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Direct Laryngoscopy

Vinuta V Patil, Bala H Subramanya, N Kiranchand, S Bala Bhaskar, Srinivasalu Dammur
BACKGROUND AND AIMS: C-MAC(®) video laryngoscope (VL) with Macintosh blade has been found to improve Cormack-Lehane (C-L) laryngoscopic view as well as intubating conditions for orotracheal intubation. However, studies done on the performance of C-MAC(®) VL for nasotracheal intubation (NTI) are very few in number. Hence, we compared laryngoscopy and intubating conditions between Macintosh direct laryngoscope and C-MAC(®) VL for NTI. METHODS: Sixty American Society of Anesthesiologists Physical Status I, II patients, aged 8-18 years, posted for tonsillectomy surgeries under general anaesthesia with NTI were randomised, into two groups...
October 2016: Indian Journal of Anaesthesia
Ramon E Abola, Elliott Bennett-Guerrero
No abstract text is available yet for this article.
November 2016: Critical Care Medicine
Eugene Kim, Byung-Gun Kim, Young-Jin Lim, Young-Tae Jeon, Jung-Won Hwang, Seo-Yun Lee, Hee-Pyoung Park
BACKGROUND: Positioning of a lightwand in the midline of the oral cavity can be challenging in patients with cervical immobilization. Direct laryngoscopy may permit the lightwand tip to more easily access the glottic opening. We tested our hypothesis that a laryngoscope-assisted lightwand technique allows more successful endotracheal intubation than does a conventional lightwand approach. METHODS: A total of 162 patients requiring cervical immobilization during intubation for cervical spine surgery were allocated randomly to 2 groups...
October 11, 2016: Anesthesia and Analgesia
Young Yong Kim, Gu Hyun Kang, Won Hee Kim, Hyun Young Choi, Yong Soo Jang, Young Jae Lee, Jae Guk Kim, Hyeongtae Kim, Gyoung Yong Kim
OBJECTIVE: This study aimed to compare intubation performance between blind intubation through supraglottic airway devices and direct laryngoscopy by novices under manikin simulation. We hypothesized that the intubation time by novices using supraglottic airway devices was superior to that with the Macintosh laryngoscope (MCL). METHODS: A prospective, randomized crossover study was conducted with 95 participants, to evaluate i-gel, air-Q, LMA Fastrach, and MCL devices...
June 2016: Clin Exp Emerg Med
Jennifer F Ha, Waseem Ostwani, Glenn Green
INTRODUCTION: With the advent of improved neonatal and pediatric intensive care management, tracheostomy is increasingly performed in children requiring prolonged ventilation. Even though tracheostomy is generally a safe procedure, there remains mortality and morbidity associated with it. OBJECTIVE: We report a rare complication of a tracheostomy tube resulting in extensive erosion and posterior tracheal false pouch secondary to a large tracheostomy tube and high positive end expiratory pressure in a 12-month-old infant...
November 2016: International Journal of Pediatric Otorhinolaryngology
Frederik Buchvald, Lue Drasbaek Phillipsen, Thomas Hjuler, Kim G Nielsen
BACKGROUND AND AIMS: Exercise-induced inspiratory symptoms (EIIS) have multiple causes, one of which is exercise-induced laryngeal obstruction (EILO). There is limited knowledge regarding EIIS in children, both in primary care practices and in pediatric asthma clinics. The aim of this study was to describe the feasibility of a diagnostic methodology and its results in a cohort of children with EIIS referred to our tertiary pediatric pulmonary center. METHODS: This study analyzed consecutively collected data in children from East Denmark and Greater Copenhagen referred during a 3½ years period...
November 2016: Pediatric Pulmonology
Andreas Moritz, Sebastian Heinrich, Andrea Irouschek, Torsten Birkholz, Johannes Prottengeier, Joachim Schmidt
BACKGROUND: Single-use plastic blades (SUPB) and single-use metal blades (SUMB) for direct laryngoscopy and tracheal intubation have not yet been compared with reusable metal blades (RUMB) in difficult airway scenarios. OBJECTIVE: The purpose of our manikin study was to compare the effectiveness of these different laryngoscope blades in a difficult airway scenario, as well as in a difficult airway scenario with simulated severe inhalation injury. METHODS: Thirty anesthetists performed tracheal intubation (TI) with each of the three laryngoscope blades in the two scenario manikins...
