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"Rapid Sequence Intubation"

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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/29331494/a-novel-difficult-airway-prediction-tool-for-emergency-airway-management-validation-of-the-heaven-criteria-in-a-large-air-medical-cohort
#2
Edward Kuzmack, Travis Inglis, David Olvera, Allen Wolfe, Kona Seng, Daniel Davis
BACKGROUND: Difficult-airway prediction tools help identify optimal airway techniques, but were derived in elective surgery patients and may not be applicable to emergency rapid sequence intubation (RSI). The HEAVEN criteria (Hypoxemia, Extremes of size, Anatomic abnormalities, Vomit/blood/fluid, Exsanguination, Neck mobility issues) may be more relevant to emergency RSI patients. OBJECTIVE: To validate the HEAVEN criteria for difficult-airway prediction in emergency RSI using a large air medical cohort...
January 10, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29315473/a-before-and-after-observational-study-of-a-protocol-for-use-of-the-c-mac-videolaryngoscope-with-a-frova-introducer-in-pre-hospital-rapid-sequence-intubation
#3
S Ångerman, H Kirves, J Nurmi
Results using videolaryngoscopy in pre-hospital rapid sequence intubation are mixed. A bougie is not commonly used with videolaryngoscopy. We hypothesised that using videolaryngoscopy and a bougie as core elements of a standardised protocol that includes a drugs and a laryngoscopy algorithm would result in a high first-pass tracheal intubation success rate. We employed videolaryngoscopy (C-MAC) combined with a bougie (Frova intubating introducer) in an anaesthetist-staffed helicopter emergency medical service...
January 8, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29297718/evaluation-of-physiologic-alterations-during-prehospital-paramedic-performed-rapid-sequence-intubation
#4
Robert G Walker, Lynn J White, Geneva N Whitmore, Alexander Esibov, Michael K Levy, Gregory C Cover, Joel D Edminster, James M Nania
OBJECTIVE: Physiologic alterations during rapid sequence intubation (RSI) have been studied in several emergency airway management settings, but few data exist to describe physiologic alterations during prehospital RSI performed by ground-based paramedics. To address this evidence gap and provide guidance for future quality improvement initiatives in our EMS system, we collected electronic monitoring data to evaluate peri-intubation vital signs changes occurring during prehospital RSI...
January 3, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29276277/impact-of-developing-adult-ketamine-order-panels-for-the-emergency-department
#5
Haley Baird, Rachel Rumbarger
Background: Ketamine in adults has been identified as a safe and effective alternative for multiple indications, each with specific evidence-based dosing ranges. Emergency department (ED) providers are tasked with appropriate ordering of ketamine. A multi-institutional retrospective analysis within EDs at a large health system from November 2013 to October 2015 reviewed ED adult ketamine prescribing patterns for procedural sedation (PS), rapid sequence intubation (RSI), and analgesia. Retrospective cohort results revealed 56% (84 of 150) of PS, 64% (16 of 25) of RSI, and 81...
July 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/29196064/acute-management-of-tension-pneumocephalus-in-a-pediatric-patient-a-case-report
#6
Lauren M L'Hommedieu, Michael W Dingeldein, Krystal L Tomei, Brendan J Kilbane
BACKGROUND: Tension pneumocephalus is a rare but life-threatening condition in which air gains entry into the cranium and exerts mass effect on the brain, resulting in increased intracranial pressure. It occurs most frequently secondary to head trauma, particularly to the orbits or sinuses. CASE REPORT: A 13-year-old male sustained facial trauma from a motor vehicle collision and was found to have tension pneumocephalus on computer tomography. The patient underwent immediate rapid sequence intubation without preceding positive pressure ventilation in the emergency department...
