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Emergency Department

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982 papers 1000+ followers All things emergency medicine. All things good.
By David Hedman Anesthesia
https://www.readbyqxmd.com/read/30017691/quantification-of-ventilation-volumes-produced-by-compressions-during-emergency-department-cardiopulmonary-resuscitation
#1
Robyn McDannold, Bentley J Bobrow, Vatsal Chikani, Annemarie Silver, Daniel W Spaite, Tyler Vadeboncoeur
BACKGROUND: Clinical investigations have shown improved outcomes with primary compression cardiopulmonary resuscitation strategies. It is unclear whether this is a result of passive ventilation via chest compressions, a low requirement for any ventilation during the early aspect of resuscitation or avoidance of inadvertent over-ventilation. OBJECTIVES: To quantify whether chest compressions with guideline-compliant depth (>2 in) produce measurable and substantial ventilation volumes during emergency department resuscitation of out-of-hospital cardiac arrest...
September 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29889671/evaluation-of-two-neck-ultrasound-measurements-as-predictors-of-difficult-direct-laryngoscopy-a-prospective-observational-study
#2
Stefano Falcetta, Simona Cavallo, Vincenzo Gabbanelli, Paolo Pelaia, Massimiliano Sorbello, Ivana Zdravkovic, Abele Donati
BACKGROUND: Unpredictable difficult laryngoscopy remains a challenge for anaesthesiologists, especially if difficult ventilation occurs during standard laryngoscopy. Accurate airway assessment should always be performed, but the common clinical screening tests have shown low sensitivity and specificity with a limited predictive value. Ultrasound-based airway assessment has been proposed recently as a useful, simple, noninvasive bedside tool as an adjunct to clinical methods, but to date, few studies are available about the potential role of ultrasound in difficult airway evaluation, and these are mostly limited to specific groups of patients...
August 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29894346/airway-management-of-near-complete-tracheal-transection-by-through-the-wound-intubation-a-case-report
#3
Yuel-Kai Jean, Paul Potnuru, Christian Diez
We present an approach to airway management in a patient with machete injuries culminating in near-complete cricotracheal transection, in addition to a gunshot wound to the neck. Initial airway was established by direct intubation through the cricotracheal wound. Once the airway was secured, a bronchoscopy-guided orotracheal intubation was performed with simultaneous retraction of the cricotracheal airway to optimize the surgical field. This case offers insight into a rarely performed approach to airway management...
June 11, 2018: A&A practice
https://www.readbyqxmd.com/read/29894918/c-mac-videolaryngoscope-versus-macintosh-laryngoscope-for-tracheal-intubation-a-systematic-review-and-meta-analysis-with-trial-sequential-analysis
#4
Hiroshi Hoshijima, Takahiro Mihara, Koichi Maruyama, Yohei Denawa, Kentaro Mizuta, Toshiya Shiga, Hiroshi Nagasaka
STUDY OBJECTIVE: The C-MAC laryngoscope (C-MAC) is a videolaryngoscope that uses a modified Macintosh blade. Although several anecdotal reports exist, it remains unclear whether the C-MAC is superior to the Macintosh laryngoscope for tracheal intubation in the adult population. DESIGN: Systematic review, meta-analysis. SETTING: Operating room, intensive care unit. MEASUREMENTS: For inclusion in our analysis, studies had to be prospective randomised trials which compared the C-MAC with the Macintosh laryngoscope for tracheal intubation in the adult population...
September 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29801551/rhabdomyolysis-associated-acute-kidney-injury
#5
Pasquale Esposito, Luca Estienne, Nicoletta Serpieri, Dario Ronchi, Giacomo P Comi, Maurizio Moggio, Lorenzo Peverelli, Stefania Bianzina, Teresa Rampino
No abstract text is available yet for this article.
