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https://www.readbyqxmd.com/read/29214627/a-12-month-descriptive-analysis-of-emergency-intubations-at-brooke-army-medical-center-a-national-emergency-airway-registry-study
#1
Michael D April, Steven G Schauer, Calvin A Brown Rd, Patrick C Ng, Jessie Fernandez, Andrea E Fantegrossi, Joseph K Maddry, Shane Summers, Daniel J Sessions, Robert M Barnwell, Mark Antonacci
Emergency airway management is a critical skill for military healthcare providers. Our goal was to describe the Emergency Department (ED) intubations at Brooke Army Medical Center (BAMC) over a 12-month period. MATERIAL AND METHODS: Physicians performing endotracheal intubations in the BAMC ED complete data collection forms for each intubation event as part of the National Emergency Airway Registry, including patient demographics, intubation techniques, success and failure rates, adverse events, and patient disposition...
October 2017: U.S. Army Medical Department Journal
https://www.readbyqxmd.com/read/29209787/-different-levels-of-experience-with-anesthetic-agents-of-german-emergency-physicians-results-of-an-online-survey
#2
A Luckscheiter, M Fischer, W Zink
BACKGROUND AND OBJECTIVE: In 2015 practice management guidelines on prehospital emergency anesthesia in adults were published in Germany. The aim of the present study was to evaluate whether emergency physicians follow these guidelines in daily practice and to assess their level of experience with the use of anesthetic agents. MATERIAL AND METHODS: In an online survey the way of induction of preclinical anesthesia (including preoxygenation time and applied monitoring techniques) was assessed with the help of virtual scenarios based on the guidelines...
December 5, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29166296/emergency-intubations-in-a-high-volume-pediatric-emergency-department
#3
Jen Heng Pek, Gene Yong-Kwang Ong
INTRODUCTION: Resuscitation of critically ill children can be chaotic, and emergency airway management is often fraught with difficulties. This study aimed to characterize the Singaporean landscape of tracheal intubation in a pediatric emergency unit, placing emphasis on safety outcomes, procedural process of care, and provider training. METHODS: A retrospective review of all cases presented to the KK Women's and Children's Hospital from January 2009 to December 2013 with intubation carried out within the pediatric emergency unit was done...
November 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29162438/peri-intubation-factors-affecting-emergency-physician-choice-of-paralytic-agent-for-rapid-sequence-intubation-of-trauma-patients
#4
Jason R West, Catherine Lott, Lee Donner, Marc Kanter, Nicholas D Caputo
INTRODUCTION: No study has assessed predictors of physician choice between the succinylcholine (Succ) and rocuronium (Roc) for rapid sequence intubation (RSI) during the initial resuscitation of trauma patients in the emergency department (ED). METHODS: We retrospectively evaluated of the use of Succ and Roc for adult trauma patients undergoing RSI at a Level 1 trauma center. The primary outcome was to identify factors affecting physician choice of paralytic agent for RSI analyzed by cluster analysis using pre-intubation vital signs and early mortality...
November 18, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29115039/spectroscopic-determination-of-succinylcholine-in-dosage-forms-using-eosin-y
#5
Magda M Ayad, Fathalla Belal, Mervet M Hosney, Samah Abo El Abass, Nora Elsayed
Two simple and sensitive analytical assay methods using spectrophotometry and spectrofluorimetry techniques were developed for the estimation of succinylcholine chloride (SUC) in pharmaceutical preparations. The suggested methods are based on the formation of an ion pair complex formed between the drug and eosin Y spectrophotometrically (Method I), or the suppressive effect of succinylcholine on the native fluorescence property of eosin Y (Method II). The spectrophotometric method (Method I) involves measuring the absorbance of the complex between succinylcholine and eosin Y at 550 nm in Britton Robinson buffer of pH 3...
November 8, 2017: Luminescence: the Journal of Biological and Chemical Luminescence
https://www.readbyqxmd.com/read/29112511/an-anesthesiologist-s-perspective-on-the-history-of-basic-airway-management-the-progressive-era-1904-to-1960
#6
Adrian A Matioc
This third installment of the history of basic airway management discusses the transitional-"progressive"-years of anesthesia from 1904 to 1960. During these 56 yr, airway management was provided primarily by basic techniques with or without the use of a face mask. Airway maneuvers were inherited from the artisanal era: head extension and mandibular advancement. The most common maneuver was head extension, also used in bronchoscopy and laryngoscopy. Basic airway management success was essential for traditional inhalation anesthesia (ether, chloroform) and for the use of the new anesthetic agents (cyclopropane, halothane) and intravenous drugs (thiopental, curare, succinylcholine)...
