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Direct Laryngoscopy

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https://www.readbyqxmd.com/read/28936963/-application-of-self-made-guidance-for-difficult-gastric-tube-placement-in-patients-with-artificial-airway
#1
Xiaojie Chen, Jinchao Zhang, Wenxiu Li, Yiqing Jiang, Lingzhi Lin
OBJECTIVE: To use evidence-based nursing on patients with artificial airway to the practice of stomach tube, and to evaluate the self made guidance for difficult gastric tube placement in patients with artificial airway. METHODS: Forty patients with artificial airway and were difficult to put the tube, and admitted to Department of Critical Care Medicine of Harrison International Peace Hospital Affiliated to Hebei Medical University from April to December in 2016 were enrolled as observation group...
September 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28930848/nociceptive-stimulation-during-macintosh-direct-laryngoscopy-compared-with-mcgrath-mac-videolaryngoscopy-a-randomized-trial-using-indirect-evaluation-using-an-automated-administration-of-propofol-and-remifentanil
#2
Rathvirak Ing, Ngai Liu, Thierry Chazot, Julien Fessler, Jean François Dreyfus, Marc Fischler, Morgan Le Guen
BACKGROUND: Decrease of the nociceptive stimulation induced by laryngoscopy could be an advantage for patients without risk of difficult intubation. The present study aimed to compare the difference in nociceptive stimulation between the use of a conventional laryngoscope or of a videolaryngoscope. Amount of nociception was assessed indirectly using the peak remifentanil concentration determined by a closed-loop administration of propofol and remifentanil with bispectral index (BIS) as the input signal (target 50)...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28928584/a-randomized-study-comparing-the-sniffing-position-with-simple-head-extension-for-glottis-visualization-and-difficulty-in-intubation-during-direct-laryngoscopy
#3
Mehmooda Akhtar, Zulfiqar Ali, Nelofar Hassan, Saqib Mehdi, Gh Mohammad Wani, Aabid Hussain Mir
BACKGROUND: Proper positioning of the head and neck is important for an optimal laryngeal visualization. Traditionally, sniffing position (SP) is recommended to provide a superior glottic visualization, during direct laryngoscopy, enhancing the ease of intubation. Various studies in the last decade of this belief have challenged the need for sniffing position during intubation. We conducted a prospective study comparing the sniffing head position with simple head extension to study the laryngoscopic view and intubation difficulty during direct laryngoscopy...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928581/a-comparative-study-of-intravenous-esmolol-labetalol-and-lignocaine-in-low-doses-for-attenuation-of-sympathomimetic-responses-to-laryngoscopy-and-endotracheal-intubation
#4
Ekta Ratnani, Om Prakash Sanjeev, Abhishek Singh, Manoj Tripathi, Hemant Kumar Chourasia
BACKGROUND: Direct layngoscopy and endotracheal intubation is a noxious stimuli and induces sympathomimetic responses. Although well tolerated in healthy subjects, it may impose life threatening arrhythmias, left ventricular failure or rupture of cerebral aneurysm in susceptible patients. Esmolol, Labetalol and Lignocaine attenuate these responses but are associated with side effects of bradycardia, hypotension etc. In lower doses, chances of these side effects are comparatively low. So we designed this prospective clinical trial to assess the efficacy of intravenous esmolol, labetalol and lignocaine in low doses for attenuation of sympathomimetic responses to endotracheal intubation...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28927951/definitive-airway-management-after-pre-hospital-supraglottic-airway-insertion-outcomes-and-a-management-algorithm-for-trauma-patients
#5
Matthew C Hernandez, Johnathon M Aho, Martin D Zielinski, Scott P Zietlow, Brian D Kim, David S Morris
BACKGROUND: Prehospital airway management increasingly involves supraglottic airway insertion and a paucity of data evaluates outcomes in trauma populations. We aim to describe definitive airway management in traumatically injured patients who necessitated prehospital supraglottic airway insertion. METHODS: We performed a single institution retrospective review of multisystem injured patients (≥15years) that received prehospital supraglottic airway insertion during 2009 to 2016...
September 16, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28895500/anesthetic-management-of-a-patient-with-tracheal-dehiscence-post-tracheal-resection-surgery
#6
Sang Kim, Maryna Khromava, Jeron Zerillo, George Silvay, Adam I Levine
We present a case of a patient with complete tracheal dehiscence and multiple false passages after recent tracheal resection and anastomosis. Loss of tracheal continuity after disruption of anastomosis with distal stump retraction presents a unique anesthetic challenge given lack of access to the trachea and the need for adequate anesthesia and analgesia for surgical neck dissection. Traditional airway management, including awake fiberoptic intubation, intubation via direct laryngoscopy, needle cricothyrotomy, and awake tracheostomy are not viable options...
