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Emergency Intubation

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https://www.readbyqxmd.com/read/28210362/serum-lactate-predicts-adverse-outcomes-in-emergency-department-patients-with-and-without-infection
#1
Kimie Oedorf, Danielle E Day, Yotam Lior, Victor Novack, Leon D Sanchez, Richard E Wolfe, Hans Kirkegaard, Nathan I Shapiro, Daniel J Henning
INTRODUCTION: Lactate levels are increasingly used to risk stratify emergency department (ED) patients with and without infection. Whether a serum lactate provides similar prognostic value across diseases is not fully elucidated. This study assesses the prognostic value of serum lactate in ED patients with and without infection to both report and compare relative predictive value across etiologies. METHODS: We conducted a prospective, observational study of ED patients displaying abnormal vital signs (AVS) (heart rate ≥130 bpm, respiratory rate ≥24 bpm, shock index ≥1, and/or systolic blood pressure <90 mmHg)...
February 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28210060/effectiveness-of-new-sedation-and-rehabilitation-methods-for-critically-ill-patients-receiving-mechanical-ventilation
#2
Kouji Yamashita, Akiyoshi Takami, Saichi Wakayama, Misato Makino, Yoshihiro Takeyama
[Purpose] The purpose of this study was to investigate the effects of new sedation management methods and cooperation between nurses and physical therapists on the duration of mechanical ventilation and hospitalization. [Subjects and Methods] Patients who had been treated at the study hospital 2 years before and after the implementation of the new methods were analyzed retrospectively and classified into a "control group" and an "intervention group", respectively. Both groups were analyzed and subsequently compared regarding the effects of the new sedation and cooperative rehabilitation...
January 2017: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/28207971/emergency-department-initiated-home-oxygen-for-bronchiolitis-a-prospective-study-of-community-follow-up-caregiver-satisfaction-and-outcomes
#3
Julia Fuzak Freeman, Sara Deakyne, Lalit Bajaj
OBJECTIVE: Retrospective studies performed have shown home oxygen to be a safe alternative to hospitalization for some patients with bronchiolitis living at high altitudes. We aimed to prospectively describe adverse events, follow-up, duration of home oxygen, factors associated with failure, and caregiver preferences. METHODS: This was a prospective observational study of hypoxemic bronchiolitis patients ages 3-18months who were discharged from a tertiary care pediatric emergency department on home oxygen over 3 winters (2011-2014)...
February 16, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28202295/feasibility-of-upright-patient-positioning-and-intubation-success-rates-at-two-academic-emergency-departments
#4
Joseph S Turner, Timothy J Ellender, Enola R Okonkwo, Tyler M Stepsis, Andrew C Stevens, Erik G Sembroski, Christopher S Eddy, Anthony J Perkins, Dylan D Cooper
OBJECTIVES: Endotracheal intubation is most commonly taught and performed in the supine position. Recent literature suggests that elevating the patient's head to a more upright position may decrease peri-intubation complications. However, there is little data on the feasibility of upright intubation in the emergency department. The goal of this study was to measure the success rate of emergency medicine residents performing intubation in supine and non-supine, including upright positions...
February 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28198754/relationship-between-adverse-tracheal-intubation-associated-events-and-picu-outcomes
#5
Margaret M Parker, Gabrielle Nuthall, Calvin Brown, Katherine Biagas, Natalie Napolitano, Lee A Polikoff, Dennis Simon, Michael Miksa, Eleanor Gradidge, Jan Hau Lee, Ashwin S Krishna, David Tellez, Geoffrey L Bird, Kyle J Rehder, David A Turner, Michelle Adu-Darko, Sholeen T Nett, Ashley T Derbyshire, Keith Meyer, John Giuliano, Erin B Owen, Janice E Sullivan, Keiko Tarquinio, Pradip Kamat, Ronald C Sanders, Matthew Pinto, G Kris Bysani, Guillaume Emeriaud, Yuki Nagai, Melissa A McCarthy, Karen H Walson, Paula Vanderford, Anthony Lee, Jesse Bain, Peter Skippen, Ryan Breuer, Sarah Tallent, Vinay Nadkarni, Akira Nishisaki
OBJECTIVE: Tracheal intubation in PICUs is a common procedure often associated with adverse events. The aim of this study is to evaluate the association between immediate events such as tracheal intubation associated events or desaturation and ICU outcomes: length of stay, duration of mechanical ventilation, and mortality. STUDY DESIGN: Prospective cohort study with 35 PICUs using a multicenter tracheal intubation quality improvement database (National Emergency Airway Registry for Children: NEAR4KIDS) from January 2013 to June 2015...
