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EM Airway

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41 papers 0 to 25 followers
By Terren Trott terren.trott@gmail.com
https://www.readbyqxmd.com/read/22070599/use-of-capnography-to-confirm-correct-tracheal-intubation-during-cardiac-arrest
#1
LETTER
T M Cook, J P Nolan
No abstract text is available yet for this article.
December 2011: Anaesthesia
https://www.readbyqxmd.com/read/25568981/single-induction-dose-of-etomidate-versus-other-induction-agents-for-endotracheal-intubation-in-critically-ill-patients
#2
REVIEW
Eric A Bruder, Ian M Ball, Stacy Ridi, William Pickett, Corinne Hohl
BACKGROUND: The use of etomidate for emergency airway interventions in critically ill patients is very common. In one large registry trial, etomidate was the most commonly used agent for this indication. Etomidate is known to suppress adrenal gland function, but it remains unclear whether or not this adrenal gland dysfunction affects mortality. OBJECTIVES: The primary objective was to assess, in populations of critically ill patients, whether a single induction dose of etomidate for emergency airway intervention affects mortality...
January 8, 2015: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/15933300/crisis-management-during-anaesthesia-laryngospasm
#3
T Visvanathan, M T Kluger, R K Webb, R N Westhorpe
BACKGROUND: Laryngospasm is usually easily detected and managed, but may present atypically and/or be precipitated by factors which are not immediately recognised. If poorly managed, it has the potential to cause morbidity and mortality such as severe hypoxaemia, pulmonary aspiration, and post-obstructive pulmonary oedema. OBJECTIVES: To examine the role of a previously described core algorithm "COVER ABCD-A SWIFT CHECK", supplemented by a specific sub-algorithm for laryngospasm, in the management of laryngospasm occurring in association with anaesthesia...
June 2005: Quality & Safety in Health Care
https://www.readbyqxmd.com/read/20944510/laryngospasm-during-emergency-department-ketamine-sedation-a-case-control-study
#4
REVIEW
Steven M Green, Mark G Roback, Baruch Krauss
OBJECTIVE: The objective of this study was to assess predictors of emergency department (ED) ketamine-associated laryngospasm using case-control techniques. METHODS: We performed a matched case-control analysis of a sample of 8282 ED ketamine sedations (including 22 occurrences of laryngospasm) assembled from 32 prior published series. We sequentially studied the association of each of 7 clinical variables with laryngospasm by assigning 4 controls to each case while matching for the remaining 6 variables...
November 2010: Pediatric Emergency Care
https://www.readbyqxmd.com/read/19434787/pediatric-laryngospasm-prevention-and-treatment
#5
REVIEW
Achir Ahmad Al-alami, Maria Markakis Zestos, Anis Shehata Baraka
PURPOSE OF REVIEW: The purpose of this review is to discuss the risk factors associated with laryngospasm and the techniques used for prevention and treatment. We also summarize the prevention and treatment modalities in organized algorithms. RECENT FINDINGS: According to recent endoscopic studies, laryngospasm is always complete, thus airway management and intravenous therapy are indicated. Parental history of children having upper respiratory infection is associated with increased risk of laryngospasm...
June 2009: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/22250698/laryngospasm-and-hypoxia-after-intramuscular-administration-of-ketamine-to-a-patient-in-excited-delirium
#6
Aaron M Burnett, Benjamin J Watters, Kelly W Barringer, Kent R Griffith, Ralph J Frascone
An advanced life support emergency medical services (EMS) unit was dispatched with law enforcement to a report of a male patient with a possible overdose and psychiatric emergency. Police restrained the patient and cleared EMS into the scene. The patient was identified as having excited delirium, and ketamine was administered intramuscularly. Sedation was achieved and the patient was transported to the closest hospital. While in the emergency department, the patient developed laryngospasm and hypoxia. The airway obstruction was overcome with bag-valve-mask ventilation...
July 2012: Prehospital Emergency Care
https://www.readbyqxmd.com/read/26003005/laryngospasm-with-apparent-aspiration-during-sedation-with-nitrous-oxide
#7
Franz E Babl, Joanne Grindlay, Michael Joseph Barrett
Nitrous oxide and oxygen mixture has become increasingly popular for the procedural sedation and analgesia of children in the emergency department. In general, nitrous oxide is regarded as a very safe agent according to large case series. We report a case of single-agent nitrous oxide sedation of a child, complicated by laryngospasm and radiographically confirmed bilateral upper lobe pulmonary opacities. Although rarely reported with parenteral sedative agents, laryngospasm and apparent aspiration has not been previously reported in isolated nitrous oxide sedation...
November 2015: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/16531603/intubating-conditions-and-hemodynamic-effects-of-etomidate-for-rapid-sequence-intubation-in-the-emergency-department-an-observational-cohort-study
#8
Peter J Zed, Riyad B Abu-Laban, David W Harrison
OBJECTIVES: To describe and analyze the intubating conditions and hemodynamic effects of etomidate in patients undergoing rapid sequence intubation (RSI) in the emergency department. METHODS: The authors conducted a prospective observational study of all patients who received etomidate for induction of RSI over a 42-month period in a large tertiary care teaching hospital. Intubating conditions were determined by the emergency physician for both sedation and paralysis and for technical difficulty using a five-point Likert scale...
