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EM Airway

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66 papers 25 to 100 followers
By Terren Trott terren.trott@gmail.com
https://www.readbyqxmd.com/read/15527629/laryngoscopy-and-morbid-obesity-a-comparison-of-the-sniff-and-ramped-positions
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
https://www.readbyqxmd.com/read/20593158/-endotracheal-tubes-in-pediatric-patients-published-formulas-to-estimate-the-optimal-size
#17
REVIEW
M von Rettberg, E Thil, H Genzwürker, C Gernoth, J Hinkelbein
BACKGROUND: Estimating the endotracheal tube size with the optimal internal diameter (ID) is of outstanding importance for airway management in pediatric patients. For many years different weight, height, and/or age-based formulas have been published. The aim of the present study was to identify and to compare published formulas to estimate optimal tube size in pediatric patients. MATERIALS AND METHODS: A PubMed search was performed to identify published formulas for tube diameter in pediatric patients...
April 2011: Der Anaesthesist
https://www.readbyqxmd.com/read/26696266/-estimation-of-the-optimal-tube-length-systematic-review-article-on-published-formulae-for-infants-and-children
#18
REVIEW
M Boensch, V Schick, O Spelten, J Hinkelbein
BACKGROUND: The correct placement of an endotracheal tube in children is essential as incorrect placement following unilateral ventilation and tube displacement may lead to far-reaching consequences, such as volutrauma and hypoxia, respectively. Different formulae referring to the correct placement of nasotracheal and orotracheal tubes have been published with reference to body weight and age. OBJECTIVE: The aim of the present review article was to identify and compare the published formulae for estimating correct endotracheal tube placement in children with their advantages and disadvantages...
February 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/26296534/cuffed-versus-uncuffed-endotracheal-tubes-in-children-a-meta-analysis
#19
REVIEW
Fenmei Shi, Ying Xiao, Wei Xiong, Qin Zhou, Xiongqing Huang
PURPOSE: Cuffed endotracheal tubes (ETTs) have increasingly been used in small children. However, the use of cuffed ETTs in small children is still controversial. The goal of this meta-analysis is to assess the current evidence regarding the postextubation morbidity and tracheal tube (TT) exchange rate of cuffed ETTs compared to uncuffed ETTs in children. METHODS: A systematic literature search in PubMed, Web of Science, Embase, and Cochrane Central Register of Controlled Trials up to November 2014 was conducted to identify randomized controlled trials (RCTs) and prospective cohort studies that compared the use of cuffed and uncuffed ETTs in children...
February 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/18184241/evaluation-of-cuffed-tracheal-tube-size-predicted-using-the-khine-formula-in-children
#20
COMPARATIVE STUDY
Caroline Duracher, Emmanuelle Schmautz, Claire Martinon, Judith Faivre, Pierre Carli, Gilles Orliaguet
BACKGROUND: The correct size of cuffed endotracheal tube (CET) limits the risk of postintubation tracheal damage. The aim of this study was to compare the size of the CET used in children with the size predicted by the Khine formula [age (years)/4 + 3]. METHODS: After ethical committee approval, 204 children aged 1 day-15 years were included prospectively in the study. The choice of the size of the CET was made at the discretion of the attending anesthesiologist...
February 2008: Paediatric Anaesthesia
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