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EM Airway

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86 papers 25 to 100 followers
By Terren Trott
Anna Lee, Lawrence T Y Fan, Tony Gin, Manoj K Karmakar, Warwick D Ngan Kee
The original and modified Mallampati tests are commonly used to predict the difficult airway, but there is controversy regarding their accuracy. We searched MEDLINE and other databases for prospective studies of patients undergoing general anesthesia in which the results of a preoperative Mallampati test were compared with the subsequent rate of difficult airway (difficult laryngoscopy, difficult intubation, or difficult ventilation as reference tests). Forty-two studies enrolling 34,513 patients were included...
June 2006: Anesthesia and Analgesia
M Lewis, S Keramati, J L Benumof, C C Berry
BACKGROUND: Previous studies have suggested that the degree of visibility of oropharyngeal structures (OP class) and mandibular space (MS) length can predict difficult laryngoscopy. However, those studies were either inconsistent or omit description of how to perform these tests with regard to body, head and tongue position, and the use of phonation, hyoid versus thyroid cartilage and inside versus outside of the mentum. The purpose of this investigation was to determine which method of testing best predicts difficult laryngoscopy...
July 1994: Anesthesiology
S R Mallampati, S P Gatt, L D Gugino, S P Desai, B Waraksa, D Freiberger, P L Liu
It has been suggested that the size of the base of the tongue is an important factor determining the degree of difficulty of direct laryngoscopy. A relatively simple grading system which involves preoperative ability to visualize the faucial pillars, soft palate and base of uvula was designed as a means of predicting the degree of difficulty in laryngeal exposure. The system was evaluated in 210 patients. The degree of difficulty in visualizing these three structures was an accurate predictor of difficulty with direct laryngoscopy (p less than 0...
July 1985: Canadian Anaesthetists' Society Journal
Zulfiqar Mohammad, Bekele Afessa, Javier D Finkielman
INTRODUCTION: Etomidate blocks adrenocortical synthesis when it is administered intravenously as a continuous infusion or a single bolus. The influence of etomidate administration on the incidence of relative adrenal insufficiency in patients with septic shock has not been formally investigated. The objective of this study was to determine the incidence of relative adrenal insufficiency in patients with septic shock after etomidate administration compared with patients with septic shock who did not receive etomidate...
2006: Critical Care: the Official Journal of the Critical Care Forum
Matthew J Binks, Rhys S Holyoak, Thomas M Melhuish, Ruan Vlok, Ellyse Bond, Leigh D White
BACKGROUND: Hypoxemia increases the risk of intubation markedly. Such concerns are multiplied in the emergency department (ED) and during retrieval where patients may be unstable, preparation or preoxygenation time limited and the environment uncontrolled. Apneic oxygenation is a promising means of preventing hypoxemia in this setting. AIM: To test the hypothesis that apnoeic oxygenation reduces the incidence of hypoxemia during endotracheal intubation in the ED and during retrieval...
June 24, 2017: American Journal of Emergency Medicine
Stephen Tai, Miguel Mascaro, Nira A Goldstein
OBJECTIVES: We evaluated the clinical characteristics of patients treated for angioedema, and determined the factors associated with the clinical course. METHODS: We performed a chart review of 367 episodes presenting from 1997 through 2008. RESULTS: The mean (+/-SD) age was 51.8 +/- 20.1 years; 65.7% of the episodes occurred in female patients; 62.4% of the episodes were in African American patients. The patients were on angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) for 49...
December 2010: Annals of Otology, Rhinology, and Laryngology
Daniel LoVerde, Daniel Clark Files, Guha Krishnaswamy
OBJECTIVES: Angioedema is a potentially life-threatening occurrence that is encountered by critical care providers. The mechanistic understanding of angioedema syndromes has improved in recent years, and novel medications are available that improve outcomes from these syndromes. This clinically focused review will describe the underlying genetics, pathophysiology, classification and treatment of angioedema syndromes, with an emphasis on the novel pharmacologic agents that have recently become available for acute treatment...
April 2017: Critical Care Medicine
T Murphy, B Howes
No abstract text is available yet for this article.
June 2017: Anaesthesia
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...
June 8, 2017: American Journal of Emergency Medicine
Kaushal H Shah, Brian Kwong, Alberto Hazan, Rebecca Batista, David H Newman, Dan Wiener
BACKGROUND: The difficulties with gum elastic bougie (GEB) use in the emergency department (ED) have never been studied prospectively. OBJECTIVES: To determine the most common difficulties associated with endotracheal intubation using a GEB in the ED. METHODS: We conducted a prospective, observational study of GEB practices in our two affiliated urban EDs with a 3-year residency training program and an annual census of 150,000 patients. Laryngoscopists performing a GEB-assisted intubation completed a structured data form after laryngoscopy, recording patient characteristics, grade of laryngeal view (using the modified Cormack-Lehane classification), reason for GEB use, and problems encountered...
October 2011: Journal of Emergency Medicine
J Li
This analysis primarily sought to determine the effectiveness of end-tidal capnography for tube placement confirmation during emergency airway management. Secondary objectives were validation of the rate of unanticipated esophageal placement during emergency intubation and quantification of the portion of intubations performed in patients with cardiac arrest where capnography is not recommended. The study was performed in two phases. For the primary objective, a meta-analysis was performed on all experimental capnography trials enrolling emergency populations...
April 2001: Journal of Emergency Medicine
Edward Scarth, Tim Cook
No abstract text is available yet for this article.
July 2012: Resuscitation
J P Ornato, J B Shipley, E M Racht, C M Slovis, K D Wrenn, P E Pepe, S L Almeida, V F Ginger, T V Fotre
STUDY OBJECTIVES: To evaluate continuous, semiquantitative end-tidal carbon dioxide (ETCO2) monitoring in the prehospital and emergency department setting for confirming proper endotracheal tube placement and assessing prognosis and blood flow during CPR. TYPE OF PARTICIPANTS: Adult patients were included if an endotracheal tube was inserted by prehospital care providers or emergency physicians for cardiac arrest, respiratory arrest, respiratory insufficiency, or airway protection...
May 1992: Annals of Emergency Medicine
S R Hayden, J Sciammarella, P Viccellio, H Thode, R Delagi
OBJECTIVE: To evaluate the ability of a disposable, colorimetric end-tidal CO2 detector to verify proper endotracheal (ET) tube placement in out-of-hospital cardiac arrest, and to correlate semiquantitative CO2 measurements with the rate of return of spontaneous circulation (ROSC). METHODS: Prospective, observational study using a convenience sample of intubated out-of-hospital cardiac arrest patients. A disposable, colorimetric end-tidal CO2 detector was attached to the ET tube after intubation...
June 1995: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
A J Sayah, W F Peacock, D T Overton
Measurement of end-tidal carbon dioxide (ETCO2) has been used to detect accidental esophageal tube placement in noncardiac arrest situations. The purpose of our study was to determine whether ETCO2 measurement could distinguish tracheal from esophageal tube placement during closed-chest massage (CCM). Twelve large dogs were anesthetized, and endotracheal tubes were placed in both the trachea and the esophagus. Placement was verified by fiberoptic endoscopy. Ventricular fibrillation was induced by a 60-Hz discharge through a right ventricular pacemaker...
August 1990: Annals of Emergency Medicine
Anand K Swaminathan, Haney Mallemat
The publisher regrets that this article has been temporarily removed. It was mistakenly published prior to its accompanying article. A replacement will appear as soon as possible. The full Elsevier Policy on Article Withdrawal can be found at
June 22, 2017: Annals of Emergency Medicine
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
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
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
2017-06-05 18:21:27
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