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By Richard Gough Paramedic tutor, Post Qualification Manager
Lucas A Myers, Charles G Gallet, Logan J Kolb, Christine M Lohse, Christopher S Russi
INTRODUCTION: This study aimed to identify factors associated with successful endotracheal intubation (ETI) by a multisite emergency medical services (EMS) agency. METHODS: We collected data from the electronic prehospital record for all ETI attempts made from January through May 2010 by paramedics and other EMS crew members at a single multistate agency. If documentation was incomplete, the study team contacted the paramedic. Paramedics use the current National Association of EMS Physicians definition of an ETI attempt (laryngoscope blade entering the mouth)...
September 2016: Western Journal of Emergency Medicine
Diana L Wadlund, Patricia C Seifert
No abstract text is available yet for this article.
October 2015: AORN Journal
Alfred Jacomet, Abel-Jan Tasman
Airway management in craniofacial trauma patients is a challenge for an anesthetist. Treating these patients requires a close interdisciplinary communication and cooperation. Maintaining the airway and oxygenation of the patient is the initial challenge in craniofacial trauma patients. The management of the difficult airway is facilitated and patient's safety improved by following one of several published difficult airway algorithms. We describe the St. Gallen difficult airway algorithm for the management of difficult airway in general and the airway in facial trauma patients in particular...
August 2015: Facial Plastic Surgery: FPS
Mark Campbell, Hilary Shanahan, Simon Ash, Jonathan Royds, Viera Husarova, Conan McCaul
BACKGROUND: The cricothyroid membrane (CTM) is the recommended site of access to the airway during cricothyrotomy to provide emergency oxygenation. We sought to compare the ability of physicians to correctly identify the CTM in male and female patients. METHODS: In a prospective observational study, anaesthetists were asked to locate the CTM by palpation which was then identified using ultrasound and the distance between the actual and estimated margin of the CTM was measured...
2014: BMC Anesthesiology
Geir Arne Sunde, Jon-Kenneth Heltne, David Lockey, Brian Burns, Mårten Sandberg, Knut Fredriksen, Karl Ove Hufthammer, Akos Soti, Richard Lyon, Helena Jäntti, Antti Kämäräinen, Bjørn Ole Reid, Tom Silfvast, Falko Harm, Stephen J M Sollid
BACKGROUND: Despite numerous studies on prehospital airway management, results are difficult to compare due to inconsistent or heterogeneous data. The objective of this study was to assess advanced airway management from international physician-staffed helicopter emergency medical services. METHODS: We collected airway data from 21 helicopter emergency medical services in Australia, England, Finland, Hungary, Norway and Switzerland over a 12-month period. A uniform Utstein-style airway template was used for collecting data...
2015: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Ju-Hwan Lee, Hoe-Chang Jung, Ji-Hoon Shim, Cheol Lee
BACKGROUND: Optimal head and neck positioning and clinical experience are important factors for successful endotracheal intubation in patients with a difficult airway. This study aimed to investigate the rate of successful endotracheal intubation between the sniffing and ramped positions in patients with an expected difficult intubation. METHODS: The study included 204 patients with an expected difficult intubation (airway difficulty score ≥ 8) based on the preoperative airway assessment...
April 2015: Korean Journal of Anesthesiology
Venkata Angirekula, Ashrit Multani
A previously healthy 65-year-old woman presented to the emergency department with a 7-day history of throat pain, difficulty swallowing, muffled voice, and subjective fevers. On presentation, she was afebrile and hemodynamically stable with normal oxygen saturation (blood pressure, 140/86 mm Hg;..
April 9, 2015: New England Journal of Medicine
Shunichiro Nakao, Akio Kimura, Yusuke Hagiwara, Kohei Hasegawa
OBJECTIVES: Although successful airway management is essential for emergency trauma care, comprehensive studies are limited. We sought to characterise current trauma care practice of airway management in the emergency departments (EDs) in Japan. DESIGN: Analysis of data from a prospective, observational, multicentre registry-the Japanese Emergency Airway Network (JEAN) registry. SETTING: 13 academic and community EDs from different geographic regions across Japan...
2015: BMJ Open
Takashi Asai
No abstract text is available yet for this article.
October 2015: Journal of Anesthesia
J Bosch, J de Nooij, M de Visser, S C Cannegieter, N J Terpstra, C Heringhaus, J Burggraaf
BACKGROUND: In Dutch ambulance practice, failure or inability to intubate patients with altered oxygenation and/or ventilation leaves bag-valve mask ventilation as the only alternative, which is undesirable for patient outcome. A novel Laryngeal Mask Airway Supreme (LMA-S) device may be a suitable alternative. AIM: To evaluate the effectiveness and suitability of the LMA-S for emergency medical services in daily out-of-hospital emergency practice. METHODS: After a period of theoretical and practical training of ambulance paramedics in the use of the LMA-S, prospective data were collected on the utilisation of LMA-S in an observational study...
