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https://www.readbyqxmd.com/read/29352616/assessing-advanced-airway-management-performance-in-a-national-cohort-of-emergency-medical-services-agencies
#1
Henry E Wang, John P Donnelly, Dustin Barton, Jeffrey L Jarvis
STUDY OBJECTIVE: Although often the focus of quality improvement efforts, emergency medical services (EMS) advanced airway management performance has few national comparisons, nor are there many assessments with benchmarks accounting for differences in agency volume or patient mix. We seek to assess variations in advanced airway management and conventional intubation performance in a national cohort of EMS agencies. METHODS: We used EMS data from ESO Solutions, a national EMS electronic health record system...
January 15, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29352416/point-of-care-ultrasound-in-pediatric-anesthesiology-and-critical-care-medicine
#2
REVIEW
Erik Su, Nicholas Dalesio, Aliaksei Pustavoitau
Ultrasound has increasingly become a clinical asset in the hands of the anesthesiologist and intensivist who cares for children. Though many applications for ultrasound parallel adult modalities, children as always are not simply small adults and benefit from the application of ultrasound to their management in various ways. Body composition and size are important factors that affect ultrasound performance in the child, as are the pathologies that may uniquely afflict children and aspects of procedures unique to this patient population...
January 19, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29349776/effect-of-palpable-vs-impalpable-cricothyroid-membranes-in-a-simulated-emergency-front-of-neck-access-scenario
#3
C F Pairaudeau, C Mendonca, C Hillermann, I Qazi, P A Baker, R E Hodgson, S Radhakrishna
The Difficult Airway Society 2015 guidelines recommend and describe in detail a surgical cricothyroidotomy technique for the can't intubate, can't oxygenate (CICO) scenario, but this can be technically challenging for anaesthetists with no surgical training. Following a structured training session, 104 anaesthetists took part individually in a simulated can't intubate, can't oxygenate event using simulation and airway models to evaluate how well they could perform these front-of-neck access techniques. Main outcomes measures were: ability to correctly perform the technical steps; procedural time; and success rate...
January 19, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29326127/skill-sets-required-for-the-management-of-military-head-face-and-neck-trauma-a-multidisciplinary-consensus-statement
#4
John Breeze, R Blanch, J Baden, A M Monaghan, D Evriviades, S E Harrisson, S Roberts, A Gibson, N MacKenzie, D Baxter, A J Gibbons, S Heppell, J G Combes, R F Rickard
INTRODUCTION: The evolution of medical practice is resulting in increasing subspecialisation, with head, face and neck (HFN) trauma in a civilian environment usually managed by a combination of surgical specialties working as a team. However, the full combination of HFN specialties commonly available in the NHS may not be available in future UK military-led operations, necessitating the identification of a group of skill sets that could be delivered by one or more deployed surgeons. METHOD: A systematic review was undertaken to identify those surgical procedures performed to treat acute military head, face, neck and eye trauma...
January 10, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29123910/management-of-pediatric-cannot-intubate-cannot-oxygenate
#5
Yohei Okada, Wataru Ishii, Norio Sato, Hirokazu Kotani, Ryoji Iiduka
Case: "Cannot intubate, cannot oxygenate" (CICO) is a rare, life-threatening situation. We describe a pediatric case of CICO and highlight some educational points.A 3-year-old boy who collapsed in the bathtub came to our emergency department. On admission, he went into cardiac arrest probably because of an airway obstruction. We judged his condition as CICO and carried out an emergent tracheostomy after several attempts to perform a cricothyroidotomy failed. We continued resuscitation; however, circulation did not return spontaneously...
October 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29115646/a-new-perspective-on-life-saving-procedures-in-a-battlefield-setting-emergency-cricothyroidotomy-needle-thoracostomy-and-chest-tube-thoracostomy-with-night-vision-goggles
#6
Sedat Bilge, Attila Aydın, Meltem Bilge, Cemile Aydın, Erdem Çevik, Mehmet Eryılmaz
BACKGROUND: In the patients with multiple and serious trauma, early applications of life-saving procedures are related to improved survival. We tried to experimentally determine the feasibility of life-saving interventions that are performed with the aid of night vision goggles (NVG) in nighttime combat scenario. METHODS: Chest tube thoracostomy (CTT), emergency cricothyroidotomy (EC), and needle thoracostomy (NT) interventions were performed by 10 combatant medical staff...
November 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29080953/fatal-acute-retropharyngeal-hemorrhage-in-neurofibromatosis-type-1
#7
Pierre-Antoine Peyron, Michael S Pollanen
We report the sudden death of a woman with neurofibromatosis type 1 (NF1). The decedent developed acute respiratory distress and died rapidly despite an emergent cricothyroidotomy. An autopsy with postmortem CT scan was performed to determine the cause of the fatal respiratory collapse and to determine if death was related to neurofibromatosis. Postmortem examination revealed the classical external hallmarks of neurofibromatosis, including innumerable cutaneous neurofibromas. In addition, there was a massive retropharyngeal hematoma with fatal extrinsic compression of the airway...