September 29, 2016: Journal of Emergency Medicine
Ricardo Fuentes, Juan Carlos De la Cuadra, Hector Lacassie, Alejandro González
: Neonates and small infants with craniofacial malformation may be very difficult or impossible to mask ventilate or intubate. We would like to report the fiberoptic intubation of a small infant with Treacher Collins Syndrome using the technique described by Ellis et al. CASE REPORT: An one month-old infant with Treacher Collins Syndrome was scheduled for mandibular surgery under general endotracheal anesthesia. Direct laryngoscopy for oral intubation failed to reveal the glottis...
September 27, 2016: Revista Brasileira de Anestesiologia
Lucas Van Oeveren, Julie Donner, Andrea Fantegrossi, Nicholas M Mohr, Calvin A Brown
BACKGROUND: Intubation in rural emergency departments (EDs) is a high-risk procedure, often with little or no specialty support. Rural EDs are utilizing real-time telemedicine links, connecting providers to an ED physician who may provide clinical guidance. INTRODUCTION: We endeavored to describe telemedicine-assisted intubation in rural EDs that are served by an ED telemedicine network. MATERIALS AND METHODS: Prospective data were collected on all patients who had an intubation attempt while on the video telemedicine link from May 1, 2014 to April 30, 2015...
September 27, 2016: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
Urte Kunz-Zurbuchen, Heinz Johannes Buhr, Hubert G Hotz, Martin E Kreis, Kai S Lehmann
PURPOSE: To evaluate the rate of surgical complications during the change from subtotal resection to hemithyroidectomy or thyroidectomy over a period of 17 years. METHODS: All operations for benign goiter at our hospital were analyzed for the periods 1996-2002 (Group 1) and 2003-2012 (Group 2). The groups were compared for recurrent laryngeal nerve damage, hypocalcemia, and other surgical complications directly postoperatively. RESULTS: In total, 1462 patients were operated on for goiter between 1996 and 2012...
September 19, 2016: Asian Journal of Surgery
Pitsucha Sanguanwit, Thavinee Trainarongsakul, Noppanan Kaewsawang, Kittisak Sawanyawisuth, Yuwares Sitthichanbuncha
BACKGROUND: Difficult airway intubation is an emergency condition both at the emergency department (ED) and in out-of-hospital situations. Retrograde intubation (RI) is another option for difficult airway management. There are limited data regarding the successful rate of RI compared with direct laryngoscopy (DL) intubation, the commonly used method in the ED. METHODS: This study was a randomized, controlled trial. Participants were randomly assigned to either the RI or the DL technique to attempt intubation on a difficult airway mannequin (Cormack and Lehane grades 3-4)...
August 30, 2016: American Journal of Emergency Medicine
Aliya Ahmed, Fauzia Anis Khan, Samina Ismail
BACKGROUND AND AIMS: Gaining expertise in procedural skills is essential for achieving clinical competence during anesthesia training. Supervisors have the important responsibility of deciding when the trainee can be allowed to perform various procedures without direct supervision while ensuring patient safety. This requires robust and reliable assessment techniques. Airway management with bag-mask ventilation and tracheal intubation are routinely performed by anesthesia trainees at induction of anesthesia and to save lives during a cardiorespiratory arrest...
July 2016: Journal of Anaesthesiology, Clinical Pharmacology
Stacey Watt, Jonathan Kalpan, Venkatesware Kolli
INTRODUCTION: The use of videolaryngoscopy continues to play a larger role in the approach to patients with airway pathology. Looking specifically at patients with potential difficulty in ventilation and intubation due to thyroid goiter, video laryngoscopy may provide a faster and easier technique to secure the airway compared to direct laryngoscopy. PRESENTATION OF CASE: In the case we will present to you, a 60-year-old female with a large goiter presented to a community hospital emergency room where she was found to be in respiratory distress with increased work of breathing...
2016: International Journal of Surgery Case Reports
Robert S Green, Dean A Fergusson, Alexis F Turgeon, Lauralyn A McIntyre, George J Kovacs, Donald E Griesdale, Ryan Zarychanski, Michael B Butler, Nelofar Kureshi, Mete Erdogan
OBJECTIVES: Various medications and devices are available for facilitation of emergent endotracheal intubations (EETIs). The objective of this study was to survey which medications and devices are being utilized for intubation by Canadian physicians. METHODS: A clinical scenario-based survey was developed to determine which medications physicians would administer to facilitate EETI, their first choice of intubation device, and backup strategy should their first choice fail...
