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endotracheal simulation

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https://www.readbyqxmd.com/read/28718208/quantification-of-nasal-airflow-resistance-in-english-bulldogs-using-computed-tomography-and-computational-fluid-dynamics
#1
Eric T Hostnik, Brian A Scansen, Rachel Zielinski, Samir N Ghadiali
Stenotic nares, edematous intranasal turbinates, mucosal swelling, and an elongated, thickened soft palate are common sources of airflow resistance for dogs with brachycephalic airway syndrome. Surgery has focused on enlarging the nasal apertures and reducing tissue of the soft palate. However, objective measures of surgical efficacy are lacking. Twenty-one English bulldogs without previous surgery were recruited for this prospective, pilot study. Computed tomography was performed using conscious sedation and without endotracheal intubation using a 128 multidetector computed tomography scanner...
July 17, 2017: Veterinary Radiology & Ultrasound
https://www.readbyqxmd.com/read/28690941/a-simulation-based-quality-improvement-approach-to-improve-pediatric-resident-competency-with-required-procedures
#2
Michelle Starr, Taylor Sawyer, Maya Jones, Maneesh Batra, Heather McPhillips
INTRODUCTION: Pediatric residents report a lack of confidence and competence with procedural skills at graduation. Training programs could benefit from improved approaches to target these needs. Using the Institute for Healthcare Improvement (IHI) Model for Improvement and three Plan-Do-Study-Act (PDSA) cycles, we examined the impact of a procedure simulation boot camp on self-reported procedural confidence and competence as well as the longitudinal impacts of these sequential interventions on Accreditation Council for Graduate Medical Education (ACGME) Graduating Resident Survey (GRS) results...
June 3, 2017: Curēus
https://www.readbyqxmd.com/read/28658109/exchange-of-supraglottic-airways-for-endotracheal-tube-using-the-eschmann-introducer-during-simulated-child-resuscitation-a-randomized-study-comparing-4-devices
#3
RANDOMIZED CONTROLLED TRIAL
Lukasz Szarpak, Zenon Truszewski, Joseph Vitale, Logan Glosser, Kurt Ruetzler, Antonio Rodríguez-Núñez
BACKGROUND: The aim of this study was to examine the application of the Eschmann tracheal tube introducer (ETTI) with 4 types of supraglottic airway devices (SADs) using a child-manikin. METHODS: A total of 79 paramedics were asked to exchange the 4 SADs for an endotracheal tube with the ETTI in 3 different scenarios using a randomized crossover study format: normal airway without chest compression; normal airway with uninterrupted chest compression; and difficult airway with uninterrupted chest compression...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28653420/impact-of-endotracheal-tube-shortening-on-work-of-breathing-in-neonatal-and-pediatric-in-vitro-lung-models
#4
Rebecca Mohr, Jörg Thomas, Vincenzo Cannizzaro, Markus Weiss, Alexander R Schmidt
BACKGROUND: Work of breathing accounts for a significant proportion of total oxygen consumption in neonates and infants. Endotracheal tube inner diameter and length significantly affect airflow resistance and thus work of breathing. While endotracheal tube shortening reduces endotracheal tube resistance, the impact on work of breathing in mechanically ventilated neonates and infants remains unknown. AIM: The objective of this in vitro study was to quantify the effect of endotracheal tube shortening on work of breathing in simulated pediatric lung settings...
June 27, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28616613/comparison-of-the-airway-access-skills-of-prehospital-staff-in-moving-and-stationary-ambulance-simulation-a-randomized-crossover-study
#5
Onur Karaca, Basak Bayram, Nese Colak Oray, Asli Acerer, Zeynep Sofuoglu
OBJECTIVES: We aimed to compare the procedural success and intervention durations regarding various airway access skills in moving and stationary ambulance simulations. MATERIAL AND METHODS: An ambulance simulator was used to simulate the moving ambulance environment, and a standard manikin was used for airway simulation. The study included 38 paramedics and paramedic students. In stationary and moving environments, a classical endotracheal intubation with a stylet, an intubation with a gum elastic bougie (GEB), a laryngeal mask airway (LMA), and a laryngeal tube (LT) were applied randomly...
June 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28601629/nasogastric-tube-placement-with-video-guided-laryngoscope-a-manikin-simulator-study
#6
Xiao-Lun Lee, Li-Chun Yeh, Yau-Dung Jin, Chun-Chih Chen, Ming-Ho Lee, Ping-Wun Huang
BACKGROUND: This study aimed to investigate video-guided laryngoscopy for nasogastric tube placement. METHODS: This was an observational comparative study performed in a hospital. The participants included volunteers from the medical staff (physicians and nurses) experienced with nasogastric intubation, and non-medical staff (medical students, pharmacists and emergent medical technicians) with knowledge of nasogastric intubation but lacking procedural experience...
