keyword
https://read.qxmd.com/read/38036442/pharmacologic-adjuncts-for-neonatal-tracheal-intubation-the-evidence-behind-premedication
#21
REVIEW
Sara K Neches, Cassandra DeMartino, Rebecca Shay
Premedication such as analgesia, sedation, vagolytics, and paralytics may improve neonatal tracheal intubation success, reduce intubation-associated adverse events, and create optimal conditions for performing this high-risk and challenging procedure. Although rapid sequence induction including a paralytic agent has been adopted for intubations in pediatric and adult critical care, neonatal clinical practice varies. This review aims to summarize details of common classes of neonatal intubation premedication including indications for use, medication route, dosage, potential adverse effects in term and preterm infants, and reversal agents...
December 1, 2023: NeoReviews
https://read.qxmd.com/read/38025566/effectiveness-of-face-mask-only-oxygenation-and-apnoeic-oxygenation-in-addition-to-face-mask-in-sustaining-pao-2-during-rapid-sequence-induction-a-randomized-control-trial
#22
JOURNAL ARTICLE
R Preya, M Ravishankar, R Sripriya
BACKGROUND AND AIMS: Apnoeic oxygenation, although useful during elective intubations, has not shown consistent beneficial results during emergency intubations in critically ill patients. We aimed to study the effectiveness of adding apnoeic oxygenation to our routine practice of using facemask alone, in emergency laparotomy patients needing rapid sequence induction (RSI), for sustaining partial pressure of oxygen (PaO2 ). MATERIAL AND METHODS: Seventy-two patients undergoing RSI for emergency laparotomy were randomly allocated to either receive pre-oxygenation with 5 L/min of oxygen (O2 ) with a facemask (Group-FM) or apnoeic oxygenation with 10 L/min of O2 through a nasal catheter in addition to pre-oxygenation (Group-NC)...
2023: Journal of Anaesthesiology, Clinical Pharmacology
https://read.qxmd.com/read/38023576/efficacy-of-metoclopramide-for-prevention-of-gastric-regurgitation-during-endotracheal-intubation-in-the-emergency-department-a-randomized-controlled-trial
#23
JOURNAL ARTICLE
Ijas Muhammed Shaji, Upendra Hansda, Chitta Ranjan Mohanty, Nitish Topno, Jithin Jacob Varghese, Sangeeta Sahoo, Satyabrata Guru
BACKGROUND: Gastric content regurgitation and aspiration are the dreaded complications of securing the airway. Cricoid pressure hinders intubation and causes lower esophageal sphincter (LES) relaxation. A recent study suggests no added benefit of cricoid pressure in preventing pulmonary aspiration of gastric contents. Metoclopramide increases LES tone, prevents gastroesophageal reflux, and increases antral contractions. Hence, we wanted to study the efficacy of metoclopramide for preventing gastric regurgitation during endotracheal intubation (ETI) in patients presenting to the emergency department (ED)...
2023: International Journal of Critical Illness and Injury Science
https://read.qxmd.com/read/38022743/factors-associated-with-postintubation-hypotension-among-patients-with-suspected-sepsis-in-emergency-department
#24
JOURNAL ARTICLE
Panvilai Tangkulpanich, Chuenruthai Angkoontassaneeyarat, Thavinee Trainarongsakul, Chetsadakon Jenpanitpong
PURPOSE: Postintubation hypotension (PIH) is a recognized complication that increases both in-hospital mortality and hospital length of stay. Sepsis is reportedly a factor associated with PIH. However, no study to date has examined which factors, including the intubation method, may be clinical predictors of PIH in patients with sepsis. This study aims to investigate factors associated with the occurrence of PIH in patients with suspected sepsis in emergency department. PATIENTS AND METHODS: This retrospective cross-sectional study was performed over a 5-year period (January 2013-December 2017) and involved patients with suspected sepsis who underwent endotracheal intubation in the emergency department of Ramathibodi Hospital...
