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EM Airway

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130 papers 25 to 100 followers
By Terren Trott terren.trott@gmail.com
https://www.readbyqxmd.com/read/27130803/hemodynamic-response-after-rapid-sequence-induction-with-ketamine-in-out-of-hospital-patients-at-risk-of-shock-as-defined-by-the-shock-index
#1
Matthew Miller, Natalie Kruit, Charlotte Heldreich, Sandra Ware, Karel Habig, Cliff Reid, Brian Burns
STUDY OBJECTIVE: Ketamine is considered a stable induction agent for rapid sequence induction; however, hypotension rates up to 24% are reported. The shock index (shock index=pulse rate/systolic blood pressure [SBP]) may identify patients at risk of adverse hemodynamic change. We investigate whether SBP and pulse rate response to ketamine induction differ when patients are classified as being at risk of shock by their shock index. METHODS: We conducted a prospective observational study of electronically collected vital sign data from patients undergoing rapid sequence induction with ketamine...
August 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29699900/apneic-oxygenation-reduces-hypoxemia-during-endotracheal-intubation-in-the-pediatric-emergency-department
#2
Adam A Vukovic, Holly R Hanson, Shelley L Murphy, Danielle Mercurio, Craig A Sheedy, Donald H Arnold
BACKGROUND: Apneic oxygenation (AO) has been evaluated in adult patients as a means of reducing hypoxemia during endotracheal intubation (ETI). While less studied in pediatric patients, its practice has been largely adopted. OBJECTIVE: Determine association between AO and hypoxemia in pediatric patients undergoing ETI. METHODS: Observational study at an urban, tertiary children's hospital emergency department. Pediatric patients undergoing ETI were examined during eras without (January 2011-June 2011) and with (August 2014-March 2017) apneic oxygenation...
April 18, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29701889/emergency-department-adult-fiberoptic-intubations-incidence-indications-and-implications-for-training
#3
Emily M Hayden, Daniel J Pallin, Susan R Wilcox, James A Gordon, Jestin N Carlson, Ron M Walls, Calvin A Brown
BACKGROUND: To describe the frequency, indications and outcomes of flexible fiberoptic intubations (FFI) performed in the emergency department (ED). METHODS: From the National Emergency Airway Registry (NEAR), we identified all encounters during 7/1/02 through 12/31/12 with the use of FFI. We determined patient, provider and intubation characteristics, success and failure rates, and modes of intubation rescue. RESULTS: Among 17,910 intubations of patients >15 years old at 13 EDs, FFI was used in 204 cases (1...
April 27, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27614374/utilization-of-a-gum-elastic-bougie-to-facilitate-single-lung-intubation
#4
RANDOMIZED CONTROLLED TRIAL
Michael Gottlieb, Vibhu Sharma, John Field, Michael Rozum, John Bailitz
INTRODUCTION: Patients with severe pulmonary hemorrhage due to unilateral trauma or a bleeding cancer often present to the emergency department in acute respiratory distress. Although it is generally recommended to perform single lung intubation, most emergency department providers do not have access to or are not familiar with double-lumen endotracheal tubes, and blind insertion of an endotracheal tube to maximum depth does not ensure that the proper (nonhemorrhagic) lung is ventilated...
December 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/18996675/success-of-the-gum-elastic-bougie-as-a-rescue-airway-in-the-emergency-department
#5
Kaushal H Shah, Brian M Kwong, Alberto Hazan, David H Newman, Dan Wiener
BACKGROUND: The gum elastic bougie (GEB) is a rescue airway device commonly found in the emergency department (ED). However, data documenting its efficacy are lacking in the emergency medicine literature. STUDY OBJECTIVES: To determine the success rate of endotracheal intubation using a GEB and the reliability of "palpable clicks" and "hold-up" in the ED setting. METHODS: The GEB was introduced at our two affiliated urban EDs with a 3-year residency training program and an annual census of 150,000...
January 2011: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29548862/defining-the-criteria-for-intubation-of-the-patient-with-thermal-burns
#6
Jenelle H Badulak, Michael Schurr, Angela Sauaia, Anna Ivashchenko, Erik Peltz
OBJECTIVES: Recent studies demonstrate that burn patients are undergoing unnecessary intubations. We sought to determine the clinical criteria that predict intubations with benefit. METHODS: This was a retrospective review of intubated adults admitted to our center with thermal burns 2008-2013. Criteria for intubation were defined as traditional criteria (suspected smoke inhalation, oropharynx soot, hoarseness, dysphagia, singed facial hair, oral edema, oral burn, non-full thickness facial burns), or ABA criteria as defined by the 2011 ABA guidelines (full thickness facial burns, stridor, respiratory distress, swelling on laryngoscopy, upper airway trauma, altered mentation, hypoxia/hypercarbia, hemodynamic instability)...
