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endotracheal simulation

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https://www.readbyqxmd.com/read/27879380/performance-of-leak-compensation-in-all-age-icu-ventilators-during-volume-targeted-neonatal-ventilation-a-lung-model-study
#1
Taiga Itagaki, Desmond J Bennett, Christopher T Chenelle, Daniel F Fisher, Robert M Kacmarek
BACKGROUND: Volume-targeted ventilation is increasingly used in low birthweight infants because of the potential for reducing volutrauma and avoiding hypocapnea. However, it is not known what level of air leak is acceptable during neonatal volume-targeted ventilation when leak compensation is activated concurrently. METHODS: Four ICU ventilators (Servo-i, PB980, V500, and Avea) were compared in available invasive volume-targeted ventilation modes (pressure control continuous spontaneous ventilation [PC-CSV] and pressure control continuous mandatory ventilation [PC-CMV])...
November 22, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27879379/performance-of-the-pneux-system-a-bench-study-comparison-with-4-other-endotracheal-tube-cuffs
#2
Christopher T Chenelle, Taiga Itagaki, Daniel F Fisher, Lorenzo Berra, Robert M Kacmarek
BACKGROUND: Cuff design affects microaspiration, a risk factor for pneumonia. We questioned whether the PneuX low-volume fold-free cuff design would prevent cuff leakage and maintain the same tracheal wall pressure as high-volume, low-pressure (HVLP) cuffs. METHODS: We evaluated 4 HVLP-cuffed endotracheal tubes (ETTs), Hi-Lo (polyvinyl chloride [PVC]), Microcuff (polyurethane [PU]), SealGuard (PU+tapered), and TaperGuard (PVC+tapered), and the PneuX with its dedicated tracheal seal monitor...
November 22, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27870588/assessment-of-paramedic-performance-on-difficult-airway-simulation
#3
Ashish R Panchal, Geoffrey Finnegan, David P Way, Thomas Terndrup
OBJECTIVE: Airway management is a common, important intervention for critically ill patients in the United States. A key element of prehospital airway management is endotracheal intubation (ETI). Prehospital ETI success rates have been shown to be as low as 77% compared to in-hospital rates of 95%. Given these rates, the use of backup airway devices is a necessary precaution for patient safety. The extent to which paramedics integrate backup airway use into their airway algorithm is unknown...
November 21, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27858851/a-comparison-of-a-traditional-endotracheal-tube-versus-etview-sl-in-endotracheal-intubation-during-different-emergency-conditions-a-randomized-crossover-cadaver-trial
#4
Zenon Truszewski, Paweł Krajewski, Marcin Fudalej, Jacek Smereka, Michael Frass, Oliver Robak, Bianka Nguyen, Kurt Ruetzler, Lukasz Szarpak
BACKGROUND: Airway management is a crucial skill essential to paramedics and personnel working in Emergency Medical Services and Emergency Departments: Lack of practice, a difficult airway, or a trauma situation may limit the ability of paramedics to perform direct laryngoscopy during cardiopulmonary resuscitation. Videoscope devices are alternatives for airway management in these situations. The ETView VivaSight SL (ETView; ETView Ltd., Misgav, Israel) is a new, single-lumen airway tube with an integrated high-resolution imaging camera...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27849480/validation-of-an-assessment-tool-for-field-endotracheal-intubation
#5
Danielle Hart, Joseph Clinton, Shilo Anders, Troy Reihsen, Mary Ann McNeil, Gregory Rule, Robert Sweet
OBJECTIVES: Endotracheal intubation (ETI) is an important skill for all emergency providers; our ability to train and assess our learners is integral to providing optimal patient care. The primary aim of this study was to assess the inter-rater reliability (IRR) and discriminant validity of a novel field ETI assessment tool using a checklist-derived performance score (PS) and critical failure (CF) rate. METHODS: Forty-three participants (18 paramedic students, 11 paramedics, and 14 emergency physicians [EPs]) performed ETI during a simulated trauma scenario on a pseudo-ventilated cadaver...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27811586/verbal-communication-during-airway-management-and-emergent-endotracheal-intubation-observations-of-team-behavior-among-multi-institutional-pediatric-intensive-care-unit-in-situ-simulations
#6
Ranna A Rozenfeld, Anna P Nannicelli, Alexandra R Brown, Walter J Eppich, Donna M Woods, Steven O Lestrud, Zehava L Noah, Jane L Holl
OBJECTIVE: To assess health-care teams' verbal communication, an observable teamwork behavior, during simulations involving pediatric emergency airway management and intubation. METHODS: We conducted video-recorded, risk-informed in situ simulations at 5 hospitals with pediatric intensive care units in the Chicago, Illinois, area. Clinicians participated in their clinical roles (eg, attending physician, bedside nurse) and had access to hospital operational systems (eg, electronic health record, medical imaging, laboratory services)...