2023: Open Access Emergency Medicine: OAEM
https://read.qxmd.com/read/38019685/comparison-of-intubating-conditions-with-succinylcholine-versus-rocuronium-in-the-prehospital-setting
#25
JOURNAL ARTICLE
J T Ramsey, Killian M Pache, Michael R Sayre, Charles Maynard, Nicholas J Johnson, Catherine R Counts
OBJECTIVE: Rapid sequence intubation (RSI) is frequently performed by emergency medical services (EMS). We investigated the relationship between succinylcholine and rocuronium use and time until first laryngoscopy attempt, first-pass success, and Cormack-Lehane (CL) grades. METHODS: We included adult patients for whom prehospital RSI was attempted from July 2015 through June 2022 in a retrospective, observational study with pre-post analysis. Timing was verified using recorded defibrillator audio in addition to review of continuous ECG, pulse oximetry, and end-tidal carbon dioxide waveforms...
November 29, 2023: Prehospital Emergency Care
https://read.qxmd.com/read/38018391/does-the-choice-of-induction-agent-in-rapid-sequence-intubation-in-the-emergency-department-influence-the-incidence-of-post-induction-hypotension
#26
JOURNAL ARTICLE
Zacchary Tamsett, Ned Douglas, Cathy King, Tanya Johnston, Connor Bentley, Brian Hao, Duron Prinsloo, Elyssia M Bourke
OBJECTIVE: To describe the effects of different induction agents on the incidence of post-induction hypotension (PIH) and its associated interventions during rapid sequence intubation (RSI) in the ED. METHODS: A single centre retrospective study of patients intubated between 2018 and 2021 was conducted in a regional Australian ED. The impact of induction agent choice, in addition to demographic and clinical factors on the incidence of PIH were determined using descriptive statistics and a multivariate analysis presented as adjusted odds ratios (aORs) and their 95% confidence intervals (CIs)...
November 29, 2023: Emergency Medicine Australasia: EMA
https://read.qxmd.com/read/37996828/evaluation-the-quality-of-bag-mask-ventilation-by-e-c-t-e-and-hook-technique-a-new-proposed-technique
#27
RANDOMIZED CONTROLLED TRIAL
Moloud Balafar, Mahboub Pouraghaei, Seyed Pouya Paknezhad, Saba Nemati Ahmad Abad, Hassan Soleimanpour
BACKGROUND: Bag-Mask Ventilation (BMV) is a crucial skill in managing emergency airway situations and induction of general anesthesia. Ensuring proficient BMV execution is imperative for healthcare providers. Various techniques exist for performing BMV. This study aims to compare the quality of ventilation achieved using the E/C technique, Thenar Eminence (T/E) technique and a novel approach referred to as the hook technique. The goal is to identify the most effective single-person BMV method...
November 23, 2023: BMC Anesthesiology
https://read.qxmd.com/read/37954797/management-of-a-large-post-tonsillectomy-thrombus-obstructing-the-laryngeal-view-a-case-report
#28
Rana Tamraz, Roman Austin, Ricardo Falcon, Tania Kraai, Richard Lock, Timothy R Petersen, Codruta Soneru
Anesthetic management of children with a post-tonsillectomy hemorrhage can be challenging. The patients may be anemic and hypovolemic and are at increased risk of having a difficult airway due to active bleeding, vomiting, and anatomical issues. A clot may also interfere with viewing the larynx, further exacerbating the difficulty of intubation. We describe a pediatric post-tonsillectomy hemorrhage case complicated by a large obstructing clot that was removed with Magill forceps after the airway was successfully secured with an endotracheal tube during rapid sequence induction...
