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EM Airway

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54 papers 100 to 500 followers Emergency and advanced airway management literature.
By Merlin Curry MD, EMT-P
https://www.readbyqxmd.com/read/28623005/pre-oxygenation-implications-in-emergency-airway-management
#1
REVIEW
Ali Pourmand, Chelsea Robinson, Kelsey Dorwart, Francis O'Connell
Transient oxygen desaturation during emergency department intubation is an event with potentially devastating consequences. Pre-oxygenation is an important means of increasing a patient's oxygen reserve and duration of safe apnea prior to intubation. In the emergent setting, important modifications to pre-oxygenation techniques need to be considered to best manage critically ill patients. In this review, we discuss recent updates in pre-oxygenation techniques and evaluate the evidence supporting both commonly used and newly emerging techniques for pre-oxygenation, assessing nature and level of illness, the best delivery method of oxygen, using delayed sequence intubation in patients who cannot tolerate non-invasive pre-oxygenation and using apneic oxygenation via nasal cannula and non-rebreather mask during intubation...
June 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/26846234/apneic-oxygenation-is-associated-with-a-reduction-in-the-incidence-of-hypoxemia-during-the-rsi-of-patients-with-intracranial-hemorrhage-in-the-emergency-department
#2
John C Sakles, Jarrod M Mosier, Asad E Patanwala, John M Dicken
Critically ill patients undergoing emergent intubation are at risk of oxygen desaturation during the management of their airway. Patients with intracranial hemorrhage (ICH) are particularly susceptible to the detrimental effects of hypoxemia. Apneic oxygenation (AP OX) may be able to reduce the occurrence of oxygen desaturation during the emergent intubation of these patients. We sought to assess the effect AP OX on oxygen desaturation during the rapid sequence intubation (RSI) of patients with ICH in the emergency department (ED)...
October 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27342820/understanding-preoxygenation-and-apneic-oxygenation-during-intubation-in-the-critically-ill
#3
Jarrod M Mosier, Cameron D Hypes, John C Sakles
No abstract text is available yet for this article.
February 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/26707526/delayed-sequence-intubation-danger-in-delaying-definitive-airway
#4
LETTER
Richard Skupski, Joseph Miller, Sophia Binz, Morta Lapkus, Mark Walsh
No abstract text is available yet for this article.
January 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/25447559/delayed-sequence-intubation-a-prospective-observational-study
#5
MULTICENTER STUDY
Scott D Weingart, N Seth Trueger, Nelson Wong, Joseph Scofi, Neil Singh, Soren S Rudolph
STUDY OBJECTIVE: We investigate a new technique for the emergency airway management of patients with altered mental status preventing adequate preoxygenation. METHODS: This was a prospective, observational, multicenter study of patients whose medical condition led them to impede optimal preintubation preparation because of delirium. A convenience sample of emergency department and ICU patients was enrolled. Patients received a dissociative dose of ketamine, allowing preoxygenation with high-flow nonrebreather mask or noninvasive positive pressure ventilation (NIPPV)...
April 2015: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/19901829/airway-catastrophes
#6
REVIEW
James H Abernathy, Scott T Reeves
PURPOSE OF REVIEW: The article reviews the epidemiology of airway injuries, airway anatomy, techniques for airway management, helpful pharmacologic adjuncts and finally alternatives to airway manipulation. RECENT FINDINGS: Principles of airway management including the maintenance of spontaneous ventilation and careful and adequate preparation for an alternative plan will always be important. Advances in pharmacologic agents provide a safer, more controlled environment through which the patient's compromised airway can be controlled...
February 2010: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/25604325/tracheal-intubation-related-complications-in-the-prehospital-setting
#7
Emmanuel Caruana, Fran├žois-Xavier Duchateau, Carole Cornaglia, Marie-Laure Devaud, Romain Pirracchio
BACKGROUND: Prehospital tracheal intubation (TI) is associated with morbidity and mortality, particularly in cases of difficult intubation. The goal of the present study was to describe factors associated with TI related complications in the prehospital setting. METHODS: This was a prospective cohort study including all patients intubated on scene in a prehospital emergency medical service over a 4 year period. TI related complications included oxygen desaturation, aspiration, vomiting, bronchospasm and/or laryngospasm, and mechanical complications (mainstem intubation, oesophageal intubation and airway lesion- that is, dental or laryngeal trauma caused by the laryngoscope)...