February 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28192567/development-and-internal-validation-of-a-clinical-risk-score-for-treating-children-with-mild-head-trauma-and-intracranial-injury
#6
Jacob K Greenberg, Yan Yan, Christopher R Carpenter, Angela Lumba-Brown, Martin S Keller, Jose A Pineda, Ross C Brownson, David D Limbrick
Importance: The appropriate treatment of children with mild traumatic brain injury (mTBI) and intracranial injury (ICI) on computed tomographic imaging remains unclear. Evidence-based risk assessments may improve patient safety and reduce resource use. Objective: To derive a risk score predicting the need for intensive care unit observation in children with mTBI and ICI. Design, Setting, and Participants: This retrospective analysis of the prospective Pediatric Emergency Care Applied Research Network (PECARN) head injury cohort study included patients enrolled in 25 North American emergency departments from 2004 to 2006...
February 13, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28188577/sofa-score-in-septic-patients-incremental-prognostic-value-over-age-comorbidities-and-parameters-of-sepsis-severity
#7
Francesca Innocenti, Camilla Tozzi, Chiara Donnini, Eleonora De Villa, Alberto Conti, Maurizio Zanobetti, Riccardo Pini
Several widely used scoring systems for septic patients have been validated in an ICU setting, and may not be appropriate for other settings like Emergency Departments (ED) or High-Dependency Units (HDU), where a relevant number of these patients are managed. The purpose of this study is to find reliable tools for prognostic assessment of septic patients managed in an ED-HDU. In 742 patients diagnosed with sepsis/severe sepsis/septic shock, not-intubated, admitted in ED between June 2008 and April 2016, SOFA, qSOFA, PIRO, MEWS, Charlson Comorbidity Index, MEDS, and APACHE II were calculated at ED admission (T0); SOFA and MEWS were also calculated after 24 h of ED-High-Dependency Unit stay (T1)...
February 10, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28188055/the-emergency-medicine-management-of-severe-alcohol-withdrawal
#8
Drew Long, Brit Long, Alex Koyfman
INTRODUCTION: Alcohol use is widespread, and withdrawal symptoms are common after decreased alcohol intake. Severe alcohol withdrawal may manifest with delirium tremens, and new therapies may assist in management of this life-threatening condition. OBJECTIVE: To provide an evidence-based review of the emergency medicine management of alcohol withdrawal and delirium tremens. DISCUSSION: The underlying pathophysiology of alcohol withdrawal syndrome (AWS) is central nervous system hyperexcitation...
February 4, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28185721/approaches-and-adjuncts-used-by-physiotherapists-when-suctioning-adult-patients-who-are-intubated-and-ventilated-in-intensive-care-units-in-australia-and-new-zealand-a-cross-sectional-survey
#9
Charissa S L Tan, Meg Harrold, Kylie Hill
BACKGROUND: Suctioning is an integral component of care for patients who are intubated and ventilated in an intensive care unit (ICU). There appears to be no published data of physiotherapy suctioning practices in Australia or New Zealand. OBJECTIVE: To describe suctioning practices and the factors which have shaped these practices, of experienced physiotherapists working with adults who are intubated and ventilated in an ICU across Australia and New Zealand. Areas of investigation focused on: (i) suctioning approach (i...