April 2006: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/19413824/anaesthesia-in-haemodynamically-compromised-emergency-patients-does-ketamine-represent-the-best-choice-of-induction-agent
#9
REVIEW
C Morris, A Perris, J Klein, P Mahoney
In rapid sequence induction of anaesthesia in the emergency setting in shocked or hypotensive patients (e.g. ruptured abdominal aortic aneurysm, polytrauma or septic shock), prior resuscitation is often suboptimal and comorbidities (particularly cardiovascular) may be extensive. The induction agents with the most favourable pharmacological properties conferring haemodynamic stability appear to be ketamine and etomidate. However, etomidate has been withdrawn from use in some countries and impairs steroidogenesis...
May 2009: Anaesthesia
https://www.readbyqxmd.com/read/22033053/the-frequency-and-significance-of-postintubation-hypotension-during-emergency-airway-management
#10
Alan C Heffner, Douglas Swords, Jeffrey A Kline, Alan E Jones
OBJECTIVE: Arterial hypotension is a recognized complication of emergency intubation, but the consequence of this event is poorly described. Our aim was to identify the incidence of postintubation hypotension (PIH) after emergency intubation and to determine its association with inhospital mortality. METHODS: Retrospective cohort study of tracheal intubations performed in a large, urban emergency department over a 1-year period. Patients were included if they were older than 17 years and had no systolic blood pressure measurements less than 90 mm Hg for 30 consecutive minutes before intubation...
August 2012: Journal of Critical Care
https://www.readbyqxmd.com/read/23273139/etomidate-for-intubation-of-patients-who-have-sepsis-or-septic-shock-where-do-we-go-from-here
#11
COMMENT
Donald E G Griesdale
Etomidate is an intravenous induction agent that is associated with hemodynamic stability during intubation. The agent is therefore attractive for use in critically ill patients who have a high risk of hemodynamic instability during this procedure. However, etomidate causes adrenal suppression, which itself has been associated with increased mortality in critically ill patients. The ongoing debate surrounding use of etomidate is thus centered on the immediate favorable hemodynamic profile versus the long-term risks of adrenal insufficiency, particularly in patients who have severe sepsis or septic shock...
December 27, 2012: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/26799349/succinylcholine-is-associated-with-increased-mortality-when-used-for-rapid-sequence-intubation-of-severely-brain-injured-patients-in-the-emergency-department
#12
Asad E Patanwala, Brian L Erstad, Denise J Roe, John C Sakles
OBJECTIVE: To compare succinylcholine and rocuronium regarding mortality in patients with traumatic brain injury (TBI) who are intubated in the emergency department (ED). METHODS: This was a retrospective cohort study conducted in an academic ED in the United States. Adult patients with TBI who underwent rapid sequence intubation (RSI) in the ED with rocuronium or succinylcholine between October 2010 and October 2014 were included. The main outcome of interest was in-hospital mortality...
January 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/20237045/rapid-sequence-induction-and-intubation-current-controversy
#13
REVIEW
Mohammad El-Orbany, Lois A Connolly
The changing opinion regarding some of the traditional components of rapid sequence induction and intubation (RSII) creates wide practice variations that impede attempts to establish a standard RSII protocol. There is controversy regarding the choice of induction drug, the dose, and the method of administration. Whereas some prefer the traditional rapid injection of a predetermined dose, others use the titration to loss of consciousness technique. The timing of neuromuscular blocking drug (NMBD) administration is different in both techniques...
May 1, 2010: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/19573904/etomidate-versus-ketamine-for-rapid-sequence-intubation-in-acutely-ill-patients-a-multicentre-randomised-controlled-trial
#14
RANDOMIZED CONTROLLED TRIAL
Patricia Jabre, Xavier Combes, Frederic Lapostolle, Mohamed Dhaouadi, Agnes Ricard-Hibon, Benoit Vivien, Lionel Bertrand, Alexandra Beltramini, Pascale Gamand, Stephane Albizzati, Deborah Perdrizet, Gaelle Lebail, Charlotte Chollet-Xemard, Virginie Maxime, Christian Brun-Buisson, Jean-Yves Lefrant, Pierre-Edouard Bollaert, Bruno Megarbane, Jean-Damien Ricard, Nadia Anguel, Eric Vicaut, Frederic Adnet
BACKGROUND: Critically ill patients often require emergency intubation. The use of etomidate as the sedative agent in this context has been challenged because it might cause a reversible adrenal insufficiency, potentially associated with increased in-hospital morbidity. We compared early and 28-day morbidity after a single dose of etomidate or ketamine used for emergency endotracheal intubation of critically ill patients. METHODS: In this randomised, controlled, single-blind trial, 655 patients who needed sedation for emergency intubation were prospectively enrolled from 12 emergency medical services or emergency departments and 65 intensive care units in France...