October 2023: Curēus
https://read.qxmd.com/read/37799234/a-randomized-double-blind-comparative-study-of-the-intubating-conditions-and-hemodynamic-effects-of-rocuronium-and-succinylcholine-in-pediatric-patients
#29
JOURNAL ARTICLE
Anil Kumar, Arvind Kumar, Alok K Bharti, Annu Choudhary, Mumtaz Hussain, Shashank Dhiraj
BACKGROUND: The incidence of unanticipated difficult airways is higher in pediatric age groups than in adults due to the different airway anatomy, difficulty in airway examination, and congenital malformations. Rocuronium bromide has a comparable onset time to succinylcholine at its proportionate dose. Hence, we compared rocuronium bromide with succinylcholine to assess intubating conditions and their side effects, if any. METHOD: A total of 200 pediatric patients of American Society of Anesthesiologists (ASA) grades I and II between one and 14 years of age of either sex posted for elective surgery were included in the study...
September 2023: Curēus
https://read.qxmd.com/read/37792524/sequence-of-administration-of-anesthetic-agents-during-rapid-sequence-induction-for-emergency-intubation-a-french-survey-on-current-practices
#30
JOURNAL ARTICLE
Pierre Catoire, Mélanie Roussel, Dorian Teissandier
No abstract text is available yet for this article.
October 5, 2023: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://read.qxmd.com/read/37789329/comparison-of-different-ratios-of-propofol-ketamine-admixture-in-rapid-sequence-induction-of-anesthesia-for-emergency-laparotomy-a-randomized-controlled-trial
#31
JOURNAL ARTICLE
Mona Elsherbiny, Ahmed Hasanin, Sahar Kasem, Mohamed Abouzeid, Maha Mostafa, Ahmed Fouad, Yaser Abdelwahab
BACKGROUND: We aimed to compare the hemodynamic effect of two ratios of propofol and ketamine (ketofol), namely 1:1 and 1:3 ratios, in rapid-sequence induction of anesthesia for emergency laparotomy. METHODS: This randomized controlled study included adult patients undergoing emergency laparotomy under general anesthesia. The patients were randomized to receive either ketofol ratio of 1:1 (n = 37) or ketofol ratio of 1:3 (n = 37). Hypotension (mean arterial pressure < 70 mmHg) was managed by 5-mcg norepinephrine...
October 3, 2023: BMC Anesthesiology
https://read.qxmd.com/read/37753416/video-documentation-as-a-measure-of-written-documentation-accuracy-in-emergency-medical-service-field-intubations
#32
JOURNAL ARTICLE
Christopher S Keller, Christopher Dilger, Shih-Chin Chou, Rasheed Lawal, Shane Jenks
INTRODUCTION: Quality improvement (QI) is a major focus of all departments and fields of health care, including emergency medical services. The chaotic and rapidly evolving atmosphere in which paramedics must practice can lead to inconsistency between what is documented and the actual events. This leads to difficulty when trying to evaluate the practitioners and when implementing a QI program. In this study, we evaluated the prevalence of discrepancy between the video and written record for Rapid Sequence Intubation (RSI) performed in the field as a demonstration of the utility of video documentation in QI...
2023: HCA Healthc J Med
https://read.qxmd.com/read/37741737/the-effect-of-ketamine-versus-etomidate-for-rapid-sequence-intubation-on-maximum-sequential-organ-failure-assessment-score-a-randomized-clinical-trial
#33
RANDOMIZED CONTROLLED TRIAL
Sarah K S Knack, Matthew E Prekker, Johanna C Moore, Lauren R Klein, Alexandra H Atkins, James R Miner, Brian E Driver
BACKGROUND: The use of induction agents for rapid sequence intubation (RSI) has been associated with hypotension in critically ill patients. Choice of induction agent may be important and the most commonly used agents are etomidate and ketamine. OBJECTIVE: This study aimed to compare the effects of a single dose of ketamine vs. etomidate for RSI on maximum Sequential Organ Failure Assessment (SOFA) score and incidence of hypotension. METHODS: This single-center, randomized, parallel-group trial compared the use of ketamine and etomidate for RSI in critically ill adult patients in the emergency department...
