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EM Airway

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70 papers 25 to 100 followers
By Terren Trott terren.trott@gmail.com
https://www.readbyqxmd.com/read/28601274/rocuronium-should-be-the-default-paralytic-in-rapid-sequence-intubation
#1
Anand K Swaminathan, Haney Mallemat
No abstract text is available yet for this article.
June 7, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28601269/the-bougie-and-first-pass-success-in-the-emergency%C3%A2-department
#2
Brian Driver, Kenneth Dodd, Lauren R Klein, Ryan Buckley, Aaron Robinson, John W McGill, Robert F Reardon, Matthew E Prekker
STUDY OBJECTIVE: The bougie may improve first-pass intubation success in operating room patients. We seek to determine whether bougie use is associated with emergency department (ED) first-pass intubation success. METHODS: We studied consecutive adult ED intubations at an urban, academic medical center during 2013. Intubation events were identified by motion-activated video recording. We determined the association between bougie use and first-pass intubation success, adjusting for neuromuscular blockade, video laryngoscopy, abnormal airway anatomy, and whether the patient was placed in the sniffing position or the head was lifted off the bed during intubation...
June 7, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/12415037/the-efficacy-of-noncontact-oxygen-delivery-methods
#3
Patrick Davies, Danny Cheng, Adam Fox, Lleona Lee
OBJECTIVES: "Wafting" oxygen is a possible strategy to deliver oxygen to a patient who may not tolerate delivery systems that involve contact on the face. We wished to assess the concentration of oxygen delivered to the patient with various methods of "wafting" oxygen. DESIGN: Three methods of wafting oxygen were examined: an infant resuscitator bag, a standard pediatric Hudson RCI face mask, and a piece of standard green oxygen tubing. Contour lines for oxygen concentrations of 30% to 70% in 10% intervals were found with a Teledyne oxygen meter, at an oxygen flow rate of 5 L/min and 10 L/min...
November 2002: Pediatrics
https://www.readbyqxmd.com/read/28537983/comparison-of-the-mallampati-classification-in-sitting-and-supine-position-to-predict-difficult-tracheal-intubation-a-prospective-observational-cohort-study
#4
Jean-Luc Hanouz, Vincent Bonnet, Clément Buléon, Thérèse Simonet, Dorothée Radenac, Guillaume Zamparini, Marc Olivier Fischer, Jean-Louis Gérard
BACKGROUND: The Mallampati classification (MLPT) is normally evaluated in the sitting position. However, many patients cannot be evaluated in the sitting position for medical reasons. Thus, we compared the MLPT in sitting and supine positions in predicting difficult tracheal intubation (DTI). We hypothesized that the diagnostic accuracy of the MLPT performed in sitting and supine positions would differ. METHODS: We performed a single-center prospective observational study in adult patients who received general anesthesia and orotracheal intubation for noncardiac surgery...
May 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/15527629/laryngoscopy-and-morbid-obesity-a-comparison-of-the-sniff-and-ramped-positions
#5
RANDOMIZED CONTROLLED TRIAL
Jeremy S Collins, Harry J M Lemmens, Jay B Brodsky, John G Brock-Utne, Richard M Levitan
BACKGROUND: The effect of patient position on the view obtained during laryngoscopy was investigated. METHODS: 60 morbidly obese patients undergoing elective bariatric were studied. Patients were randomly assigned into one of two groups. In Group 1, a conventional "sniff" position was obtained by placing a firm 7-cm cushion underneath the patient's head, thus raising the occiput a standard distance from the operating-table while the patient remained supine. In Group 2, a "ramped" position was achieved by arranging blankets underneath the patient's upper body and head until horizontal alignment was achieved between the external auditory meatus and the sternal notch...
October 2004: Obesity Surgery
https://www.readbyqxmd.com/read/21596871/head-and-neck-position-for-direct-laryngoscopy
#6
REVIEW
Mohammad El-Orbany, Harvey Woehlck, M Ramez Salem
The sniffing position (SP) has traditionally been considered the optimal head position for direct laryngoscopy (DL). Its superiority over other head positions, however, has been questioned during the last decade. We reviewed the scarce literature on the subject to examine the evidence either in favor or against the routine use of the SP. A standard definition for the position should be used (e.g., 35° neck flexion and 15° head extension) to avoid confusion about what constitutes a proper SP and to compare the results from different studies...
