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EM Airway

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117 papers 25 to 100 followers
By Terren Trott terren.trott@gmail.com
https://www.readbyqxmd.com/read/25764403/fibreoptic-vs-videolaryngoscopic-c-mac-%C3%A2-d-blade-nasal-awake-intubation-under-local-anaesthesia
#1
RANDOMIZED CONTROLLED TRIAL
A Kramer, D Müller, R Pförtner, C Mohr, H Groeben
Numerous indirect laryngoscopes have been introduced into clinical practice and their use for tracheal intubation under local anaesthesia has been described. However, a study comparing indirect laryngoscopic vs fibreoptic intubation under local anaesthesia and sedation appears lacking. Therefore, we evaluated both techniques in 100 patients with an anticipated difficult nasal intubation time for intubation the primary outcome. We also assessed success rate, glottic view, Ramsey score, and patients' and anaesthetists' satisfaction...
April 2015: Anaesthesia
https://www.readbyqxmd.com/read/29132582/airway-management-in-trauma
#2
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/27111535/a-retrospective-study-of-success-failure-and-time-needed-to-perform-awake-intubation
#3
Thomas T Joseph, Jonathan S Gal, Samuel DeMaria, Hung-Mo Lin, Adam I Levine, Jaime B Hyman
BACKGROUND: Awake intubation is the standard of care for management of the anticipated difficult airway. The performance of awake intubation may be perceived as complex and time-consuming, potentially leading clinicians to avoid this technique of airway management. This retrospective review of awake intubations at a large academic medical center was performed to determine the average time taken to perform awake intubation, its effects on hemodynamics, and the incidence and characteristics of complications and failure...
July 2016: Anesthesiology
https://www.readbyqxmd.com/read/29261566/cardiac-arrest-and-mortality-related-to-intubation-procedure-in-critically-ill-adult-patients-a-multicenter-cohort-study
#4
Audrey De Jong, Amélie Rolle, Nicolas Molinari, Catherine Paugam-Burtz, Jean-Michel Constantin, Jean-Yves Lefrant, Karim Asehnoune, Boris Jung, Emmanuel Futier, Gérald Chanques, Elie Azoulay, Samir Jaber
OBJECTIVES: To determine the prevalence of and risk factors for cardiac arrest during intubation in ICU, as well as the association of ICU intubation-related cardiac arrest with 28-day mortality. DESIGN: Retrospective analysis of prospectively collected data. SETTING: Sixty-four French ICUs. PATIENTS: Critically ill patients requiring intubation in the ICU. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: During the 1,847 intubation procedures included, 49 cardiac arrests (2...
December 19, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28045709/cricoid-pressure-controversies-narrative-review
#5
REVIEW
M Ramez Salem, Arjang Khorasani, Ahed Zeidan, George J Crystal
Since cricoid pressure was introduced into clinical practice, controversial issues have arisen, including necessity, effectiveness in preventing aspiration, quantifying the cricoid force, and its reliability in certain clinical entities and in the presence of gastric tubes. Cricoid pressure-associated complications have also been alleged, such as airway obstruction leading to interference with manual ventilation, laryngeal visualization, tracheal intubation, placement of supraglottic devices, and relaxation of the lower esophageal sphincter...
April 2017: Anesthesiology
https://www.readbyqxmd.com/read/29178953/video-laryngoscopy-does-not-improve-the-intubation-outcomes-in-emergency-and-critical-patients-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#6
Jia Jiang, Danxu Ma, Bo Li, Yun Yue, Fushan Xue
BACKGROUND: There is significant controversy regarding the influence of video laryngoscopy on the intubation outcomes in emergency and critical patients. This systematic review and meta-analysis was designed to determine whether video laryngoscopy could improve the intubation outcomes in emergency and critical patients. METHODS: We searched the Cochrane Central Register of Controlled Trials, PubMed, Embase, and Scopus databases from database inception until 15 February 2017...
November 24, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28459305/advanced-airway-type-and-its-association-with-chest-compression-interruptions-during-out-of-hospital-cardiac-arrest-resuscitation-attempts
#7
Angela F Jarman, Christy L Hopkins, J Nicholas Hansen, Jonathan R Brown, Christopher Burk, Scott T Youngquist
OBJECTIVE: To assess interruptions in chest compressions associated with advanced airway placement during cardiopulmonary resuscitation (CPR) of out-of-hospital cardiac arrest (OHCA) victims. METHODS: The method used was observational analysis of prospectively collected clinical and defibrillator data from 339 adult OHCA victims, excluding victims with <5 minutes of CPR. Interruptions in CPR, summarized by chest compression fraction (CCF), longest pause, and the number of pauses greater than 10 seconds, were compared between patients receiving bag valve mask (BVM), supraglottic airway (SGA), endotracheal intubation (ETI) via direct laryngoscopy (DL), and ETI via video laryngoscopy (VL)...