June 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29802903/difficult-intubation-and-extubation-in-adult-anaesthesia
#6
O Langeron, J-L Bourgain, D Francon, J Amour, C Baillard, G Bouroche, M Chollet Rivier, F Lenfant, B Plaud, P Schoettker, D Fletcher, L Velly, K Nouette-Gaulain
OBJECTIVE: To provide an update to French guidelines about "Difficult intubation and extubation in adult anaesthesia 2006". DESIGN: A consensus committee of 13 experts was convened. A formal conflict-of-interest (COI) policy was developed at the onset of the process and enforced throughout. The entire guidelines process was conducted independent of any industry funding. The authors were advised to follow the principles of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to guide assessment of quality of evidence...
May 23, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29132582/airway-management-in-trauma
#7
REVIEW
George Kovacs, Nicholas Sowers
Airway management in the trauma patient presents numerous unique challenges beyond placement of an endotracheal tube and outcomes are dependent on the provider's ability to anticipate difficulty. Airway management strategies for the care of the polytrauma patient are reviewed, with specific considerations for those presenting with traumatic brain injury, suspected c-spine injury, the contaminated airway, the agitated trauma patient, maxillofacial trauma, and the traumatized airway. An approach to airway management that considers the potential anatomic and physiologic challenges in caring for these complicated trauma patients is presented...
February 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/22464031/an-analogue-trial-of-inoculation-resilience-training-for-emergency-services-personnel-proof-of-concept
#8
RANDOMIZED CONTROLLED TRIAL
Tracey Varker, Grant J Devilly
BACKGROUND AND OBJECTIVES: This analogue study served as a proof of concept trial for inoculation/resilience training with emergency services personnel. METHODS: Eighty people from the general community participated in a randomized controlled trial of inoculation training to increase resilience in the mitigation of stress and trauma-type symptomatology following a stressful video of paramedics attending the scene of a car accident. Participants were randomly allocated to one of two conditions: (a) resilience training, where the participants received strategies aimed at reducing the negative effects of the event; or (b) a control 'pragmatic training' condition, where participants received practical training about what to do in the event of a car accident...
August 2012: Journal of Anxiety Disorders
https://www.readbyqxmd.com/read/28034484/evaluation-of-gum-elastic-bougie-combined-with-direct-and-indirect-laryngoscopes-in-vomitus-setting-a-randomized-simulation-trial
#9
RANDOMIZED CONTROLLED TRIAL
Fumihiro Ohchi, Nobuyasu Komasawa, Ryosuke Mihara, Kazuo Hattori, Toshiaki Minami
PURPOSE: Videolaryngoscopes may not be useful in the presence of vomitus due to blurred images on the monitor. The objective of our study is to compare the utility of gum-elastic bougie (GEB) application for tracheal intubation with the Macintosh laryngoscope (McL), which is a direct laryngoscope, with that of the Pentax-AWS Airwayscope® (AWS) and McGRATH® MAC (McGRATH) in simulated vomitus settings. METHODS: Sixteen novice doctors performed tracheal intubation on an adult manikin using McL, AWS, and McGRATH with or without GEB under normal and vomitus simulations...
April 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27749553/preoxygenation-using-invasive-ventilator-in-volume-control-mode-in-patients-with-emergency-intubation-can-shorten-the-time-of-preoxygenation-and-improve-the-quality-of-preoxygenation-a-retrospective-study
#10
Hai Wang, Jiang-Li Sun, Zheng-Hai Bai, Xiao-Bo Wang, Zheng-Liang Zhang, Hong-Hong Pei
Preoxygenation can rapidly improve oxygenation and enhance the security of endotracheal intubation, so it is very essential before endotracheal intubation. The conventional preoxygenation method self-inflating bag (SIB) is not very effective in case of emergency. So our study aims to find a more effective method of preoxygenation in a critical situation.We retrospectively analyzed data of 105 patients in this study. A total of 49 patients with preoxygenation with invasive ventilator in volume control mode (VCM) and 56 patients with preoxygenation with SIB were included...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27797983/efficacy-of-various-types-of-laryngoscope-direct-pentax-airway-scope-and-glidescope-for-endotracheal-intubation-in-various-cervical-immobilisation-scenarios-a-randomised-cross-over-simulation-study
#11
COMPARATIVE STUDY
Jong Won Kim, Kyeong Ryong Lee, Dae Young Hong, Kwang Je Baek, Young Hwan Lee, Sang O Park
OBJECTIVE: To compare the efficacy of direct laryngoscopy (DL), Pentax Airway Scope (PAWS) and GlideScope video laryngoscope (GVL) systems for endotracheal intubation (ETI) in various cervical immobilisation scenarios: manual in-line stabilisation (MILS), Philadelphia neck collar (PNC) (moderate limit of mouth opening) and Stifneck collar (SNC) (severe limit of mouth opening). DESIGN: Randomised cross-over simulation study. SETTING AND PARTICIPANTS: 35 physicians who had >30 successful ETI experiences at a tertiary hospital in Seoul, Korea...
