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EM Airway

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40 papers 100 to 500 followers Emergency and advanced airway management literature.
By Merlin Curry MD, EMT-P
https://www.readbyqxmd.com/read/26611223/a-ketamine-protocol-and-intubation-rates-for-psychiatric-air-medical-retrieval
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
https://www.readbyqxmd.com/read/26475247/does-intubation-improve-outcomes-over-supraglottic-airways-in-adult-out-of-hospital-cardiac-arrest
#7
REVIEW
Jestin N Carlson, Henry E Wang
No abstract text is available yet for this article.
March 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/24473409/paramedic-rapid-sequence-intubation-in-patients-with-non-traumatic-coma
#8
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
https://www.readbyqxmd.com/read/25243638/pediatric-airway-anatomy-may-not-be-what-we-thought-implications-for-clinical-practice-and-the-use-of-cuffed-endotracheal-tubes
#9
REVIEW
Joseph D Tobias
One of the long held tenets of pediatric anesthesia has been the notion that the pediatric airway is conical shape with the narrowest area being the cricoid region. However, recent studies using radiologic imaging techniques (magnetic resonance imaging and computed tomography) or direct bronchoscopic observation have questioned this suggesting that the narrowest segment may be at or just below the glottic opening. More importantly, it has been clearly demonstrated that the airway is elliptical in shape rather than circular with the anterior-posterior dimension being greater than the transverse dimension...
January 2015: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/22429973/the-factors-associated-with-successful-paediatric-endotracheal-intubation-on-the-first-attempt-in-emergency-departments-a-13-emergency-department-registry-study
#10
MULTICENTER STUDY
Hyuk Joong Choi, Sang Mo Je, Ji Hoon Kim, Euichung Kim
BACKGROUND: We investigated which factors are associated with successful paediatric endotracheal intubation (ETI) on the first attempt in emergency department (EDs) from multicentre emergency airway registry data. METHODS: We created a multicentre registry of intubations at 13 EDs and performed surveillance over 5 years. Each intubator filled out a data form after an intubation. We defined "paediatric patients" as patients younger than 10 years of age. We assessed the specialty and level of training of intubator, the method, the equipment, and the associated adverse events...
November 2012: Resuscitation
https://www.readbyqxmd.com/read/22560464/a-comparison-of-the-c-mac-video-laryngoscope-to-the-macintosh-direct-laryngoscope-for-intubation-in-the-emergency-department
#11
COMPARATIVE STUDY
John C Sakles, Jarrod Mosier, Stephen Chiu, Mari Cosentino, Leah Kalin
STUDY OBJECTIVE: We determine the proportion of successful intubations with the C-MAC video laryngoscope (C-MAC) compared with the direct laryngoscope in emergency department (ED) intubations. METHODS: This was a retrospective analysis of prospectively collected data entered into a continuous quality improvement database during a 28-month period in an academic ED. After each intubation, the operator completed a standardized data form evaluating multiple aspects of the intubation, including patient demographics, indication for intubation, device(s) used, reason for device selection, difficult airway characteristics, number of attempts, and outcome of each attempt...
December 2012: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/22762924/predictors-of-the-complication-of-postintubation-hypotension-during-emergency-airway-management
#12
Alan C Heffner, Douglas S Swords, Marcy L Nussbaum, Jeffrey A Kline, Alan E Jones
OBJECTIVE: Arterial hypotension is a recognized complication of emergency intubation that is independently associated with increased morbidity and mortality. Our aim was to identify factors associated with postintubation hypotension after emergency intubation. METHODS: Retrospective cohort study of tracheal intubations performed in a large, urban emergency department over a 1-year period. Patients were included if they were older than 17 years and had no systolic blood pressure measurements below 90 mm Hg for 30 consecutive minutes before intubation...
December 2012: Journal of Critical Care
https://www.readbyqxmd.com/read/25039321/endotracheal-intubation-in-the-pediatric-emergency-department
#13
Elliot Long, Stefan Sabato, Franz E Babl
BACKGROUND AND OBJECTIVES: Prospective safety data on emergency department (ED) intubation in children are limited. We aimed to describe the practice and adverse events associated with endotracheal intubation in a large urban pediatric ED. METHODS: Prospective observational study at a tertiary pediatric ED with an annual census of 82,000. The primary outcome measure was the adverse event rate. Secondary outcome measures were incidence of difficult laryngoscopy and first pass success rate without desaturation or hypotension...
