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jrgAirway

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51 papers 25 to 100 followers
By Jesse Guscott McMaster Family Practice Anesthesia program director. Medical educator, ER, Anesthesia Twitter:@GuscottJesse
https://www.readbyqxmd.com/read/23823612/effect-of-video-laryngoscopy-on-trauma-patient-survival-a-randomized-controlled-trial
#1
RANDOMIZED CONTROLLED TRIAL
Dale J Yeatts, Richard P Dutton, Peter F Hu, Yu-Wei W Chang, Clayton H Brown, Hegang Chen, Thomas E Grissom, Joseph A Kufera, Thomas M Scalea
BACKGROUND: Many resuscitation scenarios include the use of emergency intubation to support injured patients. New video-guided airway management technology is available, which may minimize the risk to patients from this procedure. METHODS: This was a controlled clinical trial conducted in the trauma receiving unit in a university-affiliated urban hospital in which 623 consecutive adult patients requiring emergency airway management were prospectively randomized to intubation with either the direct laryngoscope (DL) or the GlideScope video laryngoscope (GVL) device...
August 2013: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/20542887/prospective-audit-on-the-use-of-the-lma-supreme-for-airway-management-of-adult-patients-undergoing-elective-orthopaedic-surgery-in-prone-position
#2
V Sharma, C Verghese, P J McKenna
BACKGROUND: The LMA-Supreme (SLMA) is a single-use, latex-free, supraglottic airway device with a drain tube which allows immediate assessment of correct positioning of the device at insertion and throughout the procedure and provides access to gastric contents. The anatomically shaped airway tube facilitates easy insertion in anaesthetized patients in the supine, lateral, and prone positions. We present a prospective audit in 205 consecutive adult patients presenting for elective spine surgery in the prone position...
August 2010: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/25227646/chest-compressions-do-not-disrupt-the-seal-created-by-the-laryngeal-mask-airway-during-positive-pressure-ventilation-a-preliminary-porcine-study
#3
Jestin N Carlson, Brian P Suffoletto, David D Salcido, Eric S Logue, James J Menegazzi
OBJECTIVE: Pulmonary aspiration of gastric contents occurs 20 to 30% of the time during cardiopulmonary resuscitation (CPR) of cardiac arrest due to loss of protective airway reflexes, pressure changes generated during CPR, and positive pressure ventilation (PPV). Although the American Heart Association has recommended the laryngeal mask airway (LMA) as an acceptable alternative airway for use by emergency medical service personnel, concerns over the capacity of the device to protect from pulmonary aspiration remain...
September 2014: CJEM
https://www.readbyqxmd.com/read/28539007/videolaryngoscopy-versus-direct-laryngoscopy-for-tracheal-intubation-in-children-excluding-neonates
#4
REVIEW
Ibtihal S Abdelgadir, Robert S Phillips, Davinder Singh, Michael P Moncreiff, Joanne L Lumsden
BACKGROUND: Direct laryngoscopy is the method currently used for tracheal intubation in children. It occasionally offers unexpectedly poor laryngeal views. Indirect laryngoscopy involves visualizing the vocal cords by means other than obtaining a direct sight, with the potential to improve outcomes. We reviewed the current available literature and performed a meta-analysis to compare direct versus indirect laryngoscopy, or videolaryngoscopy, with regards to efficacy and adverse effects...
May 24, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28538645/increased-mortality-in-trauma-patients-who-develop-post-intubation-hypotension
#5
Robert S Green, Michael B Butler, Mete Erdogan
BACKGROUND: Post-intubation hypotension (PIH) is common and associated with poor outcomes in critically ill patient populations requiring emergency endotracheal intubation (ETI). The importance of PIH in the trauma population remains unclear. The objective of this study was to determine the prevalence of PIH in trauma patients and assess the association of PIH with patient outcomes. METHODS: Retrospective case series of adult (≥16 years) patients who were intubated on arrival at a tertiary trauma center in Halifax, Nova Scotia, Canada between 2000 and 2015...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28513831/avoidance-versus-use-of-neuromuscular-blocking-agents-for-improving-conditions-during-tracheal-intubation-or-direct-laryngoscopy-in-adults-and-adolescents
#6
REVIEW
Lars H Lundstrøm, Christophe Hv Duez, Anders K Nørskov, Charlotte V Rosenstock, Jakob L Thomsen, Ann Merete Møller, Søren Strande, Jørn Wetterslev
BACKGROUND: Tracheal intubation during induction of general anaesthesia is a vital procedure performed to secure a patient's airway. Several studies have identified difficult tracheal intubation (DTI) or failed tracheal intubation as one of the major contributors to anaesthesia-related mortality and morbidity. Use of neuromuscular blocking agents (NMBA) to facilitate tracheal intubation is a widely accepted practice. However, because of adverse effects, NMBA may be undesirable. Cohort studies have indicated that avoiding NMBA is an independent risk factor for difficult and failed tracheal intubation...