July 25, 2009: Lancet
https://www.readbyqxmd.com/read/27979641/awake-laryngoscopy-in-the-emergency-department
#15
Joseph E Tonna, Peter M C DeBlieux
BACKGROUND: Many emergency physicians gain familiarity with the laryngeal anatomy only during the brief view achieved during rapid sequence induction and intubation. Awake laryngoscopy in the emergency department (ED) is an important and clinically underutilized procedure. DISCUSSION: Providing benefit to the emergency physician through a slow, controlled, and deliberate examination of the airway, awake laryngoscopy facilitates confidence in the high-risk airway and eases the evolution to intubation, should it be required...
December 12, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27993308/comparison-of-etomidate-and-ketamine-for-induction-during-rapid-sequence-intubation-of%C3%A2-adult-trauma-patients
#16
Cameron P Upchurch, Carlos G Grijalva, Stephan Russ, Sean P Collins, Matthew W Semler, Todd W Rice, Dandan Liu, Jesse M Ehrenfeld, Kevin High, Tyler W Barrett, Candace D McNaughton, Wesley H Self
STUDY OBJECTIVE: Induction doses of etomidate during rapid sequence intubation cause transient adrenal dysfunction, but its clinical significance on trauma patients is uncertain. Ketamine has emerged as an alternative for rapid sequence intubation induction. Among adult trauma patients intubated in the emergency department, we compare clinical outcomes among those induced with etomidate and ketamine. METHODS: The study entailed a retrospective evaluation of a 4-year (January 2011 to December 2014) period spanning an institutional protocol switch from etomidate to ketamine as the standard induction agent for adult trauma patients undergoing rapid sequence intubation in the emergency department of an academic Level I trauma center...
January 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/16052126/predicting-difficult-intubation-in-apparently-normal-patients-a-meta-analysis-of-bedside-screening-test-performance
#17
Toshiya Shiga, Zen'ichiro Wajima, Tetsuo Inoue, Atsuhiro Sakamoto
The objective of this study was to systematically determine the diagnostic accuracy of bedside tests for predicting difficult intubation in patients with no airway pathology. Thirty-five studies (50,760 patients) were selected from electronic databases. The overall incidence of difficult intubation was 5.8% (95% confidence interval, 4.5-7.5%). Screening tests included the Mallampati oropharyngeal classification, thyromental distance, sternomental distance, mouth opening, and Wilson risk score. Each test yielded poor to moderate sensitivity (20-62%) and moderate to fair specificity (82-97%)...
August 2005: Anesthesiology
https://www.readbyqxmd.com/read/24071617/incidence-predictors-and-outcome-of-difficult-mask-ventilation-combined-with-difficult-laryngoscopy-a-report-from-the-multicenter-perioperative-outcomes-group
#18
Sachin Kheterpal, David Healy, Michael F Aziz, Amy M Shanks, Robert E Freundlich, Fiona Linton, Lizabeth D Martin, Jonathan Linton, Jerry L Epps, Ana Fernandez-Bustamante, Leslie C Jameson, Tyler Tremper, Kevin K Tremper
BACKGROUND: Research regarding difficult mask ventilation (DMV) combined with difficult laryngoscopy (DL) is extremely limited even though each technique serves as a rescue for one another. METHODS: Four tertiary care centers participating in the Multicenter Perioperative Outcomes Group used a consistent structured patient history and airway examination and airway outcome definition. DMV was defined as grade 3 or 4 mask ventilation, and DL was defined as grade 3 or 4 laryngoscopic view or four or more intubation attempts...
December 2013: Anesthesiology
https://www.readbyqxmd.com/read/9754506/assessment-of-airway-visualization-validation-of-the-percentage-of-glottic-opening-pogo-scale
#19
R M Levitan, E A Ochroch, S Kush, F S Shofer, J E Hollander
OBJECTIVE: Research defining optimal methods of intubation has been limited by the lack of a validated outcome measure to assess airway visualization. The objective of this study was to develop a reliable scale for the assessment of airway visualization during endotracheal intubation. METHODS: This prospective study was performed to assess the intra- and interphysician reliabilities of emergency physicians (EPs) for estimating the percentage of glottic opening (POGO) that is visualized during direct laryngoscopy...
September 1998: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/11939440/the-modified-cormack-lehane-score-for-the-grading-of-direct-laryngoscopy-evaluation-in-the-asian-population
#20
L K D Koh, C E Kong, P C Ip-Yam
The use of a modified Cormack-Lehane scoring system (MCLS) of laryngoscopic views, as previously introduced in the Western population, was investigated during direct laryngoscopy in the Asian population. We studied the distribution of the different grades of MCLS, the predictive factors and rate of difficult laryngoscopy, and the association with difficult intubation. Six hundred and five patients requiring tracheal intubation during general anaesthesia were prospectively studied. The optimal views during direct laryngoscopy were scored using the 5-grade MCLS system...
February 2002: Anaesthesia and Intensive Care
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