November 2, 2016: Journal of Patient Safety
https://www.readbyqxmd.com/read/27797983/efficacy-of-various-types-of-laryngoscope-direct-pentax-airway-scope-and-glidescope-for-endotracheal-intubation-in-various-cervical-immobilisation-scenarios-a-randomised-cross-over-simulation-study
#7
Jong Won Kim, Kyeong Ryong Lee, Dae Young Hong, Kwang Je Baek, Young Hwan Lee, Sang O Park
OBJECTIVE: To compare the efficacy of direct laryngoscopy (DL), Pentax Airway Scope (PAWS) and GlideScope video laryngoscope (GVL) systems for endotracheal intubation (ETI) in various cervical immobilisation scenarios: manual in-line stabilisation (MILS), Philadelphia neck collar (PNC) (moderate limit of mouth opening) and Stifneck collar (SNC) (severe limit of mouth opening). DESIGN: Randomised cross-over simulation study. SETTING AND PARTICIPANTS: 35 physicians who had >30 successful ETI experiences at a tertiary hospital in Seoul, Korea...
October 24, 2016: BMJ Open
https://www.readbyqxmd.com/read/27776036/just-in-time-video-laryngoscopy-versus-direct-laryngoscopy-for-neonatal-intubation
#8
Erin Grgurich, Cynthia Arnemann, Kim Amon, Rose Horton, Jestin N Carlson
As neonatal endotracheal intubation (ETI) is a low-frequency, high-consequence event, it is essential that providers have access to resources to aid in ETI. We sought to determine the impact of video laryngoscopy (VL) with just-in-time training on intubation outcomes over direct laryngoscopy (DL) when performed by neonatal nurses. We conducted a prospective, randomized, crossover study with neonatal nurses employed at a level 2 neonatal intensive care unit (NICU). Nurses performed both DL and VL on a neonatal mannequin using a CMAC (Karl Storz Corp, Tuttlingen, Germany) either with the assistance of the screen (VL) or without (DL)...
October 2016: Journal of Perinatal & Neonatal Nursing
https://www.readbyqxmd.com/read/27769694/cuff-pressure-monitoring-by-manual-palpation-in-intubated-patients-how-accurate-is-it-a-manikin-simulation-study
#9
Dr Gian Domenico Giusti, Dr Cecilia Rogari, Dr Alessio Gili, Dr Fulvio Nisi
BACKGROUND: Endotracheal intubation (ETI) for mechanical ventilation has a central role in the Intensive Care Unit (ICU). ETI is one of the main risk factors for the development of ventilator-associated pneumonia (VAP) as its presence reduces the natural defences of the upper airway and allows the micro-suction of secretions in the airways. In order to minimise such complications, it is fundamental to maintain a suitable pressure inside the tube cuff. AIM AND SCOPE: The main objective of the present study is to evaluate the effectiveness and reliability of palpation method, performed with the operators fingers, for detecting the tube cuff pressure...
October 18, 2016: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/27761448/non-intubated-simultaneous-en-bloc-resection-of-pulmonary-nodule-and-rib-chondrosarcoma
#10
Miao Zhang, Heng Wang, Wenbin Wu, Dong Liu, Min Li, Zhengqun Hu, Hui Zhang
Adequate surgical resection was required for patients with rib chondrosarcoma. A 61-year-old woman was presented with a palpable chest wall mass. Computed tomography (CT) of the chest revealed an isolated pulmonary nodule about 0.9 cm, and a giant rib tumor about 12 cm × 9 cm which penetrated through the 7(th) rib into thorax. CT reconstruction and simulated surgery was utilized for disease-free surgical margin (R0 resection), then a simultaneous en bloc resection of pulmonary nodule and rib tumor was performed along with chest wall reconstruction under local anesthesia and intravenous sedation without endotracheal intubation...