October 24, 2016: BMJ Open
https://www.readbyqxmd.com/read/27825693/use-of-nitroglycerin-by-bolus-prevents-intensive-care-unit-admission-in-patients-with-acute-hypertensive-heart-failure
#12
Suprat Saely Wilson, Gregory M Kwiatkowski, Scott R Millis, John D Purakal, Arushi P Mahajan, Phillip D Levy
OBJECTIVES: The purpose of this study was to compare health care resource utilization among patients who were given intravenous nitroglycerin for acute heart failure (AHF) in the emergency department (ED) by intermittent bolus, continuous infusion, or a combination of both. METHODS: We retrospectively identified 395 patients that received nitroglycerin therapy in the ED for the treatment of AHF over a 5-year period. Patients that received intermittent bolus (n=124) were compared with continuous infusion therapy (n=182) and combination therapy of bolus and infusion (n=89)...
January 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27366551/influence-of-different-doses-of-ketamine-on-intubating-conditions-during-a-rapid-sequence-induction-and-intubation-model
#13
Başak Ceyda Meço, Ahmet Onat Bermede, Zekeriyya Alanoğlu, Olcay Yaka, Neslihan Alkış
OBJECTIVE: This prospective, randomized, double-blinded study aimed to compare the effects of three different doses of ketamine or lidocaine on intubating conditions and haemodynamics in a rapid-sequence induction model with 3 mg kg(-1) propofol and 0.6 mg kg(-1) rocuronium. METHODS: A total of 128 ASA I-III patients who were scheduled for elective surgery were randomized in the following five groups: Group 1 (n=24), 1 mg kg(-1) lidocaine+3 mg kg(-1) propofol+0...
February 2016: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/26866753/head-elevated-patient-positioning-decreases-complications-of-emergent-tracheal-intubation-in-the-ward-and-intensive-care-unit
#14
MULTICENTER STUDY
Nita Khandelwal, Sarah Khorsand, Steven H Mitchell, Aaron M Joffe
BACKGROUND: Based on the data from elective surgical patients, positioning patients in a back-up head-elevated position for preoxygenation and tracheal intubation can improve patient safety. However, data specific to the emergent setting are lacking. We hypothesized that back-up head-elevated positioning would be associated with a decrease in complications related to tracheal intubation in the emergency room environment. METHODS: This retrospective study was approved by the University of Washington Human Subjects Division (Seattle, WA)...
April 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27090535/a-deliberately-restricted-laryngeal-view-with-the-glidescope%C3%A2-video-laryngoscope-is-associated-with-faster-and-easier-tracheal-intubation-when-compared-with-a-full-glottic-view-a-randomized-clinical-trial
#15
RANDOMIZED CONTROLLED TRIAL
Yuqi Gu, Joshua Robert, George Kovacs, Andrew D Milne, Ian Morris, Orlando Hung, Kirk MacQuarrie, Sean Mackinnon, J Adam Law
INTRODUCTION: During video laryngoscopy (VL) with angulated or hyper-curved blades, it is sometimes difficult to complete tracheal intubation despite a full view of the larynx. When using indirect VL, it has been suggested that it may be preferable to obtain a deliberately restricted view of the larynx to facilitate passage of the endotracheal tube. We used the GlideScope® GVL video laryngoscope (GVL) to test whether deliberately obtaining a restricted view would result in faster and easier tracheal intubation than with a full view of the larynx...