November 2015: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/21169822/use-of-the-airtraq-laryngoscope-for-emergency-intubation-in-the-prehospital-setting-a-randomized-control-trial
#8
RANDOMIZED CONTROLLED TRIAL
Helmut Trimmel, Janett Kreutziger, Georg Fertsak, Robert Fitzka, Markus Dittrich, Wolfgang G Voelckel
OBJECTIVES: The optical Airtraq laryngoscope (Prodol Meditec, Vizcaya, Spain) has been shown to have advantages when compared with direct laryngoscopy in difficult airway patients. Furthermore, it has been suggested that it is easy to use and handle even for inexperienced advanced life support providers. As such, we sought to assess whether the Airtraq may be a reliable alternative to conventional intubation when used in the prehospital setting. DESIGN, SETTING, AND PATIENTS: Prospective, randomized control trial in emergency patients requiring endotracheal intubation provided by anesthesiologists or emergency physicians responding with an emergency medical service helicopter or ground unit associated with the Department of Anesthesiology, General Hospital, Wiener Neustadt, Austria...
March 2011: Critical Care Medicine
https://www.readbyqxmd.com/read/24741494/making-endotracheal-intubation-easy-and-successful-particularly-in-unexpected-difficult-airway
#9
Susanne Abdulla, Sina Abdulla, Karl-Peter Schwemm, Regina Eckhardt, Walied Abdulla
BACKGROUND: Difficult intubation, most often due to poor view of the vocal cords on laryngoscopy is an intermittent and often challenging problem for clinically practicing anesthesiologists, maxillofacial surgeons, ear nose, and throat (ENT), emergency, and critical care physicians. PURPOSE: We present a new approach for facilitating difficult intubation and evaluate its efficacy in a retrospective observational study. SETTINGS AND DESIGN: Operating room, emergency department, intensive care unit (ICU), retrospective observational study...
January 2014: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/28258332/progress-in-difficult-airway-management
#10
EDITORIAL
Takashi Asai
No abstract text is available yet for this article.
August 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/27894561/apneic-oxygenation-may-not-prevent-severe-hypoxemia-during-rapid-sequence-intubation-a-retrospective-helicopter-emergency-medical-service-study
#11
Sattha Riyapan, Jeffrey Lubin
OBJECTIVE: This study sought to determine the effectiveness of apneic oxygenation in preventing hypoxemia during prehospital rapid sequence intubation (RSI). METHODS: We performed a case-cohort study using a pre-existing database looking at intubation management by a single helicopter emergency medical service between July 2013 and June 2015. Apneic oxygenation using high-flow nasal cannula (15 L/min) was introduced to the standard RSI protocol in July 2014. Severe hypoxemia was defined as an incidence of oxygen saturation less than 90%...
November 2016: Air Medical Journal
https://www.readbyqxmd.com/read/22491606/single-drug-sedation-with-fentanyl-for-prehospital-postintubation-sedation-in-trauma-patients
#12
COMPARATIVE STUDY
Christopher P Michetti, John F Maguire, Aditya Kaushik, Ranjit R Pullarkat, Thomas V Boro, Anne G Rizzo, Hani Seoudi, Melody Meehan, Linda Robinson
BACKGROUND: A fentanyl-only (FO) regimen for prehospital postintubation sedation in trauma patients was compared with the standard protocol (SP) of fentanyl + benzodiazepine. METHODS: Intubated patients transported to a Level I trauma center from December 1, 2005, to April 30, 2009, were retrospectively reviewed. Before 2007, only SP was used; afterward both regimens were used. Groups were compared for hemodynamic and neurologic parameters in the prehospital setting and trauma bay, fluid volumes, time until general or neurosurgical intervention (NSI), and other outcomes...
April 2012: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/26759664/the-physiologically-difficult-airway
#13
REVIEW
Jarrod M Mosier, Raj Joshi, Cameron Hypes, Garrett Pacheco, Terence Valenzuela, John C Sakles
Airway management in critically ill patients involves the identification and management of the potentially difficult airway in order to avoid untoward complications. This focus on difficult airway management has traditionally referred to identifying anatomic characteristics of the patient that make either visualizing the glottic opening or placement of the tracheal tube through the vocal cords difficult. This paper will describe the physiologically difficult airway, in which physiologic derangements of the patient increase the risk of cardiovascular collapse from airway management...