September 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/27752609/comparison-of-the-gliderite-to-the-conventional-malleable-stylet-for-endotracheal-intubation-by-the-macintosh-laryngoscope-a-simulation-study-using-manikins
#11
Yong Tack Kong, Hyun Jung Lee, Ji Ung Na, Dong Hyuk Shin, Sang Kuk Han, Jeong Hun Lee, Pil Cho Choi
OBJECTIVE: To compare the effectiveness of the GlideRite stylet with the conventional malleable stylet (CMS) in endotracheal intubation (ETI) by the Macintosh laryngoscope. METHODS: This study is a randomized, crossover, simulation study. Participants performed ETI using both the GlideRite stylet and the CMS in a normal airway model and a tongue edema model (simulated difficult airway resulting in lower percentage of glottic opening [POGO]). RESULTS: In both the normal and tongue edema models, all 36 participants successfully performed ETI with the two stylets on the first attempt...
March 2016: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/27752604/comparison-of-intubation-times-using-a-manikin-with-an-immobilized-cervical-spine-macintosh-laryngoscope-vs-glidescope-vs-fiberoptic-bronchoscope
#12
Jung-In Ko, Sang Ook Ha, Min Seok Koo, Miyoung Kwon, Jieun Kim, Jin Jeon, So Hee Park, Sangwoo Shim, Youjin Chang, Taejin Park
OBJECTIVE: Airway management in patients with suspected cervical spine injury is classified as a "difficult airway." The best device for managing difficult airways is not known. Therefore, we conducted an intubation study simulating patients with cervical spine injury using three devices: a conventional Macintosh laryngoscope, a video laryngoscope (GlideScope), and a fiberoptic bronchoscope (MAF-TM). Success rates, intubation time, and complication rates were compared. METHODS: Nine physician experts in airway management participated in this study...
December 2015: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/27751699/comparing-the-effectiveness-of-a-novel-suction-set-up-using-an-adult-endotracheal-tube-connected-to-a-meconium-aspirator-vs-a-traditional-yankauer-suction-instrument
#13
Jonathan Kei, Donald P Mebust
BACKGROUND: It has been suggested that an adult 8.0 endotracheal tube (ETT) connected to a neonatal meconium aspirator would improve suctioning during emergent endotracheal intubation compared to the Yankauer suction instrument, the standard tool used by emergency physicians. OBJECTIVES: This study was designed to compare the effectiveness of a Yankauer vs. an ETT-meconium aspirator set-up in suctioning liquids of different viscosities. METHODS: The Yankauer and ETT-meconium aspirator device underwent a head-to-head timed comparison, suctioning 250 mL of three different fluids, varying in viscosity...
October 14, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27690714/can-ems-providers-provide-appropriate-tidal-volumes-in-a-simulated-adult-sized-patient-with-a-pediatric-sized-bag-valve-mask
#14
Jeffrey Siegler, Melissa Kroll, Susan Wojcik, Hawnwan Philip Moy
INTRODUCTION: In the prehospital setting, Emergency Medical Services (EMS) professionals rely on providing positive pressure ventilation with a bag-valve-mask (BVM). Multiple emergency medicine and critical care studies have shown that lung-protective ventilation protocols reduce morbidity and mortality. Our primary objective was to determine if a group of EMS professionals could provide ventilations with a smaller BVM that would be sufficient to ventilate patients. Secondary objectives included 1) if the pediatric bag provided volumes similar to lung-protective ventilation in the hospital setting and 2) compare volumes provided to the patient depending on the type of airway (mask, King tube, and intubation)...
October 3, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27651525/effects-of-leak-compensation-on-patient-ventilator-synchrony-during-premature-neonatal-invasive-and-noninvasive-ventilation-a-lung-model-study
#15
Taiga Itagaki, Christopher T Chenelle, Desmond J Bennett, Daniel F Fisher, Robert M Kacmarek
BACKGROUND: During both nasal noninvasive ventilation (NIV) and invasive ventilation of neonates, the presence of air leaks causes triggering and cycling asynchrony. METHODS: Five ICU ventilators (PB840, PB980, Servo-i, V500, and Avea) were compared in available invasive ventilation and NIV ventilator modes (pressure control continuous spontaneous ventilation [PC-CSV] and pressure control continuous mandatory ventilation [PC-CMV]). The V500 and Avea do not provide PC-CSV and PC-CMV in NIV...