August 30, 2016: CJEM
Pierre-Louis Declercq, Michael Bubenheim, Stéphanie Gelinotte, Kévin Guernon, Jean-Baptiste Michot, Vincent Royon, Dorothée Carpentier, Gaëtan Béduneau, Fabienne Tamion, Christophe Girault
BACKGROUND: Different video-laryngoscopes (VDLs) for endotracheal intubation (ETI) have recently been developed. We compared the performance of the VDL Airway Scope (AWS) with the direct laryngoscopy by Macintosh (DLM) for ETI success, time and learning. METHODS: We performed an experimental manikin controlled study. Twenty experienced (experts) and 40 inexperienced operators (novices) for DLM-ETI were enrolled. None of them had experience with the use of AWS-VDL...
December 2016: Annals of Intensive Care
Harsha Dhirubhai Makwana, Nilay N Suthar, Mehul P Gajjar, Advait V Thakor
BACKGROUND: Our existing undergraduate curriculum lacks developing competency for endotracheal intubation. Even though it is a lifesaving procedure, interns are exposed only during their posting in anesthesia or emergency medicine and so, when need arises, they fail to perform endotracheal intubation and it leads to catastrophes. AIMS AND OBJECTIVES: The aim of this study was to develop competency in interns for endotracheal intubation. MATERIALS AND METHODS: A study was conducted on fifty interns of medical college...
July 2016: International Journal of Applied and Basic Medical Research
Julena Foglia, David Archer, Saul Pytka, Leyla Baghirzada, Kaylene Duttchen
STUDY OBJECTIVE: To determine if an endotracheal (ET) tube will distort the laryngeal view obtained with direct laryngoscopy measuring with the modified Cormack-Lehane scale (MCL). DESIGN: Observational single-arm study. SETTING: The University of Calgary teaching hospitals. PATIENTS: Patients between 18 and 86 years of age undergoing elective surgical procedures. A total of 173 patients were enrolled and analyzed. INTERVENTIONS: Direct laryngoscopy view obtained before ET intubation and directly after intubation...
September 2016: Journal of Clinical Anesthesia
Jan Florian Heuer, Sören Heitmann, Thomas A Crozier, Annalen Bleckmann, Michael Quintel, Sebastian G Russo
DESIGN: Prospective, randomized, clinical trial. SETTING: University hospital operation room. PATIENTS: 104 patients scheduled for elective dental or maxillofacial surgery were randomized to two groups: GlideScope® classic (GSc) and GlideScope® direct (GSd). INTERVENTIONS: We compared the video laryngoscopes GSc and GSd with each other and with direct laryngoscopy (DL) for nasotracheal intubation with regard to visualization of the glottis, intubation success rate, and required time for and ease of intubation...
September 2016: Journal of Clinical Anesthesia
William B Landry, Bobby D Nossaman
STUDY OBJECTIVE: The purpose of this study was to analyze previously reported airway risk factors in the performance of Miller laryngoscopy and orotracheal intubation. DESIGN: Prospective, observational study. SETTING: Operating rooms. PATIENTS: A total of 978 American Society of Anesthesiologists I-III adults requiring general orotracheal anesthesia for elective surgery. INTERVENTIONS: None. MEASUREMENTS: Nine previously reported airway risk factors used in predicting difficult laryngoscopy, modified McCormack-Lehane views observed during initial unaided Miller blade laryngoscopy, and number of attempts or need for alternate airway tools to facilitate orotracheal intubation...
September 2016: Journal of Clinical Anesthesia
Simon Sulser, Dirk Ubmann, Martin Schlaepfer, Martin Brueesch, Georg Goliasch, Burkhardt Seifert, Donat R Spahn, Kurt Ruetzler
BACKGROUND: Airway management in the emergency room can be challenging when patients suffer from life-threatening conditions. Mental stress, ignorance of the patient's medical history, potential cervical injury or immobilisation and the presence of vomit and/or blood may also contribute to a difficult airway. Videolaryngoscopes have been introduced into clinical practice to visualise the airway and ultimately increase the success rate of airway management. OBJECTIVE: The aim of this study was to test the hypothesis that the C-MAC videolaryngoscope improves first-attempt intubation success rate compared with direct laryngoscopy in patients undergoing emergency rapid sequence intubation in the emergency room setting...
August 16, 2016: European Journal of Anaesthesiology
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