September 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29018000/waveform-capnography-an-alternative-to-physician-gestalt-in-determining-optimal-intubating-conditions-after-administration-of-paralytic-agents
#8
Anthony Scoccimarro, Jason R West, Marc Kanter, Nicholas D Caputo
PURPOSE: We sought to evaluate the utility of waveform capnography (WC) in detecting paralysis, by using apnoea as a surrogate determinant, as compared with clinical gestalt during rapid sequence intubation. Additionally, we sought to determine if this improves the time to intubation and first pass success rates through more consistent and expedient means of detecting optimal intubating conditions (ie, paralysis). METHODS: A prospective observational cohort study of consecutively enrolled patients was conducted from April to June 2016 at an academic, urban, level 1 trauma centre in New York City...
October 10, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28634050/was-capnographic-waveform-the-gold-standard-to-confirm-the-endotracheal-intubation-we-need-more-proofs
#9
LETTER
Jing Wang, Hui Gong, Yansong Li
No abstract text is available yet for this article.
October 2017: Resuscitation
https://www.readbyqxmd.com/read/28754524/reply-to-letter-was-capnographic-waveform-the-gold-standard-to-confirm-the-endotracheal-intubation-we-need-more-proof
#10
LETTER
Jay G Ladde, James F Brown, Jesus V Roa, Christopher Hunter, George A Ralls, Linda Papa
No abstract text is available yet for this article.
October 2017: Resuscitation
https://www.readbyqxmd.com/read/12589988/the-assessment-of-three-methods-to-verify-tracheal-tube-placement-in-the-emergency-setting
#11
COMPARATIVE STUDY
Taku Takeda, Koichi Tanigawa, Hitoshi Tanaka, Yuri Hayashi, Eiichi Goto, Keiichi Tanaka
We studied prospectively the reliability of clinical methods, end-tidal carbon dioxide (ETCO(2)) detection, and the esophageal detector device (EDD) for verifying tracheal intubation in 137 adult patients in the emergency department. Immediately after intubation, the tracheal tube position was tested by the EDD and ETCO(2) monitor, followed by auscultation of the chest. The views obtained at laryngoscopy were classified according to the Cormack grade. Of the 13 esophageal intubations that occurred, one false-positive result occurred in the EDD test and auscultation...
February 2003: Resuscitation
https://www.readbyqxmd.com/read/24105333/sustained-life-like-waveform-capnography-after-human-cadaveric-tracheal-intubation
#12
Cliff Reid, Anthony Lewis, Karel Habig, Brian Burns, Frank Billson, Sven Kunkel, Wesley Fisk
INTRODUCTION: Fresh frozen cadavers are effective training models for airway management. We hypothesised that residual carbon dioxide (CO2) in cadaveric lung would be detectable using standard clinical monitoring systems, facilitating detection of tracheal tube placement and further enhancing the fidelity of clinical simulation using a cadaveric model. METHODS: The tracheas of two fresh frozen unembalmed cadavers were intubated via direct laryngoscopy. Each tracheal tube was connected to a self-inflating bag and a sidestream CO2 detector...
March 2015: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/21828342/out-of-theatre-tracheal-intubation-prospective-multicentre-study-of-clinical-practice-and-adverse-events
#13
MULTICENTER STUDY
T M Bowles, D A Freshwater-Turner, D J Janssen, C J Peden
BACKGROUND: Tracheal intubation is commonly performed outside the operating theatre and is associated with higher risk than intubation in theatre. Recent guidelines and publications including the 4th National Audit Project of the Royal College of Anaesthetists have sought to improve the safety of out-of-theatre intubations. METHODS: We performed a prospective observational study examining all tracheal intubations occurring outside the operating theatre in nine hospitals over a 1 month period...
November 2011: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/26184656/availability-and-use-of-capnography-for-in-hospital-cardiac-arrests-in-the-united-kingdom
#14
MULTICENTER STUDY
Sarah Turle, Peter B Sherren, Stuart Nicholson, Thomas Callaghan, Stephen J Shepherd
BACKGROUND: Airway complications occur more frequently outside the operating theatre and in emergency situations. Capnography remains the gold standard for confirming correct endotracheal tube placement, retaining high sensitivity and specificity in cardiac arrest. The 2010 European Resuscitation Council guidelines for adult advanced life support recommended waveform capnography in this setting. We investigated current UK practice relating to the availability and use of this technology during cardiac arrest...
