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EM Airway

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59 papers 100 to 500 followers Emergency and advanced airway management literature.
By Merlin Curry MD, EMT-P
https://www.readbyqxmd.com/read/30189067/airway-management-for-trauma-patients
#1
Benjamin D Walrath, Stephen Harper, Ed Barnard, Joshua M Tobin, Brendon Drew, Cord Cunningham, Chetan Kharod, James Spradling, Craig Stone, Matthew Martin
Trauma airway management is a critical skill for medical providers supporting combat casualties since it is an integral component of damage control resuscitation and surgery. This clinical practice guideline presents methods for optimizing the airway management of patients with traumatic injury in the operational medical treatment facility environment. The guidelines represent the knowledge and experience of 10 co-authors from 3 allied countries representing Emergency Medicine, Surgery and Anesthesia.
September 1, 2018: Military Medicine
https://www.readbyqxmd.com/read/29549828/a-comparison-between-video-laryngoscopy-and-direct-laryngoscopy-for-endotracheal-intubation-in-the-emergency-department-a-meta-analysis-of-randomized-controlled-trials
#2
Sulagna Bhattacharjee, Souvik Maitra, Dalim K Baidya
STUDY OBJECTIVES: Direct laryngoscopy is the most commonly used modality for endotracheal intubation in the emergency department. Video laryngoscopy may improve glottic view during laryngoscopy and intubation success rate in such patients. This meta-analysis has been designed to compare clinical efficacy of video laryngoscopy with direct laryngoscopy for endotracheal intubation in the emergency department. DESIGN: Meta-analysis of randomized controlled trial. SETTING: Randomized controlled trials comparing video laryngoscopy and direct laryngoscopy for endotracheal intubation in adult patients in emergency department...
June 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29377753/flight-versus-ground-out-of-hospital-rapid-sequence-intubation-success-a-systematic-review-and-meta-analysis
#3
Pieter F Fouche, Christopher Stein, Paul Simpson, Jestin N Carlson, Kristina M Zverinova, Suhail A Doi
INTRODUCTION: Endotracheal intubation (ETI) is a critical procedure performed by both air medical and ground based emergency medical services (EMS). Previous work has suggested that ETI success rates are greater for air medical providers. However, air medical providers may have greater airway experience, enhanced airway education, and access to alternative ETI options such as rapid sequence intubation (RSI). We sought to analyze the impact of the type of EMS on RSI success. METHODS: A systematic literature search of Medline, Embase, and the Cochrane Library was conducted and eligibility, data extraction, and assessment of risk of bias were assessed independently by two reviewers...
September 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29351759/tracheal-intubation-in-critically-ill-patients-a-comprehensive-systematic-review-of-randomized-trials
#4
REVIEW
Luca Cabrini, Giovanni Landoni, Martina Baiardo Radaelli, Omar Saleh, Carmine D Votta, Evgeny Fominskiy, Alessandro Putzu, Cézar Daniel Snak de Souza, Massimo Antonelli, Rinaldo Bellomo, Paolo Pelosi, Alberto Zangrillo
BACKGROUND: We performed a systematic review of randomized controlled studies evaluating any drug, technique or device aimed at improving the success rate or safety of tracheal intubation in the critically ill. METHODS: We searched PubMed, BioMed Central, Embase and the Cochrane Central Register of Clinical Trials and references of retrieved articles. Finally, pertinent reviews were also scanned to detect further studies until May 2017. The following inclusion criteria were considered: tracheal intubation in adult critically ill patients; randomized controlled trial; study performed in Intensive Care Unit, Emergency Department or ordinary ward; and work published in the last 20 years...
January 20, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29132582/airway-management-in-trauma
#5
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/28623005/pre-oxygenation-implications-in-emergency-airway-management
#6
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...
August 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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
Emmanuel Caruana, François-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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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