February 6, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/28178944/two-case-reports-of-unexpected-tracheal-agenesis-in-the-neonate-3-c-s-beyond-algorithms-for-difficult-airway-management
#10
Beate Grass, Leopold Simma, Michael Reinehr, Urs Zimmermann, Claudine Gysin, Georg Henze, Vincenzo Cannizzaro
BACKGROUND: Handling neonates with postnatal respiratory failure due to congenital airway malformations implies knowledge about emergency management of unexpected difficult airway. In these stressful situations both technical and communication skills of the caretakers are essential. CASE PRESENTATION: Two cases with prenatally unknown tracheal agenesis are reported. CONCLUSION: In the presented cases, airway malformation and subsequent difficulties upon endotracheal intubation were not adequately communicated between caretakers...
February 8, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28173712/incidence-and-risk-factors-of-postoperative-sore-throat-after-endotracheal-intubation-in-korean-patients
#11
Jin Young Lee, Woo Seog Sim, Eun Sung Kim, Sangmin M Lee, Duk Kyung Kim, Yu Ri Na, Dahye Park, Hue Jung Park
Objective To investigate the incidence of postoperative sore throat (POST) in Korean patients undergoing general anaesthesia with endotracheal intubation and to assess potential risk factors. Methods This prospective study enrolled patients who underwent all types of elective surgical procedures with endotracheal intubation and general anaesthesia. The patients were categorized into group S (those with a POST) or group N (those without a POST). The demographic, clinical and anaesthetic characteristics of each group were compared...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28168228/changes-in-the-first-pass-success-rate-with-the-glidescope-video-laryngoscope-and-direct-laryngoscope-a-ten-year-observational-study-in-two-academic-emergency-departments
#12
Joon Ki Lee, Hyunggu Kang, Hyuk Joong Choi
OBJECTIVE: The aim of this study was to assess the success rate of the GlideScope video laryngoscope (GVL) and direct laryngoscope (DL) over ten years in two academic emergency departments. METHODS: We used adult intubation data using DL and GVL collected from airway management registries at two academic emergency departments. We analyzed changes in first-pass success (FPS) rate by device and operator training level. We conducted a multivariate logistic regression analysis to predict the FPS according to time period...
December 2016: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/28166446/use-of-intranasal-naloxone-by-basic-life-support-providers
#13
Scott G Weiner, Patricia M Mitchell, Elizabeth S Temin, Breanne K Langlois, K Sophia Dyer
STUDY OBJECTIVES: Intranasal delivery of naloxone to reverse the effects of opioid overdose by Advanced Life Support (ALS) providers has been studied in several prehospital settings. In 2006, in response to the increase in opioid-related overdoses, a special waiver from the state allowed administration of intranasal naloxone by Basic Life Support (BLS) providers in our city. This study aimed to determine: 1) if patients who received a 2-mg dose of nasal naloxone administered by BLS required repeat dosing while in the emergency department (ED), and 2) the disposition of these patients...
February 6, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28166084/unexpected-complication-of-cocaine-associated-anti-neutrophil-cytoplasmic-antibody-vasculitis-related-to-persistent-in-hospital-cocaine-use
#14
Travis D Olives, Rebecca L Kornas, Russell Fujisawa, Jon B Cole
INTRODUCTION: Levamisole-adulterated cocaine has been implicated in anti-neutrophil cytoplasmic antibody (ANCA) vasculitis. We present a case of spontaneous intraperitoneal hemorrhage, an unexpectedly severe complication of cocaine-related ANCA vasculitis, developing late during hospitalization. CASE REPORT: An adult male with a history of hepatitis C, distant cocaine use, and limited health care presented to a local emergency department (ED) with volume overload, renal failure, hyperkalemia and non-anion gap metabolic acidosis...
February 3, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28151928/multiple-fentanyl-overdoses-new-haven-connecticut-june-23-2016
#15
Anthony J Tomassoni, Kathryn F Hawk, Karen Jubanyik, Daniel P Nogee, Thomas Durant, Kara L Lynch, Rushaben Patel, David Dinh, Andrew Ulrich, Gail D'Onofrio
On the evening of June 23, 2016, a white powder advertised as cocaine was purchased off the streets from multiple sources and used by an unknown number of persons in New Haven, Connecticut. During a period of less than 8 hours, 12 patients were brought to the emergency department (ED) at Yale New Haven Hospital, experiencing signs and symptoms consistent with opioid overdose. The route of intoxication was not known, but presumed to be insufflation ("snorting") in most cases. Some patients required doses of the opioid antidote naloxone exceeding 4 mg (usual initial dose = 0...