December 2014: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/24658913/airway-management-in-the-critically-ill
#14
Jarrod M Mosier, J Adam Law
Successful first attempt intubation of the critically ill patient is of extreme importance. While these patients are anatomically and physiologically complicated, making intubation particularly risky, several important steps have recently been shown to improve the chances of a safe first attempt success. Proper evaluation, planning, positioning, preoxygenation, and in select patients the use of a neuromuscular blocking agent have all been shown to be useful for minimizing the difficult intubation and intubation- related complications...
May 2014: Intensive Care Medicine
https://www.readbyqxmd.com/read/20363528/emergency-department-management-of-the-airway-in-obese-adults
#15
REVIEW
James Dargin, Ron Medzon
Airway management in obese adults can be challenging, and much of the literature on this subject focuses on elective surgical cases, rather than acutely ill patients. In this article, we review the emergency department evaluation of the airway in obesity, discussing anatomy, physiology, and pharmacology. In addition, we describe techniques and devices used to improve intubating conditions in the obese patient. After our review of the relevant literature, we conclude that research in this particular area of acute care remains in its infancy...
August 2010: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/22313556/emergency-surgical-cricothyroidotomy-24-successful-cases-leading-to-a-simple-scalpel-finger-tube-method
#16
Bruce R Paix, William M Griggs
Surgical airway access justifiably remains the final option for managing the 'can't intubate can't ventilate' situation, but available techniques are often complicated and might require special equipment. This paper reports on the real world experience of two experienced Australian medical specialists with backgrounds in Anaesthesia and Aeromedical Retrieval who performed 24 surgical airways, mainly under adverse prehospital conditions, over a combined 40 years of practice. All attempts were successful, the majority through a simple open 'scalpel-finger-tube' method, which is described here...
February 2012: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/9506489/airway-management-in-the-emergency-department-a-one-year-study-of-610-tracheal-intubations
#17
J C Sakles, E G Laurin, A A Rantapaa, E A Panacek
STUDY OBJECTIVE: To describe the methods, success rates, and immediate complications of tracheal intubations performed in the emergency department of an urban teaching hospital. METHODS: This was an observational, consecutive series undertaken in an urban university hospital with an emergency medicine residency training program and an annual ED census of 60,000 patients. The study population included all patients for whom intubation was attempted in the ED during a 1-year period (July 1, 1995 through June 30, 1996)...
March 1998: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/23725520/emergency-cricothyrotomy-a-systematic-review
#18
REVIEW
Sofie Langvad, Per Kristian Hyldmo, Anders Rostrup Nakstad, Gunn Elisabeth Vist, Marten Sandberg
BACKGROUND: An emergency cricothyrotomy is the last-resort in most airway management protocols and is performed when it is not possible to intubate or ventilate a patient. This situation can rapidly prove fatal, making it important to identify the best method to establish a secure airway. We conducted a systematic review to identify whether there exists superiority between available commercial kits versus traditional surgical and needle techniques. METHODS: Medline, EMBASE and other databases were searched for pertinent studies...
2013: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/16187466/airway-management-by-us-and-canadian-emergency-medicine-residents-a-multicenter-analysis-of-more-than-6-000-endotracheal-intubation-attempts
#19
MULTICENTER STUDY
Mark J Sagarin, Erik D Barton, Yi-Mei Chng, Ron M Walls
STUDY OBJECTIVE: We determine success rates of endotracheal intubation performed in emergency departments (EDs) by North American emergency medicine residents. METHODS: During 58 months, physicians performing intubations at 31 university-affiliated EDs in 3 nations completed a data form that was entered into the National Emergency Airway Registry 2 database. Included were all patients undergoing endotracheal intubation in the ED. The data form included patients' age, sex, weight, indication for intubation, technique of airway management, names and dosages of all medications used to facilitate intubation, level of training and specialty of the intubator, number of attempts, success or failure, and adverse events...
October 2005: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/23242753/complications-and-failure-of-airway-management
#20
REVIEW
T M Cook, S R MacDougall-Davis
Airway management complications causing temporary patient harm are common, but serious injury is rare. Because most airways are easy, most complications occur in easy airways: these complications can and do lead to harm and death. Because these events are rare, most of our learning comes from large litigation and critical incident databases that help identify patterns and areas where care can be improved: but both have limitations. The recent 4th National Audit Project of the Royal College of Anaesthetists and Difficult Airway Society provides important detailed information and our best estimates of the incidence of major airway complications...
December 2012: British Journal of Anaesthesia
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