June 7, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/28526471/-comparison-of-different-stylets-used-for-intubation-with-the-c-mac-d-blade-%C3%A2-videolaryngoscope-a-randomized-controlled-study
#7
Dilek Ömür, Başak Bayram, Şule Özbilgin, Volkan Hancı, Bahar Kuvaki
OBJECTIVE: The angle of the C-MAC D-Blade(®) videolaryngoscope, which is used for difficult airway interventions, is not compatible with routinely used endotracheal tubes. METHODS: A prospective randomized crossover study was performed comparing five intubation methods for use with standardized airways, including using different stylets or no stylet: Group HS, hockey-stick stylet; Group DS, D-blade type stylet; Group CS, CoPilot(®) videolaryngoscope rigid stylet(®); Group GEB, gum elastic bougie; and Group NS, no stylet...
May 17, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28518132/mind-the-gap-can-videolaryngoscopy-bridge-the-competency-gap-in-neonatal-endotracheal-intubation-among-pediatric-trainees-a-randomized-controlled-study
#8
S Parmekar, J L Arnold, C Anselmo, M Pammi, J Hagan, C J Fernandes, K Lingappan
BACKGROUND: To study the impact of videolaryngoscopy (VL) on intubation success among pediatric trainees compared with direct laryngoscopy (DL). METHODS: One hundred pediatric residents were enrolled in a randomized, crossover, simulation study comparing VL to DL. Following a didactic session on neonatal intubation, residents intubated a standard neonatal mannequin. Three Neonatal Resuscitation Program (NRP) scenarios were then conducted, followed by a mannequin intubation with the alternate device...
May 18, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28471440/accuracy-of-the-nasal-tragus-length-measurement-for-correct-endotracheal-tube-placement-in-a-cohort-of-neonatal-resuscitation-simulators
#9
M M Gray, H Delaney, R Umoren, T P Strandjord, T Sawyer
OBJECTIVE: Nasal-tragus length (NTL) estimates of endotracheal tube (ETT) depth are replacing weight-based estimates for endotracheal tube depth in neonates requiring endotracheal intubation. Existing neonatal simulators were designed before interest in using the NTL, and may lack fidelity in this measurement. The objective of this study is to evaluate the accuracy of the adjusted NTL formula and the Neonatal Resuscitation Program (NRP) gestational age/weight-based ETT depth chart in predicting proper endotracheal tube insertion depth in a cohort of neonatal simulators...
May 4, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28456389/development-of-reliable-and-validated-tools-to-evaluate-technical-resuscitation-skills-in-a-pediatric-simulation-setting-resuscitation-and-emergency-simulation-checklist-for-assessment-in-pediatrics
#10
Camille Faudeux, Antoine Tran, Audrey Dupont, Jonathan Desmontils, Isabelle Montaudié, Jean Bréaud, Marc Braun, Jean-Paul Fournier, Etienne Bérard, Noémie Berlengi, Cyril Schweitzer, Hervé Haas, Hervé Caci, Amélie Gatin, Lisa Giovannini-Chami
OBJECTIVES: To develop a reliable and validated tool to evaluate technical resuscitation skills in a pediatric simulation setting. STUDY DESIGN: Four Resuscitation and Emergency Simulation Checklist for Assessment in Pediatrics (RESCAPE) evaluation tools were created, following international guidelines: intraosseous needle insertion, bag mask ventilation, endotracheal intubation, and cardiac massage. We applied a modified Delphi methodology evaluation to binary rating items...
April 26, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28441181/inhaled-treprostinil-drug-delivery-during-mechanical-ventilation-and-spontaneous-breathing-using-two-different-nebulizers
#11
Donna K Parker, Shuijie Shen, Jiang Zheng, D Dunbar Ivy, Dave N Crotwell, Justin C Hotz, Robert M DiBlasi
OBJECTIVES: To determine the feasibility of delivering inhaled treprostinil during mechanical ventilation and spontaneous unassisted ventilation using the Tyvaso Inhalation System and the vibrating mesh nebulizer. We sought to compare differences in fine particle fraction, and absolute inhaled treprostinil mass delivered to neonatal, pediatric, and adult models affixed with a face mask, conventional, and high-frequency ventilation between Tyvaso Inhalation System and with different nebulizer locations between Tyvaso Inhalation System and vibrating mesh nebulizer...
June 2017: Pediatric Critical Care 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
#12
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/28422820/comparison-of-the-etview-single-lumen-and-macintosh-laryngoscopes-for-endotracheal-intubation-in-an-airway-manikin-with-immobilized-cervical-spine-by-novice-paramedics-a-randomized-crossover-manikin-trial
#13
RANDOMIZED CONTROLLED TRIAL
Pawel Gawlowski, Jacek Smereka, Marcin Madziala, Barak Cohen, Kurt Ruetzler, Lukasz Szarpak
CONTEXT: Management of the airway of a trauma victim is considered challenging. Various approaches have been described to achieve airway control in this setup; many of them include video-assited viewing of the larynx during intubation. ETView Single Lumen (SL) is a novice single-use endotracheal tube equiped with a video camera and a light source at its distal tip. Its use was previously described in seeral clinical and training setups. OBJECTIVE: The aim was to evaluate the efficacy of the VivaSight SL compared with classic direct laryngoscopy performed with a Macintosh blade in a manikin-simulated trauma setup presenting various degrees of airway challenge when performed by inexperienced physicians...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28410880/the-effect-of-user-experience-and-inflation-technique-on-endotracheal-tube-cuff-pressure-using-a-feline-airway-simulator
#14
Donna M White, José I Redondo, Alastair R Mair, Fernando Martinez-Taboada
OBJECTIVE: The effect of user experience and inflation technique on endotracheal tube cuff pressure using a feline airway simulator. STUDY DESIGN: Prospective, experimental clinical study. METHODS: Participants included veterinary students at the beginning (group S1) and end (group S2) of their 2-week anaesthesia rotation and veterinary anaesthetists (group A). The feline airway simulator was designed to simulate an average size feline trachea, intubated with a 4...