September 2015: Resuscitation
https://www.readbyqxmd.com/read/11145768/misplaced-endotracheal-tubes-by-paramedics-in-an-urban-emergency-medical-services-system
#15
S H Katz, J L Falk
STUDY OBJECTIVE: To determine the incidence of unrecognized, misplaced endotracheal tubes inserted by paramedics in a large urban, decentralized emergency medical services (EMS) system. METHODS: We conducted a prospective, observational study of patients intubated in the field by paramedics before emergency department arrival. During an 8-month period, emergency physicians assessed tube position at ED arrival using a combination of auscultation, end-tidal carbon dioxide (ETCO(2)) monitoring, and direct laryngoscopy...
January 2001: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/15855946/the-effectiveness-of-out-of-hospital-use-of-continuous-end-tidal-carbon-dioxide-monitoring-on-the-rate-of-unrecognized-misplaced-intubation-within-a-regional-emergency-medical-services-system
#16
Salvatore Silvestri, George A Ralls, Baruch Krauss, Josef Thundiyil, Steven G Rothrock, Amy Senn, Eric Carter, Jay Falk
STUDY OBJECTIVE: We evaluate the association between out-of-hospital use of continuous end-tidal carbon dioxide (ETCO2) monitoring and unrecognized misplaced intubations within a regional emergency medical services (EMS) system. METHODS: This was a prospective, observational study, conducted during a 10-month period, on all patients arriving at a regional Level I trauma center emergency department who underwent out-of-hospital endotracheal intubation. The regional EMS system that serves the trauma service area is composed of multiple countywide systems containing numerous EMS agencies...
May 2005: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/25400399/capnography-during-cardiopulmonary-resuscitation-current-evidence-and-future-directions
#17
REVIEW
Bhavani Shankar Kodali, Richard D Urman
Capnography continues to be an important tool in measuring expired carbon dioxide (CO2). Most recent Advanced Cardiac Life Support (ACLS) guidelines now recommend using capnography to ascertain the effectiveness of chest compressions and duration of cardiopulmonary resuscitation (CPR). Based on an extensive review of available published literature, we selected all available peer-reviewed research investigations and case reports. Available evidence suggests that there is significant correlation between partial pressure of end-tidal CO2 (PETCO2) and cardiac output that can indicate the return of spontaneous circulation (ROSC)...
October 2014: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28111195/endotracheal-tube-placement-confirmation-100-sensitivity-and-specificity-with-sustained-four-phase-capnographic-waveforms-in-a-cadaveric-experimental-model
#18
Salvatore Silvestri, Jay G Ladde, James F Brown, Jesus V Roa, Christopher Hunter, George A Ralls, Linda Papa
BACKGROUND: Waveform capnography is considered the gold standard for verification of proper endotracheal tube placement, but current guidelines caution that it is unreliable in low-perfusion states such as cardiac arrest. Recent case reports found that long-deceased cadavers can produce capnographic waveforms. The purpose of this study was to determine the predictive value of waveform capnography for endotracheal tube placement verification and detection of misplacement using a cadaveric experimental model...
June 2017: Resuscitation
https://www.readbyqxmd.com/read/17789877/curare-alkaloids-from-chondodendron-tomentosum
#19
O Wintersteiner, J D Dutcher
Crystalline d-tubocurarine has been isolated in good yield from curare prepared from a single plant species, namely, Chondodendron tomentosum. This result establishes with certainty the botanical origin of this compound and substantiates the supposition that it is this species which furnishes the active constituent in certain types of curare. The extract from this plant furthermore yielded two new tertiary alkaloids which could be converted into physiologically active quaternary bases. Methylation of the phenolic hydroxyl groups in the quaternary bases resulted in a 3-9-fold increase in physiological potency...
May 21, 1943: Science
https://www.readbyqxmd.com/read/28917549/a-multicenter-randomized-trial-of-a-checklist-for-endotracheal-intubation-of-critically-ill-adults
#20
David R Janz, Matthew W Semler, Aaron M Joffe, Jonathan D Casey, Robert J Lentz, Bennett P deBoisblanc, Yasin A Khan, Jairo I Santanilla, Itay Bentov, Todd W Rice
BACKGROUND: Hypoxemia and hypotension are common complications during endotracheal intubation of critically ill adults. Verbal performance of a written, preintubation checklist may prevent these complications. We compared a written, verbally performed, preintubation checklist with usual care regarding lowest arterial oxygen saturation or lowest systolic BP experienced by critically ill adults undergoing endotracheal intubation. METHODS: A multicenter trial in which 262 adults undergoing endotracheal intubation were randomized to a written, verbally performed, preintubation checklist (checklist) or no preintubation checklist (usual care)...
September 14, 2017: Chest
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