December 2015: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/19413824/anaesthesia-in-haemodynamically-compromised-emergency-patients-does-ketamine-represent-the-best-choice-of-induction-agent
#14
REVIEW
C Morris, A Perris, J Klein, P Mahoney
In rapid sequence induction of anaesthesia in the emergency setting in shocked or hypotensive patients (e.g. ruptured abdominal aortic aneurysm, polytrauma or septic shock), prior resuscitation is often suboptimal and comorbidities (particularly cardiovascular) may be extensive. The induction agents with the most favourable pharmacological properties conferring haemodynamic stability appear to be ketamine and etomidate. However, etomidate has been withdrawn from use in some countries and impairs steroidogenesis...
May 2009: Anaesthesia
https://www.readbyqxmd.com/read/26611223/a-ketamine-protocol-and-intubation-rates-for-psychiatric-air-medical-retrieval
#15
Minh Le Cong, Ian Humble
OBJECTIVE: The air medical transfer of psychiatric patients with acute agitation is a regular requirement in only a few countries, with ours (Australia) being one of them. The optimal strategy has yet to be well described, ranging from physical restraints to general anesthesia with endotracheal intubation. In an Australian air medical service, Royal Flying Doctor Service (Queensland Section) rates of endotracheal intubation required for patient management were retrospectively compared before and after implementation of a ketamine sedation protocol for this patient population...
November 2015: Air Medical Journal
https://www.readbyqxmd.com/read/26416129/intubation-of-the-neurologically-injured-patient
#16
REVIEW
Joshua Bucher, Alex Koyfman
BACKGROUND: Intubation of the neurologically injured patient is a critical procedure that must be done in a manner to prevent further neurologic injury. Although many different medications and techniques have been used to meet specific needs, there is little to no evidence to support many claims. OBJECTIVE: To review the literature regarding important topics relating to intubating patients with neurologic injury. DISCUSSION: Airway management requires ideal preoxygenation and airway maneuvers to minimize manipulation of the larynx and to maximize first-pass success...
December 2015: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/26006743/endotracheal-intubation-versus-supraglottic-airway-placement-in-out-of-hospital-cardiac-arrest-a-meta-analysis
#17
REVIEW
Justin L Benoit, Ryan B Gerecht, Michael T Steuerwald, Jason T McMullan
OBJECTIVE: Overall survival from out-of-hospital cardiac arrest (OHCA) is less than 10%. After initial bag-valve mask ventilation, 80% of patients receive an advanced airway, either by endotracheal intubation (ETI) or placement of a supraglottic airway (SGA). The objective of this meta-analysis was to compare patient outcomes for these two advanced airway methods in OHCA patients treated by Emergency Medical Services (EMS). METHODS: A dual-reviewer search was conducted in PubMed, Scopus, and the Cochrane Database to identify all relevant peer-reviewed articles for inclusion in the meta-analysis...
August 2015: Resuscitation
https://www.readbyqxmd.com/read/26856657/difficult-intubation-factors-in-prehospital-rapid-sequence-intubation-by-an-australian-helicopter-emergency-medical-service
#18
Brian Burns, Karel Habig, Hilary Eason, Sandra Ware
OBJECTIVE: Prehospital rapid sequence intubation (RSI) of critically ill trauma patients is a high-risk procedure that may be associated with an increased rate of severe complications such as failed intubation, failure of oxygenation, hypoxia, hypotension, or need for surgical airway. The objective of this study was to describe the factors associated with difficult intubation in prehospital RSI as defined by more than a single look at laryngoscopy to achieve tracheal intubation. METHODS: This is an observational study using prospectively collected data...
January 2016: Air Medical Journal
https://www.readbyqxmd.com/read/26687513/technique-for-exchanging-the-king-laryngeal-tube-for-an-endotracheal-tube
#19
Lauren Klein, Glenn Paetow, Rebecca Kornas, Rob Reardon
No abstract text is available yet for this article.
March 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/26556848/difficult-airway-society-2015-guidelines-for-management-of-unanticipated-difficult-intubation-in-adults
#20
COMMENT
C Frerk, V S Mitchell, A F McNarry, C Mendonca, R Bhagrath, A Patel, E P O'Sullivan, N M Woodall, I Ahmad
These guidelines provide a strategy to manage unanticipated difficulty with tracheal intubation. They are founded on published evidence. Where evidence is lacking, they have been directed by feedback from members of the Difficult Airway Society and based on expert opinion. These guidelines have been informed by advances in the understanding of crisis management; they emphasize the recognition and declaration of difficulty during airway management. A simplified, single algorithm now covers unanticipated difficulties in both routine intubation and rapid sequence induction...
December 2015: British Journal of Anaesthesia
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