, Lukasz Szarpak
INTRODUCTION: The aim of this study was to compare C-MAC videolaryngoscopy with direct laryngoscopy for intubation in simulated cervical spine immobilization conditions. METHODS: The study was designed as a prospective randomized crossover manikin trial. 70 paramedics with <5years of medical experience participated in the study. The paramedics attempted to intubate manikins in 3 airway scenarios: normal airway without cervical immobilization (Scenario A); manual inline cervical immobilization (Scenario B); cervical immobilization using cervical extraction collar (Scenario C)...
August 2017: American Journal of Emergency Medicine
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