May 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28505486/respiratory-support-techniques-to-avoid-desaturation-in-critically-ill-patients-requiring-endotracheal-intubation-a-systematic-review-and-meta-analysis
#7
REVIEW
Vincenzo Russotto, Andrea Cortegiani, Santi Maurizio Raineri, Cesare Gregoretti, Antonino Giarratano
PURPOSE: To evaluate which respiratory support method for critically ill patients undergoing endotracheal intubation (ETI) is associated with less desaturation. METHODS: We searched PubMed, Cochrane Library, Scopus and CINAHL databases. We included randomized (RCT) and non-randomized (non-RCT) studies investigating any method of respiratory support before/during ETI compared to a reference control. RESULTS: Apneic oxygenation (ApOx) was the most commonly investigated respiratory support technique for critically ill patients undergoing intubation (4 RCTs, 358 patients)...
May 8, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28109012/the-impact-of-a-soiled-airway-on-intubation-success-in-the-emergency-department-when-using-the-glidescope-or-the-direct-laryngoscope
#8
John C Sakles, G Judson Corn, Patrick Hollinger, Brittany Arcaris, Asad E Patanwala, Jarrod M Mosier
BACKGROUND: The objective was to determine the impact of a soiled airway on firstpass success when using the GlideScope video laryngoscope or the direct laryngoscope for intubation in the emergency department (ED). METHODS: Data were prospectively collected on all patients intubated in an academic ED from July 1, 2007, to June 30, 2016. Patients ≥ 18 years of age, who underwent rapid sequence intubation by an emergency medicine resident with the GlideScope or the direct laryngoscope, were included in the analysis...
May 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28487139/a-multicenter-randomized-trial-of-ramped%C3%A2-position-vs%C3%A2-sniffing-position-during%C3%A2-endotracheal-intubation-of-critically%C3%A2-ill-adults
#9
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 the ramped position (head of the bed elevated to 25°) with the sniffing position (torso supine, neck flexed, and head extended) among 260 adults undergoing endotracheal intubation by pulmonary and critical care medicine fellows in four ICUs between July 22, 2015, and July 19, 2016...
May 6, 2017: Chest
https://www.readbyqxmd.com/read/28420641/should-we-intubate-patients-during-cardiopulmonary-resuscitation
#10
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/28336412/a-pilot-prospective-randomized-trial-of-video-versus-direct-laryngoscopy-for-paramedic-endotracheal-intubation
#11
Scott Ducharme, Brandon Kramer, David Gelbart, Caroline Colleran, Brian Risavi, Jestin N Carlson
BACKGROUND: Prehospital intubation poses several unique challenges. Video assisted laryngoscopy has been shown to help increase intubation success in the hospital setting; however, little prospective data have examined video assisted laryngoscopy in traditional ground ambulance agencies. METHODS: We performed a randomized, cross-over, non-blinded trial in ground ambulances comparing first attempt success and overall intubation success between video assisted laryngoscopy using the King Video Laryngoscope (KVL) and direct laryngoscopy (DL)...
May 2017: Resuscitation
https://www.readbyqxmd.com/read/28168630/airway-management-outside-the-operating-room-how-to-better-prepare
#12
Peter G Brindley, Martin Beed, J Adam Law, Orlando Hung, Richard Levitan, Michael F Murphy, Laura V Duggan
Airway management outside the operating room is associated with increased risks compared with airway management inside the operating room. Moreover, airway management-whether in the intensive care unit, emergency department, interventional radiology suite, or general wards-often requires mastery of not only the anatomically difficult airway but also the physiologically and situationally difficult airway. The 2015 Difficult Airway Society Guidelines encourage the airway team to "stop and think". This article provides a practical review of how that evidence applies during emergency airway management outside of the operating room...