November 28, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29162438/peri-intubation-factors-affecting-emergency-physician-choice-of-paralytic-agent-for-rapid-sequence-intubation-of-trauma-patients
#7
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/29157794/analgosedative-interventions-after-rapid-sequence-intubation-with-rocuronium-in-the-emergency-department
#8
Emily Kilber, Daniel H Jarrell, John C Sakles, Christopher J Edwards, Asad E Patanwala
OBJECTIVES: The use of etomidate and rocuronium for rapid sequence intubation (RSI) results in a duration of paralysis that exceeds the duration of sedation. The primary objective of this study was to compare the number of analgosedative (AGS) interventions early versus late post-RSI, with this drug combination. The secondary objective was to descriptively assess time to first AGS intervention. METHODS: This was a retrospective cohort study conducted in an academic ED in the United States between January 2015 and June 2016...
November 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29149690/a-modified-montpellier-protocol-for-intubating-intensive-care-unit-patients-is-associated-with-an-increase-in-first-pass-intubation-success-and-fewer-complications
#9
Keith A Corl, Christopher Dado, Ankita Agarwal, Nader Azab, Tim Amass, Sarah J Marks, Mitchell M Levy, Roland C Merchant, Jason Aliotta
BACKGROUND: The Montpellier protocol for intubating patients in the intensive care unit (ICU) is associated with a decrease in intubation-related complications. We sought to determine if implementation of a simplified version of the Montpellier protocol that removed selected components and allowed for a variety of pre-oxygenation modalities increased first-pass intubation success and reduced intubation-related complications. METHODS: A prospective pre/post-comparison of a modified Montpellier protocol in two medical and one medical/surgical/cardiac ICU within a hospital system...
November 10, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29095178/changing-the-emergency-department-s-practice-of-rapid-sequence-intubation-to-reduce-the-incidence-of-hypoxia
#10
Michael D Gooch, Eric Roberts
Rapid sequence intubation (RSI) is an advanced procedure performed by nurse practitioners in the emergency department (ED). Hypoxia is one of the most common complications associated with RSI, which may lead to serious sequela, including death. Hypoxia may result from medications that are given to facilitate the procedure or the underlying disease process. Without preventive measures, oxygen levels may fall rapidly when patients are no longer actively breathing. The incidence of RSI-induced hypoxia may be mitigated with proper education, preoxygenation, positioning, and the utilization of passive (apneic) oxygenation...
October 2017: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/29018000/waveform-capnography-an-alternative-to-physician-gestalt-in-determining-optimal-intubating-conditions-after-administration-of-paralytic-agents
#11
Anthony Scoccimarro, Jason R West, Marc Kanter, Nicholas D Caputo
PURPOSE: We sought to evaluate the utility of waveform capnography (WC) in detecting paralysis, by using apnoea as a surrogate determinant, as compared with clinical gestalt during rapid sequence intubation. Additionally, we sought to determine if this improves the time to intubation and first pass success rates through more consistent and expedient means of detecting optimal intubating conditions (ie, paralysis). METHODS: A prospective observational cohort study of consecutively enrolled patients was conducted from April to June 2016 at an academic, urban, level 1 trauma centre in New York City...
October 10, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28960597/ideal-cricoid-pressure-is-biomechanically-impossible-during-laryngoscopy
#12
Christopher E Trethewy, Steven R Doherty, Julie M Burrows, Don Clausen
OBJECTIVE: This study was a prospective, randomized controlled trial of rapid sequence intubation (RSI) with cricoid pressure (CP) within the emergency department (ED). The primary aim of the study was to examine the link between ideal CP and the incidence of aspiration. METHOD: Patients > 18 years of age undergoing RSI in the ED of two hospitals in New South Wales, Australia, were randomly assigned to receive measured CP using weighing scales to target the ideal CP range (3...
September 28, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28917437/effects-of-intravenous-administration-of-fentanyl-and-lidocaine-on-hemodynamic-responses-following-endotracheal-intubation
#13
Amir Masoud Hashemian, Hamid Zamani Moghadam Doloo, Maziar Saadatfar, Roya Moallem, Maryam Moradifar, Raheleh Faramarzi, Mohammad Davood Sharifi
OBJECTIVES: To compare the effects of intravenous fentanyl and lidocaine on hemodynamic changes following endotracheal intubation in patients requiring Rapid Sequence Intubation (RSI) in the emergency department (ED). METHODS: A single-centered, prospective, simple non-randomized, double-blind clinical trial was conducted on 96 patients who needed RSI in Edalatian ED. They were randomly divided into three groups (fentanyl group (F), lidocaine group (L), and fentanyl plus lidocaine (M) as our control group)...