August 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27110526/effect-of-etomidate-versus-combination-of-propofol-ketamine-and-thiopental-ketamine-on-hemodynamic-response-to-laryngoscopy-and-intubation-a-randomized-double-blind-clinical-trial
#16
Afshin Gholipour Baradari, Abolfazl Firouzian, Alieh Zamani Kiasari, Mohsen Aarabi, Seyed Abdollah Emadi, Ali Davanlou, Nima Motamed, Ensieh Yousefi Abdolmaleki
BACKGROUND: Laryngoscopy and intubation frequently used for airway management during general anesthesia, is frequently associated with undesirable hemodynamic disturbances. OBJECTIVES: The aim of this study was to compare the effects of etomidate, combination of propofol-ketamine and thiopental-ketamine as induction agents on hemodynamic response to laryngoscopy and intubation. PATIENTS AND METHODS: In a double blind, randomized clinical trial a total of 120 adult patients of both sexes, aged 18 - 45 years, scheduled for elective surgery under general anesthesia were randomly assigned into three equally sized groups...
February 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27107688/a-quantitative-comparison-of-physiologic-indicators-of-cardiopulmonary-resuscitation-quality-diastolic-blood-pressure-versus-end-tidal-carbon-dioxide
#17
COMPARATIVE STUDY
Ryan W Morgan, Benjamin French, Todd J Kilbaugh, Maryam Y Naim, Heather Wolfe, George Bratinov, Wesley Shoap, Ting-Chang Hsieh, Vinay M Nadkarni, Robert A Berg, Robert M Sutton
AIM: The American Heart Association (AHA) recommends monitoring invasive arterial diastolic blood pressure (DBP) and end-tidal carbon dioxide (ETCO2) during cardiopulmonary resuscitation (CPR) when available. In intensive care unit patients, both may be available to the rescuer. The objective of this study was to compare DBP vs. ETCO2 during CPR as predictors of cardiac arrest survival. METHODS: In two models of cardiac arrest (primary ventricular fibrillation [VF] and asphyxia-associated VF), 3-month old swine received either standard AHA guideline-based CPR or patient-centric, BP-guided CPR...
July 2016: Resuscitation
https://www.readbyqxmd.com/read/27130846/when-is-an-expert-truly-an-expert
#18
Melanie Heniff
No abstract text is available yet for this article.
October 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/26602425/lidocaine-induced-cardiac-arrest-in-the-emergency-department-effectiveness-of-lipid-therapy
#19
Kevin James Tierney, Tiffany Murano, Brenda Natal
BACKGROUND: Local anesthetics are commonly used in the emergency department (ED). Overdoses can lead to disastrous complications including cardiac toxicity and arrest. Recognition of local anesthetic systemic toxicity (LAST) is important; however, prevention is even more critical. Knowledge of proper lidocaine dosage can prevent LAST. LAST may be effectively treated with lipid emulsion therapy. Although the mechanism is not well understood, its use may have a profound impact on morbidity and mortality...
January 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/26237037/vasopressors-for-the-treatment-of-septic-shock-systematic-review-and-meta-analysis
#20
REVIEW
Tomer Avni, Adi Lador, Shaul Lev, Leonard Leibovici, Mical Paul, Alon Grossman
OBJECTIVE: International guidelines recommend dopamine or norepinephrine as first-line vasopressor agents in septic shock. Phenylephrine, epinephrine, vasopressin and terlipressin are considered second-line agents. Our objective was to assess the evidence for the efficiency and safety of all vasopressors in septic shock. METHODS: Systematic review and meta-analysis. We searched electronic database of MEDLINE, CENTRAL, LILACS and conference proceedings up to June 2014...
2015: PloS One
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