February 24, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28395952/a-novel-methodology-for-assessing-laryngeal-and-vagus-nerve-integrity-in-patients-under-general-anesthesia
#15
Catherine F Sinclair, Maria J Téllez, Oscar R Tapia, Sedat Ulkatan, Vedran Deletis
OBJECTIVE: To describe a novel methodology for intraoperative neuro-monitoring of laryngeal and vagus nerves by utilizing the laryngeal adductor reflex (LAR). METHODS: Case series of 15 patients undergoing thyroid and cervical spine surgeries under total intravenous general anesthesia. Vocal fold mucosa was electrically stimulated to elicit a LAR using endotracheal tube based electrodes. Contralateral R1 (cR1) and R2 (cR2) responses were recorded using the endotracheal tube electrode contralateral to the simulating electrode...
July 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/28349627/rigid-catheters-reduced-duration-of-less-invasive-surfactant-therapy-procedures-in-manikins
#16
V Rigo, C Debauche, P Maton, I Broux, D Van Laere
AIM: Different catheters can be used for less invasive surfactant therapy (LIST): feeding tubes inserted with or without Magill forceps, different angiocatheters and centre specific devices, such as umbilical catheters affixed to a stylet. This study compared the effectiveness of LIST devices and endotracheal tubes (ETT). METHODS: Video recordings of 20 neonatologists simulating different LIST techniques on two manikin heads were analysed. Procedural effectiveness was evaluated by the duration of procedures and failure rates...
March 27, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28347552/learning-outcomes-evaluation-of-a-simulation-based-introductory-course-to-anaesthesia
#17
J L Rábago, M López-Doueil, R Sancho, P Hernández-Pinto, N Neira, E Capa, E Larraz, C G Redondo-Figuero, J M Maestre
OBJECTIVE: An increased number of errors and reduced patient safety have been reported during the incorporation of residents, as this period involves learning new skills. The objectives were to evaluate the learning outcomes of an immersive simulation boot-camp for incoming residents before starting the clinical rotations. Airway assessment, airway control with direct laryngoscopy, and epidural catheterization competencies were evaluated. MATERIAL AND METHOD: Twelve first-year anaesthesiology residents participated...
March 24, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28343335/a-new-infant-hybrid-respiratory-simulator-preliminary-evaluation-based-on-clinical-data
#18
Barbara Stankiewicz, Krzysztof J Pałko, Marek Darowski, Krzysztof Zieliński, Maciej Kozarski
A new hybrid (numerical-physical) simulator of the respiratory system, designed to simulate spontaneous and artificial/assisted ventilation of preterm and full-term infants underwent preliminary evaluation. A numerical, seven-compartmental model of the respiratory system mechanics allows the operator to simulate global and peripheral obstruction and restriction of the lungs. The physical part of the simulator is a piston-based construction of impedance transformer. LabVIEW real-time software coordinates the work of both parts of the simulator and its interaction with a ventilator...
March 25, 2017: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/28336019/endotracheal-cuff-pressure-changes-during-helicopter-transport-a-systematic-review
#19
Ashleigh J Delorenzo, Matthew Shepherd, Paul A Jennings
OBJECTIVE: Cuff pressures are important in ventilated patients undergoing helicopter transport. An altitude-related increase in endotracheal tube (ETT) intracuff pressure has been shown in simulated hypobaric environments, model tracheas, and animal studies and may not accurately reflect in vivo pressures. The aim of this study was to determine if ETT intracuff pressure increases above the critical perfusion pressure of the trachea in ventilated patients during helicopter transport. METHODS: Ovid Medline, CINAHL, Embase, Scopus, and the Cochrane Library were searched from their commencement to January 29, 2016...
March 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28333703/higher-fresh-gas-flow-rates-decrease-tidal-volume-during-pressure-control-ventilation
#20
Shazia Mohammad, Nikolaus Gravenstein, Drew Gonsalves, Terrie Vasilopoulos, Samsun Lampotang
BACKGROUND: We observed that increasing fresh gas flow (FGF) decreased exhaled tidal volume (VT) during pressure control ventilation (PCV). A literature search produced no such description whereby unintended VT changes occur with FGF changes during PCV. METHODS: To model an infant's lungs, 1 lung of a mechanical lung model (Dual Adult TTL 1600; Michigan Instruments, Inc, Grand Rapids, MI) was set at a compliance of 0.0068 L/cm H2O. An Rp50 resistor (27.2 cm H2O/L/s at 15 L/min) simulated normal bronchial resistance...
May 2017: Anesthesia and Analgesia
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