February 3, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28149591/non-intubated-subxiphoid-uniportal-video-assisted-thoracoscopic-thymectomy-using-glasses-free-3d-vision
#16
Long Jiang, Jun Liu, Wenlong Shao, Jingpei Li, Jianxing He
Trans-sternal thymectomy has long been accepted as the standard surgical procedure for thymic masses. Recently, minimally invasive methods, such as video-assisted thoracoscopic surgery (VATS) and, even more recently, non-intubated anesthesia, have emerged. These methods provide advantages including reductions in surgical trauma, postoperative associated pain, and in regards to VATS, provide certain cosmetic benefits. Considering these advantages, we herein present a case of subxiphoid uniportal VATS for thymic mass using a glasses-free 3D thoracoscopic display system...
December 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28148274/severity-dependent-differences-in-early-management-of-thoracic-trauma-in-severely-injured-patients%C3%A2-analysis-based-on-the-traumaregister-dgu%C3%A2
#17
J Bayer, R Lefering, S Reinhardt, J Kühle, N P Südkamp, T Hammer
BACKGROUND: Major trauma is associated with chest injuries in nearly 50% of multiple injuries. Thoracic trauma is a relevant source of comorbidity throughout the period of multiply-injured patient care and may require swift and well-thought-out interventions in order to avert a deleterious outcome. In this epidemiological study we seek to characterize groups of different thoracic trauma severity in severely injured patients and identify related differences in prehospital and early clinical management...
February 2, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28144270/a-clinical-trial-evaluating-the-laryngeal-mask-airway-supreme-in-obese-children-during-general-anesthesia
#18
Yue Tian, Xiu-Ying Wu, Lu Li, Ling Ma, Yun-Feng Li
INTRODUCTION: The laryngeal mask airway (LMA)-Supreme is a disposable double-lumen laryngeal mask airway that is widely used in clinical practice. However, its use in obese children has not been evaluated. The aim of this study was to determine whether the LMA-Supreme could perform equally as well as endotracheal intubation in obese children having a minor surgical procedure. MATERIAL AND METHODS: After ethical board approval, 100 obese male children receiving non-emergent appendectomy for chronic appendicitis or surgery to correct concealed penis were randomly divided into an endotracheal intubation group and an LMA-Supreme group...
February 1, 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28133086/-usefulness-of-transnasal-decompression-tubes-in-patients-with-right-sided-obstructive-colorectal-cancer
#19
Ryouichi Tomita, Shigeru Fujisaki, Takeo Azuhata, Yuko Takamoto, Kenichi Sakurai
PURPOSE: We performed this retrospective study to evaluate the usefulness of a transnasal decompression tube(long ileus tube)as a bridge to surgery in patients with right-sided obstructive colorectal cancer. PATIENTS AND METHODS: There were 8 patients(5 men and 3 women, aged 64 to 85 years with a mean age of 75.9 years)who had undergone transnasal decom- pression in the last 10 years. RESULT: 1) The success rate of intubation was 100%(8/8)...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28132766/piloting-a-pediatric-trauma-course-in-western-jamaica-lessons-learned-and-future-directions
#20
Hadley K Wesson, Valerie Plant, Marieka Helou, Karen Wharton, Delroy Fray, Jeffrey Haynes, Charles Bagwell
INTRODUCTION: Pediatric injuries are a leading cause of death in low- and middle-income countries (LMICs). Despite this, there are few formal pediatric-specific trauma educational initiatives available in LMICs. While new educational tools are being developed to address this, they have not been piloted in LMICs. In Jamaica, pediatric injuries are a leading cause of hospital admission but care is limited by a lack of training in triage and stabilization. Our objective was to implement and evaluate a pediatric trauma course in Jamaica to determine the impact this may have on further course development...
January 10, 2017: Journal of Pediatric Surgery
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