November 7, 2017: Anesthesiology
https://www.readbyqxmd.com/read/29083331/the-effect-of-remifentanil-on-succinylcholine-induced-changes-in-serum-potassium-and-creatine-kinase-a-prospective-randomized-double-blind-study
#7
Karim Nasseri, Shoaleh Shami, Mousa Shirmohammadi, Farzad Sarshivi, Negin Ghadami
BACKGROUND AND AIM OF THE WORK: Succinylcholine is still included as drugs favored by anesthetists because of its rapid onset and short duration of action. However, it can bring about complications such as hyperkalemia and increased serum creatine phosphokinase (CPK). This study aims at evaluating the effects of remifentanil on succinylcholine-induced postoperative changes in serum potassium and CPK. METHODS: In this study, 59 patients with short term lower abdominal surgery were randomly divided into two groups...
October 23, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/29064876/incidence-of-anaphylaxis-associated-with-sugammadex
#8
Yusuke Miyazaki, Hiroshi Sunaga, Kotaro Kida, Shotaro Hobo, Nobuyoshi Inoue, Masayuki Muto, Shoichi Uezono
We retrospectively investigated the incidence of potential sugammadex-induced anaphylaxis at a single center in Japan over a period of 3 years. The overall incidence of intraoperative hypersensitivity reaction was 0.22% (95% confidence interval [CI], 0.17%-0.29%), and the incidence of anaphylaxis was 0.059% (95% CI, 0.032%-0.10%). The total number of patients who received sugammadex during the study period was 15,479, and the incidence of anaphylaxis associated with sugammadex was 0.039% (n = 6; 95% CI, 0.014%-0...
October 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29055963/a-fatal-case-of-acute-bentazone-overdose-despite-cricothyroidotomy-during-cardiopulmonary-resuscitation
#9
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/29041919/preparing-for-the-unexpected-special-considerations-and-complications-after-sugammadex-administration
#10
REVIEW
Hajime Iwasaki, J Ross Renew, Takayuki Kunisawa, Sorin J Brull
Sugammadex, a modified gamma-cyclodextrin, has changed clinical practice of neuromuscular reversal dramatically. With the introduction of this selective relaxant binding agent, rapid and reliable neuromuscular reversal from any depth of block became possible. Sugammadex can reverse neuromuscular blockade without the muscarinic side effects typically associated with the administration of acetylcholinesterase inhibitors. However, what remained unchanged is the incidence of residual neuromuscular blockade. It is known that sugammadex cannot always prevent its occurrence, if appropriate dosing is not chosen based on the level of neuromuscular paralysis prior to administration determined by objective neuromuscular monitoring...
October 17, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29032298/factors-and-outcomes-associated-with-inpatient-cardiac-arrest-following-emergent-endotracheal-intubation
#11
Gabriel Wardi, Julian Villar, Thien Nguyen, Anuja Vyas, Nicholas Pokrajac, Anushirvan Minokadeh, Daniel Lasoff, Christopher Tainter, Jeremy R Beitler, Rebecca E Sell
BACKGROUND: Inpatient peri-intubation cardiac arrest (PICA) following emergent endotracheal intubation (ETI) is an uncommon but potentially preventable type of cardiac arrest (CA). Limited published data exist describing factors associated with inpatient PICA and patient outcomes. This study identifies risk factors associated with PICA among hospitalized patients emergently intubated out of the operating room and compares PICA to other types of inpatient CA. METHODS: Retrospective case-control study of patients at our institution over a five-year period...
December 2017: Resuscitation
https://www.readbyqxmd.com/read/28936613/chronic-inflammatory-demyelinating-polyradiculoneuropathy-and-anesthesia-a-case-series
#12
Andrew R Mortenson, Juraj Sprung, James C Watson, P James B Dyck, Toby N Weingarten
Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an acquired autoimmune demyelinating polyneuropathy characterized by symmetrical diffuse weakness that also can rarely affect bulbar and respiratory muscles. The study objective was to describe perioperative outcomes of patients with CIDP who received general anesthesia. This retrospective observational study evaluated patients with active (diagnosed or treated within the previous year) CIDP who underwent general anesthesia at our institution between January 1, 2010, and December 31, 2015...
September 21, 2017: Acta Neurologica Belgica
https://www.readbyqxmd.com/read/28879341/airway-obstruction-by-dissection-of-the-inner-layer-of-a-reinforced-endotracheal-tube-in-a-patient-with-ludwig-s-angina-a-case-report
#13
Sung-Min Shim, Jae-Ho Park, Dong-Min Hyun, Hwa-Mi Lee
Intraoperative airway obstruction is perplexing to anesthesiologists because the patient may fall into danger rapidly. A 74-year-old woman underwent an emergency incision and drainage for a deep neck infection of dental origin. She was orally intubated with a 6. 0 mm internal diameter reinforced endotracheal tube by video laryngoscope using volatile induction and maintenance anesthesia (VIMA) with sevoflurane, fentanyl (100 µg), and succinylcholine (75 mg). During surgery, peak inspiratory pressure increased from 22 to 38 cmH2O and plateau pressure increased from 20 to 28 cmH2O...