May 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/19860753/risk-of-pulmonary-aspiration-with-laryngeal-mask-airway-and-tracheal-tube-analysis-on-65-712-procedures-with-positive-pressure-ventilation
#13
COMPARATIVE STUDY
A Bernardini, G Natalini
We compared the risk of pulmonary aspiration in patients whose lungs were mechanically ventilated through a laryngeal mask airway (35 630 procedures) or tracheal tube (30 082 procedures). Three cases of pulmonary aspiration occurred with the laryngeal mask airway and seven with the tracheal tube. There were no deaths related to pulmonary aspiration. The incidence and outcome of pulmonary aspiration detected in this study were similar to those previously reported. The adjusted odds ratio (OR) for pulmonary aspiration with the laryngeal mask airway was 1...
December 2009: Anaesthesia
https://www.readbyqxmd.com/read/28050802/the-effectiveness-of-apneic-oxygenation-during-tracheal-intubation-in-various-clinical-settings-a-narrative-review
#14
REVIEW
David T Wong, Amanda J Yee, Siaw May Leong, Frances Chung
PURPOSE: During the process of tracheal intubation, patients are apneic or hypoventilating and are at risk of becoming hypoxemic. This risk is especially high in patients with acute or chronic respiratory failure and accompanying compromised respiratory reserve. To address this concern, apneic oxygenation can be administered during tracheal intubation to aid in maintaining arterial oxygen saturation. The objective of this narrative review is to examine the utilization of apneic oxygenation within the operating room, intensive care unit (ICU), emergency department, and pre-hospital settings and to determine its efficacy compared with controls...
April 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27810460/bystander-cricothyroidotomy-with-household-devices-a-fresh-cadaveric-feasibility-study
#15
Christian Braun, Ulrich Kisser, Astrid Huber, Klaus Stelter
INTRODUCTION: In various motion pictures, medical TV shows and internet chatrooms, non-medical devices were presented as tools for life-saving cricothyroidotomies. However, there is uncertainty about whether it is possible for a bystander to perform a cricothyroidotomy and maintain gas exchange using improvised household items. This study examines the ability of bystanders to carry out an emergency cricothyroidotomy in fresh human cadavers using only a pocket knife and a ballpoint pen...
January 2017: Resuscitation
https://www.readbyqxmd.com/read/27993309/improving-the-safety-of-rapid-sequence-intubation-in-the-emergency-department
#16
EDITORIAL
John C Sakles
No abstract text is available yet for this article.
January 2017: Annals 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
#17
COMPARATIVE STUDY
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/27785883/systematic-review-and-meta-analysis-of-first-pass-success-rates-in-emergency-department-intubation-creating-a-benchmark-for-emergency-airway-care
#18
Louise Park, Irene Zeng, Andrew Brainard
OBJECTIVE: Many EDs have begun to evaluate their airway performance. The first-pass success (FPS) rate is a commonly used marker of proficiency, and has been associated with rates of adverse events. The aim of this systematic review and meta-analysis is to quantify the ED FPS rates and summarise the rates of adverse events associated with endotracheal intubation. METHODS: A structured literature search was performed through MEDLINE and EMBASE. Research published since 2000 was included if it prospectively collected data on all patients intubated in the ED and reported the FPS rates...
February 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/27449997/a-proposal-for-a-new-scoring-system-to-predict-difficult-ventilation-through-a-supraglottic-airway
#19
T Saito, S T H Chew, W L Liu, K K Thinn, T Asai, L K Ti
BACKGROUND: The aim of this study was to propose and validate a new clinical score to predict difficult ventilation through a supraglottic airway device. METHODS: The score was proposed from our previously reported derivation data, and we prospectively validated the score in 5532 patients from November 2013 to April 2014. Predictive accuracy of the score was compared by the area under the receiver operating characteristic (ROC) curve (AUC). We assigned point values to each of the identified four risk factors: male, age >45 yr, short thyromental distance, and limited neck movement, their sum composing the score...
September 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27432055/ultrasonographic-identification-of-the-cricothyroid-membrane-best-evidence-techniques-and-clinical-impact
#20
M S Kristensen, W H Teoh, S S Rudolph
Inability to identify the cricothyroid membrane by inspection and palpation contributes substantially to the high failure rate of cricothyrotomy. This narrative review summarizes the current evidence for application of airway ultrasonography for identification of the cricothyroid membrane compared with the clinical techniques. We identified the best-documented techniques for bedside use, their success rates, and the necessary training for airway-ultrasound-naïve clinicians. After a short but structured training, the cricothyroid membrane can be identified using ultrasound in difficult patients by previously airway-ultrasound naïve anaesthetists with double the success rate of palpation...
September 2016: British Journal of Anaesthesia
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