September 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28874303/airway-management-in-an-infant-with-a-large-supraglottic-mass-after-failed-fiberoptic-intubation
#7
Rajeev Sharma, Vidit Kaushal, Mohit Tyagi, Ashish Mittal
BACKGROUND: Fiberoptic bronchoscope-guided tracheal intubation is the gold standard for managing patients with supraglottic growths. In infants with a large and overhanging epiglottis, the success of fiberoptic-guided intubation relies heavily on the available space between the inferior surface of the epiglottis and the posterior pharyngeal wall or, more specifically, the superior surface of the supraglottic growth. CASE REPORT: We describe the inability to negotiate the tip of the fiberscope between the epiglottis and the supraglottic growth and the successful use of direct laryngoscopy to improve the available space along with the usefulness of "bubbling of air" to locate the glottic opening in an infant...
September 2, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28864483/cadaveric-study-of-movement-in-the-unstable-upper-cervical-spine-during-emergency-management-tracheal-intubation-and-cervical-spine-immobilisation-a-study-protocol-for-a-prospective-randomised-crossover-trial
#8
Shiyao Liao, Erik Popp, Petra Hüttlin, Frank Weilbacher, Matthias Münzberg, Niko Schneider, Michael Kreinest
INTRODUCTION: Emergency management of upper cervical spine injuries often requires cervical spine immobilisation and some critical patients also require airway management. The movement of cervical spine created by tracheal intubation and cervical spine immobilisation can potentially exacerbate cervical spinal cord injury. However, the evidence that previous studies have provided remains unclear, due to lack of a direct measurement technique for dural sac's space during dynamic processes...
September 1, 2017: BMJ Open
https://www.readbyqxmd.com/read/28846537/a-comparison-of-the-video-laryngoscopes-with-macintosh-laryngoscope-for-nasotracheal-intubation
#9
Kuang-Yi Tseng, I-Cheng Lu, Ya-Chun Shen, Chia-Heng Lin, Po-Nien Chen, Kuang-I Cheng
Nasotracheal intubation (NTI) is usually required in patients undergoing maxillofacial surgery. Though video-scopes have been demonstrated to perform well in oral endotracheal intubation, limited information is available concerning NTI. The aim of the study is to compare the efficiency of video-scopes and the traditional direct laryngoscopy in NTI. One hundred and eight patients scheduled for elective oro-maxillofacial surgery under nasotracheal intubation general anesthesia were randomly allocated into one of 3 groups of GlideScope, Pentax AirWay Scope, or Macintosh laryngoscope respectively...
March 2017: Asian J Anesthesiol
https://www.readbyqxmd.com/read/28835153/efficacy-of-pentax-airway-scope-versus-macintosh-laryngoscope-when-used-by-novice-personnel-a-prospective-randomized-controlled-study
#10
Kyu Nam Kim, Mi Ae Jeong, You Na Oh, Soo Yeon Kim, Ji Yoon Kim
Objective To determine whether intubation education using the Pentax Airway Scope (AWS) in normal airways is more useful than direct laryngoscopy (Macintosh laryngoscope) in novice personnel. Methods Eleven intern doctors without intubation experience performed 60 sequential intubations with each device on a manikin and 10 sequential intubations in adult patients. The time required for successful intubation, percentage of glottic opening (POGO) score, number of intubation attempts, and number of dental injuries were analyzed for each intubation technique...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28827261/evaluation-of-the-mcgrath-mac-and-macintosh-laryngoscope-for-tracheal-intubation-in-2000-patients-undergoing-general-anaesthesia-the-randomised-multicentre-emma-trial-study-protocol
#11
Marc Kriege, Christian Alflen, Irene Tzanova, Irene Schmidtmann, Tim Piepho, Ruediger R Noppens
INTRODUCTION: The direct laryngoscopy technique using a Macintosh blade is the first choice globally for most anaesthetists. In case of an unanticipated difficult airway, the complication rate increases with the number of intubation attempts. Recently, McGrath MAC (McGrath) video laryngoscopy has become a widely accepted method for securing an airway by tracheal intubation because it allows the visualisation of the glottis without a direct line of sight. Several studies and case reports have highlighted the benefit of the video laryngoscope in the visualisation of the glottis and found it to be superior in difficult intubation situations...
August 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28818287/application-of-flexible-endoscopy-based-biopsy-in-the-diagnosis-of-tumour-pathologies-in-otorhinolaryngology
#12
Carlos Saga, Manuel Olalde, Ekhiñe Larruskain, Leire Álvarez, Xabier Altuna
INTRODUCTION AND OBJECTIVES: Interventional endoscopy allows us to act on the pathology of the patient with minimal discomfort, low costs and high efficiency. We assessed the validity of flexible endoscopic biopsies in our hospital, in lesions suspected of malignancy in the rhino-pharyngo-laryngeal space. SUBJECTS AND METHODS: Retrospective study of patients with a pathology suspected of malignancy assessed between 2006-2016 in our centre. We evaluated the effectiveness, the tolerance and the number of complications...