July 2011: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/25844128/comparison-of-the-rate-of-successful-endotracheal-intubation-between-the-sniffing-and-ramped-positions-in-patients-with-an-expected-difficult-intubation-a-prospective-randomized-study
#7
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
https://www.readbyqxmd.com/read/28487139/a-multicenter-randomized-trial-of-ramped-position-versus-sniffing-position-during-endotracheal-intubation-of-critically-ill-adults
#8
Matthew W Semler, David R Janz, Derek W Russell, Jonathan D Casey, Robert J Lentz, Aline N Zouk, Bennett P deBoisblanc, Jairo I Santanilla, Yasin A Khan, Aaron M Joffe, William S Stigler, Todd W Rice
BACKGROUND: Hypoxemia is the most common complication during endotracheal intubation of critically ill adults. Intubation in the ramped position has been hypothesized to prevent hypoxemia by increasing functional residual capacity and decreasing the duration of intubation, but has never been studied outside of the operating room. METHODS: Multicenter, randomized trial comparing ramped position (head of the bed elevated to 25 degrees) to sniffing position (torso supine, neck flexed, head extended) among 260 adults undergoing endotracheal intubation by Pulmonary and Critical Care Medicine fellows in four intensive care units between July 22, 2015 and July 19, 2016...
May 6, 2017: Chest
https://www.readbyqxmd.com/read/25981908/high-flow-oxygen-through-nasal-cannula-in-acute-hypoxemic-respiratory-failure
#9
RANDOMIZED CONTROLLED TRIAL
Jean-Pierre Frat, Arnaud W Thille, Alain Mercat, Christophe Girault, Stéphanie Ragot, Sébastien Perbet, Gwénael Prat, Thierry Boulain, Elise Morawiec, Alice Cottereau, Jérôme Devaquet, Saad Nseir, Keyvan Razazi, Jean-Paul Mira, Laurent Argaud, Jean-Charles Chakarian, Jean-Damien Ricard, Xavier Wittebole, Stéphanie Chevalier, Alexandre Herbland, Muriel Fartoukh, Jean-Michel Constantin, Jean-Marie Tonnelier, Marc Pierrot, Armelle Mathonnet, Gaëtan Béduneau, Céline Delétage-Métreau, Jean-Christophe M Richard, Laurent Brochard, René Robert
BACKGROUND: Whether noninvasive ventilation should be administered in patients with acute hypoxemic respiratory failure is debated. Therapy with high-flow oxygen through a nasal cannula may offer an alternative in patients with hypoxemia. METHODS: We performed a multicenter, open-label trial in which we randomly assigned patients without hypercapnia who had acute hypoxemic respiratory failure and a ratio of the partial pressure of arterial oxygen to the fraction of inspired oxygen of 300 mm Hg or less to high-flow oxygen therapy, standard oxygen therapy delivered through a face mask, or noninvasive positive-pressure ventilation...
June 4, 2015: New England Journal of Medicine
https://www.readbyqxmd.com/read/26950708/auscultation-versus-point-of-care-ultrasound-to-determine-endotracheal-versus-bronchial-intubation-a-diagnostic-accuracy-study
#10
RANDOMIZED CONTROLLED TRIAL
Davinder Ramsingh, Ethan Frank, Robert Haughton, John Schilling, Kimberly M Gimenez, Esther Banh, Joseph Rinehart, Maxime Cannesson
BACKGROUND: Unrecognized malposition of the endotracheal tube (ETT) can lead to severe complications in patients under general anesthesia. The focus of this double-blinded randomized study was to assess the accuracy of point-of-care ultrasound in verifying the correct position of the ETT and to compare it with the accuracy of auscultation. METHODS: Forty-two adult patients requiring general anesthesia with ETT were consented. Patients were randomized to right main bronchus, left main bronchus, or tracheal intubation...
May 2016: Anesthesiology
https://www.readbyqxmd.com/read/27095126/video-laryngoscopy-vs-direct-laryngoscopy-which-should-be-chosen-for-endotracheal-intubation-during-cardiopulmonary-resuscitation-a-prospective-randomized-controlled-study-of-experienced-intubators
#11
Jong Won Kim, Sang O Park, Kyeong Ryong Lee, Dae Young Hong, Kwang Je Baek, Young Hwan Lee, Jeong Hun Lee, Pil Cho Choi
AIM: This study compared endotracheal intubation (ETI) performance during cardiopulmonary resuscitation (CPR) between direct laryngoscopy (DL) and video laryngoscopy (VL) (GlideScope(®)) by experienced intubators (>50 successful ETIs). METHODS: This was a prospective randomized controlled study conducted in an emergency department between 2011 and 2013. Intubators who used DL or VL were randomly allocated to ETI during CPR. Data were collected from recorded video clips and rhythm sheets...
August 2016: Resuscitation
https://www.readbyqxmd.com/read/28118658/whether-to-intubate-during-cardiopulmonary-resuscitation-conventional-wisdom-vs-big-data
#12
EDITORIAL
Derek C Angus
No abstract text is available yet for this article.