December 2017: Forensic Science, Medicine, and Pathology
https://www.readbyqxmd.com/read/29066133/enhancement-of-cricothyroidotomy-education-using-a-novel-technique-cadaver-autografting
#8
Ryan F Coughlin, Iris Chandler, John C Binford, James W Bonz, David C Hile
BACKGROUND: Cricothyroidotomy is a lifesaving procedure required in up to 2% of emergent airways. Emergency medicine training programs frequently instruct this procedure via cadaver training, but cadaver cost and availability limit the opportunity for all trainees to perform the critical initial skin incision. Cadaver autografting is a novel way to simulate all steps of the procedure. OBJECTIVE: Our aim was to determine whether the technique of autografting cadaver tissue improves the experience of cricothyroidotomy simulation education for emergency medicine trainees...
December 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29059667/-life-saving-cricothyroidotomy-in-throat-and-laryngeal-injuries-case-study
#9
Maja Chrzanowska-Wąsik, Leszek Sobiech, Vadim Matsibora, Tomasz Stankiewicz, Mariusz Goniewicz, Kamil Bednarz, Patryk Rzońca
The percentage of laryngeal injuries managed by hospital emergency departments is low. Currently, with the Emergency Medical Services working more efficiently, diagnostic imaging tools being more available and more precise surgical procedures after the injury, the mortality and disability rate among trauma victims is systematically decreasing. The given paper presents a case of a multiple organ trauma, including trauma to the larynx and throat, experienced during agricultural works. Life-saving surgical cricothyroidotomy using a tracheal tube was performed after preliminary diagnosis of the patient...
2017: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29057187/modelling-and-manufacturing-of-a-3d-printed-trachea-for-cricothyroidotomy-simulation
#10
Gregory Doucet, Stephen Ryan, Michael Bartellas, Michael Parsons, Adam Dubrowski, Tia Renouf
Cricothyroidotomy is a life-saving medical procedure that allows for tracheal intubation. Most current cricothyroidotomy simulation models are either expensive or not anatomically accurate and provide the learner with an unrealistic simulation experience. The goal of this project is to improve current simulation techniques by utilizing rapid prototyping using 3D printing technology and expert opinions to develop inexpensive and anatomically accurate trachea simulators. In doing so, emergency cricothyroidotomy simulation can be made accessible, accurate, cost-effective and reproducible...
August 18, 2017: Curēus
https://www.readbyqxmd.com/read/29055963/a-fatal-case-of-acute-bentazone-overdose-despite-cricothyroidotomy-during-cardiopulmonary-resuscitation
#11
Kyungwon Lee
Bentazone is classified as a moderately hazardous (class II) herbicide by the World Health Organization. A 53-year-old Korean woman was transferred to the emergency department after a suicide attempt using approximately 500 mL of bentazone one hour prior to admission. Upon admission, she was alert and tachycardia of 125/min was observed. She was treated with gastric lavage and activated charcoal, during which she experienced diarrhea. Two hours after bentazone ingestion, cardiac arrest and muscle rigidity throughout the body occurred...
October 20, 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/28837293/-%C3%A2-golden-hour-%C3%A2-and-the-sellick-manoeuvre-in-emergency-care-we-must-not-throw-out-the-baby-with-the-bathwater
#12
Lukas Bürki, Bertrand Yersin
This article evaluates 3 controversial subjects of pre-hospital emergency care : 1) The concept of the « Golden hour » predicates an increased morbidity and mortality for injured patients, if pre-hospital care exceeds 1 hour. In the subgroup of patients presenting with severe hemorrhagic injuries or penetrating trauma to the torso, a transport of 60 minutes or less decreases mortality ; 2) The Sellick manoeuvre is used to decrease the risk of bronchoaspiration in patients undergoing an emergency intubation...
August 9, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28709415/assessing-anesthesiology-residents-out-of-the-operating-room-ooor-emergent-airway-management
#13
Lauryn R Rochlen, Michelle Housey, Ian Gannon, Shannon Mitchell, Deborah M Rooney, Alan R Tait, Milo Engoren
BACKGROUND: At many academic institutions, anesthesiology residents are responsible for managing emergent intubations outside of the operating room (OOOR), with complications estimated to be as high as 39%. In order to create an OOOR training curriculum, we evaluated residents' familiarity with the content and correct adherence to the American Society of Anesthesiologists' Difficult Airway Algorithm (ASA DAA). METHODS: Residents completed a pre-simulation multiple-choice survey measuring their understanding and use of the DAA...