September 2014: Emergency Medicine Journal: EMJ
Jan L Jensen, Ka Wai Cheung, John M Tallon, Andrew H Travers
This systematic review included controlled clinical trials comparing tracheal intubation (TI) with alternative airway techniques (AAT) (bag mask ventilation and use of extraglottic devices) performed by paramedics in the prehospital setting. A priori outcomes to be assessed were survival, neurologic outcome, airway management success rates and complications. We identified trials using EMBASE, MEDLINE, CINAHL, The Cochrane Library, Web of Science, author contacts and hand searching. We included 5 trials enrolling a total of 1559 patients...
March 2010: CJEM
Henry E Wang, Judith R Lave, Carl A Sirio, Donald M Yealy
Paramedics provide life-saving emergency medical care to patients in the out-of-hospital setting, but only selected emergency interventions have proved to be safe or effective. Endotracheal intubation (the insertion of an emergency breathing tube into the trachea) is an important and high-profile procedure performed by paramedics. In our study population, we found that errors occurred in 22 percent of intubation attempts, with a frequency of up to 40 percent in selected ambulance systems. These findings indicate frequent errors associated with this life-saving technique...
March 2006: Health Affairs
Henry E Wang, G K Balasubramani, Lawrence J Cook, Donald M Yealy, Judith R Lave
BACKGROUND: While prior studies describe the clinical presentation of patients requiring paramedic out-of-hospital endotracheal intubation (ETI), limited data characterize the underlying medical conditions or comorbidities. OBJECTIVE: To characterize the medical conditions and comorbidities of patients receiving successful paramedic out-of-hospital ETI. METHODS: We used Pennsylvania statewide emergency medical services (EMS) clinical data, including all successful ETIs performed during 2003-2005...
July 2011: Prehospital Emergency Care
Hans Morten Lossius, Jo Røislien, David J Lockey
INTRODUCTION: Pre-hospital airway management is a controversial subject, but there is general agreement that a small number of seriously ill or injured patients require urgent emergency tracheal intubation (ETI) and ventilation. Many European emergency medical services (EMS) systems provide physicians to care for these patients while other systems rely on paramedics (or, rarely, nurses). The ETI success rate is an important measure of provider and EMS system success and a marker of patient safety...
February 11, 2012: Critical Care: the Official Journal of the Critical Care Forum
Azim Mirzazadeh, Nima Ostadrahimi, Seyedeh Mojgan Ghalandarpoorattar, Fariba Asghari
This study was done to explore the views of patients and their companions concerning endotracheal intubation training on newly deceased patients and the necessity of obtaining their consent in this regard. In this cross-sectional descriptive analytical study, we used a questionnaire to collect data through structured interviews conducted by the researcher on patient discharge day. A convenient sample of over 18 year old patients hospitalized at a teaching hospital were enrolled, and after receiving patient consent, one of each patient's companions was enrolled in the study as well...
2014: Journal of Medical Ethics and History of Medicine
C E Buonopane, V Pasta, D Sottile, L Del Vecchio, A Maturo, R Merola, A Panunzi, P Urciuoli, V D'Orazi
BACKGROUND: Cricothyroidotomy is a surgical airway technique in which an airway device is inserted into the trachea through an incision made at the cricothyroid membrane. It is used for the management of the "difficult airways" and may be a lifesaving procedure in "can't intubate, can't oxygenate" situations. However, many healthcare professionals working in emergency settings have little of no experience with this procedure. Achievement of theoretical and practical knowledge of different cricothyrotomy techniques is therefore a fundamental prerequisite for those healthcare professionals...
July 2014: Il Giornale di Chirurgia
Ruggero M Corso, Salvatore Zampone, Marcello Baccanelli, Massimiliano Sorbello, Giorgio Gambale
No abstract text is available yet for this article.
2014: World Journal of Emergency Medicine
Vaibhav K Nasa, Shaila S Kamath
BACKGROUND: The major responsibility of anaesthesiologist is to maintain adequate gas exchange in his patients in all circumstances and this require that patency of upper airway is constantly maintained. Problems with upper airway management are among the most frequent causes of anaesthetic mishaps. Using intubation difficulty scale (IDS) we made an attempt to objectively assess the predictors of difficult intubation. We assessed classical bedside tests such as modified Mallampati test, Thyromental distance test and also neck extension test...
July 2014: Journal of Clinical and Diagnostic Research: JCDR
S A Bernard, K Smith, R Porter, C Jones, A Gailey, B Cresswell, D Cudini, S Hill, B Moore, T St Clair
INTRODUCTION: Pre-hospital intubation by paramedics is widely used in comatose patients prior to transportation to hospital, but the optimal technique for intubation is uncertain. One approach is paramedic rapid sequence intubation (RSI), which may improve outcomes in adult patients with traumatic brain injury. However, many patients present to emergency medical services with coma of non-traumatic cause and the role of paramedic RSI in these patients remains uncertain. METHODS: The electronic Victorian Ambulance Clinical Information System was searched for the term 'suxamethonium' between 2008 and 2011...
January 2015: Emergency Medicine Journal: EMJ
Malcolm Woollard, R Furber
No abstract text is available yet for this article.
March 2010: Emergency Medicine Journal: EMJ
2014-06-26 19:59:22
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