July 21, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28889210/ketamine-and-midazolam-differently-impact-post-intubation-hemodynamic-profile-when-used-as-induction-agents-during-emergency-airway-management-in-hemodynamically-stable-patients-with-st-elevation-myocardial-infarction
#14
Marco Zuin, Gianluca Rigatelli, Fabio Dell'Avvocata, Giuseppe Faggian, Luca Conte, Sara Giatti, Flavio Michielan, Loris Roncon
We investigated the incidence of post-intubation hypotension (PIH) in hemodynamically stable patients with STEMI requiring rapid sequences intubation (RSI) and medicated with ketamine or midazolam as induction agent. STEMI patients admitted between 1st January 2009 and 1st January 2017 who did not receive any type of inotropic support before the endotracheal intubation (ETI) was reviewed. PIH was defined as a reduction greater than 20% or a drop of systolic blood pressure (SBP) below 90 mmHg within 10 min from the administration of the induction agent [ketamine (1 mg/kg) or midazolam (0...
September 9, 2017: Heart and Vessels
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
#15
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/28791775/maintenance-of-oxygenation-during-rapid-sequence-intubation-in-the-emergency-department
#16
John C Sakles
No abstract text is available yet for this article.
November 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28791755/emergency-department-use-of-apneic-oxygenation-versus-usual-care-during-rapid-sequence-intubation-a-randomized-controlled-trial-the-endao-trial
#17
Nicholas Caputo, Ben Azan, Rui Domingues, Lee Donner, Mark Fenig, Douglas Fields, Robert Fraser, Karlene Hosford, Richard Iuorio, Marc Kanter, Moira McCarty, Thomas Parry, Andaleeb Raja, Mary Ryan, Blaine Williams, Hemlata Sharma, Daniel Singer, Chris Shields, Sandra Scott, Jason R West
OBJECTIVES: Desaturation leading to hypoxemia may occur during rapid sequence intubation (RSI). Apneic oxygenation (AO) was developed to prevent the occurrence of oxygen desaturation during the apnea period. The purpose of this study was to determine if the application of AO increases the average lowest oxygen saturation during RSI when compared to usual care (UC) in the emergency setting. METHODS: A randomized controlled trial was conducted at an academic, urban, Level I trauma center...
November 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28759496/addition-of-nasal-cannula-can-either-impair-or-enhance-preoxygenation-with-a-bag-valve-mask-a-randomized-crossover-design-study-comparing-oxygen-flow-rates
#18
David McQuade, Matthew R Miller, Clare Hayes-Bradley
BACKGROUND: A critical safety component of emergency anesthesia is the avoidance of hypoxemia during the apneic phase of a rapid sequence intubation. Preoxygenation with a bag valve mask (BVM) or anesthetic circuit may be improved with supplemental oxygen by nasal cannula (NC) if there is a mask leak. In addition, NC is recommended for apneic oxygenation after induction and may be placed before preoxygenation. However, the optimum NC flow rate for preoxygenation or whether the presence of NC alone creates a mask leak remains unclear...
July 26, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28754359/the-continued-challenges-of-out-of-hospital-rapid-sequence-intubation
#19
EDITORIAL
Henry E Wang
No abstract text is available yet for this article.
October 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28739243/heaven-criteria-derivation-of-a-new-difficult-airway-prediction-tool
#20
Daniel P Davis, David J Olvera
OBJECTIVE: Airway management is vitally important in the management of critically ill and injured patients. Current tools to predict the difficult airway have limited application in the emergency airway situation. The aim of this study was to derive a novel difficult airway prediction tool for emergency intubation. METHODS: A retrospective descriptive analysis was performed in a population of air medical rapid sequence intubation patients requiring more than 1 attempt...
July 2017: Air Medical Journal
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