July 15, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28704628/positive-affect-is-associated-with-reduced-fixation-in-a-realistic-medical-simulation
#14
Monique F Crane, Sue Brouwers, Kirsty Forrest, Suyin Tan, Thomas Loveday, Mark W Wiggins, Chris Munday, Leila David
OBJECTIVE: This study extends previous research by exploring the association between mood states (i.e., positive and negative affect) and fixation in practicing anesthetists using a realistic medical simulation. BACKGROUND: The impact of practitioner emotional states on fixation is a neglected area of research. Emerging evidence is demonstrating the role of positive affect in facilitating problem solving and innovation, with demonstrated implications for practitioner fixation...
August 2017: Human Factors
https://www.readbyqxmd.com/read/28704285/cricothyroidotomy-in-situ-simulation-curriculum-cric-study-training-residents-for-rare-procedures
#15
Andrew Petrosoniak, Agnes Ryzynski, Gerald Lebovic, Karen Woolfrey
INTRODUCTION: Technical skill acquisition for rare procedures can be challenging given the few real-life training opportunities. In situ simulation (ISS), a training technique that takes place in the actual workplace, is a promising method to promote environmental fidelity for rare procedures. This study evaluated a simulation-based technical skill curriculum for cricothyroidotomy using deliberate practice, followed by an ISS evaluation session. METHODS: Twenty emergency medicine residents participated in a two-part curriculum to improve cricothryoidotomy performance...
April 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/28599039/manikin-human-patient-simulator-training
#16
Gregory T Horn, F Y Bowling, David E Lowe, James G Parimore, David R Stagliano, Nicholas M Studer
BACKGROUND: Human-patient simulators (HPSs) may help enhance medical education. Manikin HPS devices respond to common field medical interventions, such as cricothyroidotomy, and have realistic feedback features, such as respirations and pulses. This study surveys Special Operations Medics for evaluations of HPS features. METHODS: Of 518 subjects, 376 completed testing and surveys with valid responses. A total of 102 variables were divided into three categories-general characteristics, procedures, and injuries-and assessed on a fivepoint Likert scale...
December 0: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28582801/emergency-airway-management-in-australian-and-new-zealand-emergency-departments-a-multicentre-descriptive-study-of-3710-emergency-intubations
#17
Hatem Alkhouri, John Vassiliadis, Matthew Murray, John Mackenzie, Alex Tzannes, Sally McCarthy, Toby Fogg
OBJECTIVE: The aim of this study was to describe the practice of endotracheal intubation across a range of Australasian EDs. METHODS: We established a multicentre airway registry (The Australian and New Zealand Emergency Department Airway Registry [ANZEDAR]) prospectively capturing intubations from 43 Australian and New Zealand EDs over 24 months using the ANZEDAR form. Information recorded included patient demographics, intubation indications, predicted difficulty, rapid sequence induction and endotracheal intubation preparation technique, induction drugs, airway adjuncts and complications...
October 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28582363/positive-pressure-ventilation-through-small-cricothyroidotomy-tubes-in-a-model-lung
#18
Aya Yoshidome, Kazuyoshi Aoyama, Ichiro Takenaka
No abstract text is available yet for this article.
July 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28291128/the-use-of-ultrasound-in-obstetric-anesthesia
#19
Carolyn F Weiniger, Limor Sharoni
PURPOSE OF REVIEW: The current review considers an array of recent applications for point-of-care ultrasound in clinical practice including diagnostic and therapeutic procedures that may be relevant for the obstetric anesthesiologist. The rapid advancement of technology and clinical applications for bedside ultrasound in obstetric anesthesiology requires an appraisal of the limitations and uses. RECENT FINDINGS: The review presents the most recent literature describing ultrasound-guided airway assessments, airway management, cricothyroidotomy, transthoracic echocardiography, gastric volume assessments, point-of-care lung ultrasound diagnoses, intracranial pressure assessments, vascular access, neuraxial blocks, and transversus abdominis plane blocks...
June 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28268756/3d-force-torque-characterization-of-emergency-cricothyroidotomy-procedure-using-an-instrumented-scalpel
#20
Adam Ryason, Ganesh Sankaranarayanan, Kathryn L Butler, Marc DeMoya, Suvranu De
Emergency Cricothyroidotomy (CCT) is a surgical procedure performed to secure a patient's airway. This high-stakes, but seldom-performed procedure is an ideal candidate for a virtual reality simulator to enhance physician training. For the first time, this study characterizes the force/torque characteristics of the cricothyroidotomy procedure, to guide development of a virtual reality CCT simulator for use in medical training. We analyze the upper force and torque thresholds experienced at the human-scalpel interface...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
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