August 14, 2017: Acta Otorrinolaringológica Española
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
#13
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/28797305/improved-success-rates-using-videolaryngoscopy-in-unexperienced-users-a-randomized-crossover-study-in-airway-manikins
#14
Hendrik Eismann, Lion Sieg, Nicola Etti, Lars Friedrich, Christian Schröter, Philipp Mommsen, Christian Krettek, Christian Zeckey
BACKGROUND: Videolaryngoscopy has been proven to be a safe procedure managing difficult airways in the hands of airway specialists. Information about the success rates in unexperienced users of videolaryngoscopy compared to conventional laryngoscopy is sparse. Therefore, we aimed to evaluate if there might be more success in securing an airway if the unexperienced provider is using a videolaryngoscope in simulated airways in a randomized manikin study. Differences between commonly used videolaryngoscopes were elucidated...
August 10, 2017: European Journal of Medical Research
https://www.readbyqxmd.com/read/28766977/surgical-management-of-supraglottic-stenosis-using-intubationless-optiflow
#15
Kenric Tam, Caroline Jeffery, C Kwang Sung
OBJECTIVE: Airway management during endoscopic surgical treatment of supraglottic and pharyngeal stenosis is often challenging and can be accomplished by various means, including tracheostomy, jet ventilation, or direct laryngoscopy. We describe CO2 laser excision of supraglottic-pharyngeal stenosis using intubationless Optiflow high-flow nasal cannula (HFNC). METHODS: A 55-year-old male presented with dyspnea and dysphagia secondary to severe supraglottic-pharyngeal stenosis in the setting of previous chemoradiation for a T0N2aM0 squamous cell carcinoma...
September 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/28760377/the-occurrence-of-aspiration-pneumonia-after-emergency-endotracheal-intubation
#16
Brian E Driver, Lauren R Klein, Alexandra L Schick, Matthew E Prekker, Robert F Reardon, James R Miner
STUDY OBJECTIVE: Adverse events, including aspiration, occur during Emergency Department (ED) intubation, but their contemporary incidence is not well described. We sought to estimate the rate of aspiration pneumonia potentially related to emergency intubation. METHODS: We conducted a prospective observational study of adult patients who were endotracheally intubated in the ED. Using a standard definition, we determined the proportion of patients who developed aspiration pneumonia after intubation...
July 19, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28752692/in-reply-comparing-direct-and-video-laryngoscopy-for-prehospital-intubation-can-meta-analysis-provide-and-exact-solution
#17
P Brian Savino, Scott Reichelderfer, Mary P Mercer, Karl A Sporer, Ralph C Wang
We thank the authors for this letter and appreciate the opportunity to respond to the comments and clarify our position. We agree with the authors in a number of their specific comments, and will attempt to address each of them. The first comment refers to the difference in video laryngoscopy devices and how "… pooling of results from studies evaluating performance of different VLs for prehospital intubation may lead to intrinsic inconsistencies in the primary endpoints." This article is protected by copyright...
July 28, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28752646/comparing-direct-and-video-laryngoscopy-for-prehospital-intubation-can-meta-analysis-provide-an-exact-solution
#18
Hui-Xian Li, Fu-Shan Xue, Gui-Zhen Yang, Ya-Yang Liu
The recent systemic review and meta-analysis by Savino et al.(1) comparing performance of video versus direct laryngoscopy for prehospital intubation was of great interested to us. They conclude that among physician intubators with significant direct laryngoscopy (DL) experience, video laryngoscopy (VL) does not increase overall or first-pass success rate and may lead to worsening performance. However, among non-physician intubators with less experience with DL, VL may provide benefit in the prehospital setting...
July 28, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28750882/unrecognized-failed-airway-management-using-a-supraglottic-airway-device
#19
Veer D Vithalani, Sabrina Vlk, Steven Q Davis, Neal J Richmond
BACKGROUND: 911 Emergency Medical Services (EMS) systems utilize supraglottic devices for either primary advanced airway management, or for airway rescue following failed attempts at direct laryngoscopy endotracheal intubation. There is, however, limited data on objective confirmation of supraglottic airway placement in the prehospital environment. Furthermore, the ability of EMS field providers to recognize a misplaced airway is unknown. METHODS: Retrospective review of patients who underwent airway management using the King LTS-D supraglottic airway in a large urban EMS system, between 3/1/15-9/30/2015...
October 2017: Resuscitation
https://www.readbyqxmd.com/read/28740393/current-evidence-for-the-use-of-c-mac-videolaryngoscope-in-adult-airway-management-a-review-of-the-literature
#20
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
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