March 13, 2018: Burns: Journal of the International Society for Burn Injuries
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
#7
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...
March 14, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29345513/no-benefit-in-neurologic-outcomes-of-survivors-of-out-of-hospital-cardiac-arrest-with-mechanical-compression-device
#8
Ryan Newberry, Ted Redman, Elliot Ross, Rachel Ely, Clayton Saidler, Allyson Arana, David Wampler, David Miramontes
INTRODUCTION: Out-of-hospital cardiac arrest (OHCA) is a major cause of death and morbidity in the United States. Quality cardiopulmonary resuscitation (CPR) has proven to be a key factor in improving survival. The aim of our study was to investigate the outcomes of OHCA when mechanical CPR (LUCAS 2 Chest Compression System™) was utilized compared to conventional CPR. Although controlled trials have not demonstrated a survival benefit to the routine use of mechanical CPR devices, there continues to be an interest for their use in OHCA...
May 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29351759/tracheal-intubation-in-critically-ill-patients-a-comprehensive-systematic-review-of-randomized-trials
#9
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/29486039/effect-of-bag-mask-ventilation-vs-endotracheal-intubation-during-cardiopulmonary-resuscitation-on-neurological-outcome-after-out-of-hospital-cardiorespiratory-arrest-a-randomized-clinical-trial
#10
RANDOMIZED CONTROLLED TRIAL
Patricia Jabre, Andrea Penaloza, David Pinero, Francois-Xavier Duchateau, Stephen W Borron, Francois Javaudin, Olivier Richard, Diane de Longueville, Guillem Bouilleau, Marie-Laure Devaud, Matthieu Heidet, Caroline Lejeune, Sophie Fauroux, Jean-Luc Greingor, Alessandro Manara, Jean-Christophe Hubert, Bertrand Guihard, Olivier Vermylen, Pascale Lievens, Yannick Auffret, Celine Maisondieu, Stephanie Huet, Benoît Claessens, Frederic Lapostolle, Nicolas Javaud, Paul-Georges Reuter, Elinor Baker, Eric Vicaut, Frédéric Adnet
Importance: Bag-mask ventilation (BMV) is a less complex technique than endotracheal intubation (ETI) for airway management during the advanced cardiac life support phase of cardiopulmonary resuscitation of patients with out-of-hospital cardiorespiratory arrest. It has been reported as superior in terms of survival. Objectives: To assess noninferiority of BMV vs ETI for advanced airway management with regard to survival with favorable neurological function at day 28...
February 27, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/26759664/the-physiologically-difficult-airway
#11
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/23911630/incidence-and-factors-associated-with-cardiac-arrest-complicating-emergency-airway-management
#12
Alan C Heffner, Douglas S Swords, Marcy N Neale, Alan E Jones
OBJECTIVE: Cardiac arrest (CA) is a rare but recognized complication of emergency airway management. Our aim was to measure the incidence of peri-intubation CA during emergency intubation and identify factors associated with this complication. METHODS: Retrospective cohort study of emergency endotracheal intubations performed in a large, urban emergency department over a one-year period. Patients were included if they were >18 years old and not in CA prior to intubation...
November 2013: Resuscitation
https://www.readbyqxmd.com/read/28499514/needle-decompression-of-tension-pneumothorax-with-colorimetric-capnography
#13
Nimesh D Naik, Matthew C Hernandez, Jeff R Anderson, Erika K Ross, Martin D Zielinski, Johnathon M Aho
BACKGROUND: The success of needle decompression for tension pneumothorax is variable, and there are no objective measures assessing effective decompression. Colorimetric capnography, which detects carbon dioxide present within the pleural space, may serve as a simple test to assess effective needle decompression. METHODS: Three swine underwent traumatically induced tension pneumothorax (standard of care, n = 15; standard of care with needle capnography, n = 15)...
November 2017: Chest
https://www.readbyqxmd.com/read/25764403/fibreoptic-vs-videolaryngoscopic-c-mac-%C3%A2-d-blade-nasal-awake-intubation-under-local-anaesthesia
#14
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
#15
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
#16
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
#17
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...
April 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/28045709/cricoid-pressure-controversies-narrative-review
#18
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
#19
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
#20
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
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