February 7, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/25541427/video-laryngoscopy-improves-the-first-attempt-success-in-endotracheal-intubation-during-cardiopulmonary-resuscitation-among-novice-physicians
#13
Sang O Park, Jong Won Kim, Joon Ho Na, Ki Ho Lee, Kyeong Ryong Lee, Dae Young Hong, Kwang Je Baek
AIM: To compare the first-attempt success in endotracheal intubation (ETI) during cardiopulmonary resuscitation (CPR) using direct laryngoscopy (DL) and video laryngoscopy (VL) (GlideScope(®)) among novice emergency physicians (EPs). METHODS: This study is a historically controlled clinical design. From May 2011 to April 2013 out-of-hospital cardiac arrest patients were intubated during CPR by novice EPs. CPR data was automatically recorded by pre-installed video and subsequently analysed...
April 2015: Resuscitation
https://www.readbyqxmd.com/read/25611791/the-concordance-of-ultrasound-technique-versus-x-ray-to-confirm-endotracheal-tube-position-in-neonates
#14
R Chowdhry, B Dangman, J M B Pinheiro
OBJECTIVE: Given the distressingly high incidence of ETT malposition in the neonatal population, patients are exposed to ionizing radiation to confirm endotracheal tube (ETT) position. Our objective is to determine if ultrasound technique is concordant with X-ray in determining whether an ETT is deeply positioned or not. STUDY DESIGN: Prospective observational clinical trial. After obtaining informed consent, patients with an ETT who required X-ray for clinical reasons underwent sonographic evaluation of the ETT by an ultrasound technologist or pediatric radiologist, usually within the hour...
July 2015: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/15508663/secondary-confirmation-of-endotracheal-tube-position-by-ultrasound-image
#15
RANDOMIZED CONTROLLED TRIAL
Kai-Sheng Hsieh, Cheng-Liang Lee, Chu-Chung Lin, Ta-Cheng Huang, Ken-Pen Weng, Wen-Hsien Lu
OBJECTIVE: Secondary confirmation of endotracheal (ET) tube position by ultrasound image. DESIGN: Prospective, randomized study. SETTING: A medical center-based tertiary pediatric intensive care unit. PATIENTS: A total of 59 patients aged from newborn to 17 yrs old underwent ET tube insertion because of cardiopulmonary arrest or impending respiratory failure. INTERVENTION: Ultrasound imaging was performed immediately before and after the ET tube placement procedure...
September 2004: Critical Care Medicine
https://www.readbyqxmd.com/read/22612446/role-of-ultrasound-compared-to-age-related-formulas-for-uncuffed-endotracheal-intubation-in-a-pediatric-population
#16
Christoph Schramm, Jana Knop, Katrin Jensen, Konstanze Plaschke
BACKGROUND: It is often difficult to determine the correct size of endotracheal tubes (ETT) needed for intubating pediatric patients. Therefore, we evaluated the role of ultrasound in pediatric patients to compare the correct size of an uncuffed (ETT) with the minimal transverse diameter of the subglottic airway (MTDSA) measured by ultrasound and with tube size predicted by different age-related formulas. METHODS: A total of 50 pediatric patients ≤ 5 years were enrolled...
August 2012: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28420641/should-we-intubate-patients-during-cardiopulmonary-resuscitation
#17
EDITORIAL
Carl L Gwinnutt
No abstract text is available yet for this article.
April 18, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28412161/the-effect-of-the-apneic-period-on-the-respiratory-physiology-of-patients-undergoing-intubation-in-the-emergency-department
#18
Jason R West, Anthony Scoccimarro, Cody Kramer, Nicholas D Caputo
OBJECTIVES: We sought to examine the physiological impact the apneic period has on the respiratory physiology of patients undergoing intubation in the emergency department and whether DAO, the delivery of 15L oxygen by nasal cannula during apnea, can affect the development of respiratory acidosis. METHODS: This was a prospective observational cohort study conducted at an urban academic level 1 trauma center. A convenience sample of 100 patients was taken. Timed data collection forms were completed during the periintubation period...
April 2, 2017: American 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
#19
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/28358178/time-to-intubation-in-obese-patients-a-randomized-study-comparing-direct-laryngoscopy-and-videolaryngoscopy-in-experienced-anaesthetists
#20
Fredrik Ander, Anders Magnuson, Lars Berggren, Rebecca Ahlstrand, Alex de Leon
BACKGROUND: Airway management may be difficult in obese patients. Moreover, during prolonged intubation, oxygen desaturation develops rapidly. Videolaryngoscopy improves the view of the larynx, and the Storz® C-MACTM has been shown to be superior to other videolaryngoscopes in terms of intubation time in obese patients. However, no effort has been made to compare the Storz® C-MACTM with direct laryngoscopy. The aim of the study was to evaluate if the use of Storz® C-MACTM may reduce intubation time when compared to direct laryngoscopy (classic Macintosh® blade)...
March 28, 2017: Minerva Anestesiologica
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