September 20, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27639755/longitudinal-effects-of-single-dose-simulation-education-with-structured-debriefing-and-verbal-feedback-on-endotracheal-suctioning-knowledge-and-skills-a-randomized-controlled-trial
#16
Miia M Jansson, Hannu P Syrjälä, Pasi P Ohtonen, Merja H Meriläinen, Helvi A Kyngäs, Tero I Ala-Kokko
We evaluated the longitudinal effects of single-dose simulation education with structured debriefing and verbal feedback on critical care nurses' endotracheal suctioning knowledge and skills. To do this we used an experimental design without other competing intervention. Twenty-four months after simulation education, no significant time and group differences or time × group interactions were identified between the study groups. The need for regularly repeated educational interventions with audiovisual or individualized performance feedback and repeated bedside demonstrations is evident...
September 14, 2016: American Journal of Infection Control
https://www.readbyqxmd.com/read/27637439/laryngeal-cuff-force-application-modeling-during-air-medical-evacuation-simulation
#17
David Eisenbrey, Arthur B Eisenbrey, Patrick Pettengill
Endotracheal tubes are intended to protect the airway and assist with mechanical ventilation in sedated patients. The blood vessels of the tracheal mucosa can be compressed by high tracheal tube cuff pressures (> 30 cm H2O), leading to reduced mucosal blood flow with resulting ischemia and morbidity. Previous research showed a direct correlation between aircraft pressure altitude and the pressure reading from the tracheal cuff, with resulting pressures > 80 cm H2O at 10,000 ft. Standard practice is to periodically remove air from the cuff during ascent based on assumed increased pressure on the adjacent tracheal mucosa...
September 2016: Air Medical Journal
https://www.readbyqxmd.com/read/27602899/automated-control-of-endotracheal-tube-cuff-pressure-during-simulated-flight
#18
Thomas Blakeman, Dario Rodriquez, James Woods, Daniel Cox, Joel Elterman, Richard Branson
BACKGROUND: Successful mechanical ventilation requires that the airway be controlled by an endotracheal tube (ETT) with an inflatable cuff to seal the airway. Aeromedical evacuation represents a unique challenge in which to manage ETT cuffs. We evaluated three methods of automatic ETT cuff pressure adjustment during changes in altitude in an altitude chamber. METHODS: Size 7.5 and 8.0 mm ETTs that are currently included in the Critical Care Air Transport Team allowance standard were used for the evaluation...
November 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27563242/decreased-pseudomonas-aeruginosa-biofilm-formation-on-nanomodified-endotracheal-tubes-a-dynamic-lung-model
#19
Mary C Machado, Thomas J Webster
Ventilator-associated pneumonia (VAP) is a serious complication of mechanical ventilation that has been shown to be associated with increased mortality rates and medical costs in the pediatric intensive care unit. Currently, there is no cost-effective solution to the problems posed by VAP. Endotracheal tubes (ETTs) that are resistant to bacterial colonization and that inhibit biofilm formation could provide a novel solution to the problems posed by VAP. The objective of this in vitro study was to evaluate differences in the growth of Pseudomonas aeruginosa on unmodified polyvinyl chloride (PVC) ETTs and on ETTs etched with a fungal lipase, Rhizopus arrhizus, to create nanoscale surface features...
2016: International Journal of Nanomedicine
https://www.readbyqxmd.com/read/27559721/diagnosis-of-subglottic-stenosis-in-a-rabbit-model-using-long-range-optical-coherence-tomography
#20
Olubunmi Ajose-Popoola, Erica Su, Ashley Hamamoto, Alex Wang, Joseph C Jing, Tony D Nguyen, Jason J Chen, Kathryn E Osann, Zhongping Chen, Gurpreet S Ahuja, Brian J F Wong
OBJECTIVES/HYPOTHESIS: Current imaging modalities lack the necessary resolution to diagnose subglottic stenosis. The aim of this study was to use optical coherence tomography (OCT) to evaluate nascent subglottic mucosal injury and characterize mucosal thickness and structural changes using texture analysis in a simulated intubation rabbit model. STUDY DESIGN: Prospective animal study in rabbits. METHODS: Three-centimeter-long sections of endotracheal tubes (ETT) were endoscopically placed in the subglottis and proximal trachea of New Zealand White rabbits (n = 10) and secured via suture...
August 25, 2016: Laryngoscope
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