June 2017: Journal of Dental Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28814478/effect-of-patient-weight-on-first-pass-success-and-neuromuscular-blocking-agent-dosing-for-rapid-sequence-intubation-in-the-emergency-department
#14
Asad E Patanwala, John C Sakles
OBJECTIVES: The primary objective of this study was to determine the association between patient weight and first pass success (FPS) during rapid sequence intubation (RSI) in the ED. The secondary objective was to evaluate the association between patient weight and neuromuscular blocking agent (NMBA) dosing. METHODS: This was a retrospective cohort study conducted in a tertiary care academic ED. Consecutive adult patients who underwent RSI in the ED between January 2014 and June 2016 were included...
November 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28780538/optimal-dose-of-succinylcholine-for-laryngeal-mask-airway-insertion-systematic-review-meta-analysis-and-metaregression-of-randomised-control-trials
#15
Alan Hsi-Wen Liao, Yu-Cih Lin, Chyi-Huey Bai, Chien-Yu Chen
OBJECTIVES: To evaluate the optimal dose of succinylcholine for laryngeal mask airway (LMA) insertion and all related morbidities. DESIGN: Systematic review, meta-analysis and metaregression of randomised controlled trials (RCTs). DATA SOURCE AND STUDY ELIGIBILITY CRITERIA: A comprehensive search of RCTs in the PubMed, Embase, the Cochrane Library and the ClinicalTrials.gov registry up to July 2016 and articles that evaluated the use of succinylcholine chloride for LMA insertion were included in the analyses...
August 4, 2017: BMJ Open
https://www.readbyqxmd.com/read/28763317/rocuronium-is-more-hepatotoxic-than-succinylcholine-in-vitro
#16
Martin Sauer, Ines Piel, Cristof Haubner, Georg Richter, Miriam Mann, Gabriele Nöldge-Schomburg, Thomas Mencke
BACKGROUND: The development of liver failure is a major problem in critically ill patients. The hepatotoxicity of many drugs, as one important reason for liver failure, is poorly screened for in human models. Rocuronium and succinylcholine are neuromuscular blocking agents used for tracheal intubation and for rapid-sequence induction. OBJECTIVE: We used an in-vitro test with a permanent cell line and compared rocuronium and succinylcholine for hepatotoxicity. DESIGN: In-vitro study...
September 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28754225/-low-dose-propofol-vs-lidocaine-for-relief-of-resistant-post-extubation-laryngospasm-in-the-obstetric-patient
#17
Ali M Mokhtar, Ahmed A Badawy
BACKGROUND: Post-extubation laryngospasm is a dangerous complication that should be managed promptly. Standard measures were described for its management. We aimed to compare the efficacy of propofol (0.5mg.kg(-1)) vs. lidocaine (1.5mg.kg(-1)) for treatment of resistant post-extubation laryngospasm in the obstetric patients, after failure of the standard measures. METHOD: This study was conducted over 2 years on all obstetric patients scheduled for cesarean delivery...
July 25, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28719515/anaesthetic-management-of-patients-with-myopathies
#18
Mark Schieren, Jerome Defosse, Andreas Böhmer, Frank Wappler, Mark U Gerbershagen
: The anaesthetic management of patients with myopathies is challenging. Considering the low incidence and heterogeneity of these disorders, most anaesthetists are unfamiliar with key symptoms, associated co-morbidities and implications for anaesthesia. The pre-anaesthetic assessment aims at the detection of potentially undiagnosed myopathic patients and, in case of known or suspected muscular disease, on the quantification of disease progression. Ancillary testing (e.g. echocardiography, ECG, lung function testing etc...
October 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28705229/brugada-syndrome-in-a-patient-with-amyotrophic-lateral-sclerosis-a-case-report
#19
Anusha Battineni, Rohit Gummi, Naresh Mullaguri, Raghav Govindarajan
BACKGROUND: Amyotrophic lateral sclerosis is a fatal neuromuscular disorder characterized by progressive death of the upper and lower motor neurons in the central nervous system. Patients with this disease die mostly as a result of respiratory failure; however, owing to prolonged survival through assisted ventilation, cardiovascular causes are increasingly responsible for mortality. We report what is to the best of our knowledge the first case of type 2 Brugada syndrome causing ventricular tachyarrhythmia and cardiac arrest in a patient with upper limb onset amyotrophic lateral sclerosis...
July 14, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28663634/comparison-of-effect-of-ephedrine-and-priming-on-the-onset-time-of-vecuronium
#20
Krishnadas Anandan, Indu Suseela, Harish Valiya Purayil
BACKGROUND: Succinylcholine has been the neuromuscular blocking drug of choice for laryngoscopy and intubation, but it has several adverse effects. Nondepolarizing neuromuscular blocking drugs are good alternative provided their onset of action is hastened. Priming technique and use of ephedrine or MgSO4 pretreatment is good options. AIMS: To compare the effects of priming and ephedrine pretreatment on the onset time of intubating dose of vecuronium. SETTINGS AND DESIGN: A prospective, randomized comparative study was done at a state-owned tertiary care teaching hospital...
April 2017: Anesthesia, Essays and Researches
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