November 2023: Journal of Emergency Medicine
https://read.qxmd.com/read/37730575/gastric-insufflation-and-surgical-view-according-to-mask-ventilation-method-for-laparoscopic-cholecystectomy-a-randomized-controlled-study
#34
RANDOMIZED CONTROLLED TRIAL
Yun Kyung Jung, Cho Long Kim, Mi Ae Jeong, Jeong Min Sung, Kyeong Geun Lee, Na Yeon Kim, Leekyeong Kang, Hyunyoung Lim
BACKGROUND: Proper mask ventilation is important to prevent air inflow into the stomach during induction of general anesthesia, and it is difficult to send airflow only through the trachea without gastric inflation. Changes in gastric insufflation according to mask ventilation during anesthesia induction were compared. METHODS: In this prospective, randomized, single-blind study, 230 patients were analyzed to a facemask-ventilated group (Ventilation group) or no-ventilation group (Apnea group) during anesthesia induction...
September 20, 2023: BMC Anesthesiology
https://read.qxmd.com/read/37707379/society-of-critical-care-medicine-clinical-practice-guidelines-for-rapid-sequence-intubation-in-the-critically-ill-adult-patient
#35
JOURNAL ARTICLE
Nicole M Acquisto, Jarrod M Mosier, Edward A Bittner, Asad E Patanwala, Karen G Hirsch, Pamela Hargwood, John M Oropello, Ryan P Bodkin, Christine M Groth, Kevin A Kaucher, Angela A Slampak-Cindric, Edward M Manno, Stephen A Mayer, Lars-Kristofer N Peterson, Jeremy Fulmer, Christopher Galton, Thomas P Bleck, Karin Chase, Alan C Heffner, Kyle J Gunnerson, Bryan Boling, Michael J Murray
RATIONALE: Controversies and practice variations exist related to the pharmacologic and nonpharmacologic management of the airway during rapid sequence intubation (RSI). OBJECTIVES: To develop evidence-based recommendations on pharmacologic and nonpharmacologic topics related to RSI. DESIGN: A guideline panel of 20 Society of Critical Care Medicine members with experience with RSI and emergency airway management met virtually at least monthly from the panel's inception in 2018 through 2020 and face-to-face at the 2020 Critical Care Congress...
October 1, 2023: Critical Care Medicine
https://read.qxmd.com/read/37701008/facilitated-intubation-time-to-re-examine-an-old-technique-with-its-associated-risks-mitigated-by-new-technology
#36
JOURNAL ARTICLE
Joshua B Lowe, Michael J Yoo, John O Patrick, Rachel E Bridwell
BACKGROUND: Facilitated intubation (FI) refers to intubation performed using a sedative or anesthetic drug as an induction agent, without the use of a paralytic (neuromuscular blocking agent). In comparison, rapid sequence intubation (RSI) employs both an induction agent and a paralytic drug. RSI has been seen to outperform FI in terms of first-pass success when performing direct laryngoscopy and was quickly adopted as the gold standard in all situations. Recently, ketamine-only intubation has been used in situations where there is distorted anatomy or apnea intolerance (physically and physiologically difficult airways) resulting in an increased risk of a can't intubate/can't oxygenate scenario or significant hypoxemia...
August 2023: Curēus
https://read.qxmd.com/read/37680406/transnasal-humidified-rapid-insufflation-ventilatory-exchange-versus-conventional-facemask-breathing-for-preoxygenation-during-rapid-sequence-induction
#37
JOURNAL ARTICLE
Diksha Karlupia, Kamakshi Garg, Richa Jain, Anju Grewal
INTRODUCTION: Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE), if used for pre-oxygenation and apnoeic oxygenation, has the propensity to extend the safe apnoea time and thereby decrease the incidence of desaturation during rapid sequence induction (RSI) for emergency surgeries. Hence, we proposed to evaluate the comparative efficacy of pre-oxygenation with the use of conventional facemask breathing versus THRIVE during RSI in patients undergoing general anaesthesia (GA) for emergency surgeries...
August 2023: Curēus
https://read.qxmd.com/read/37595303/extreme-paralysis-following-rocuronium-administration-in-a-myasthenia-gravis-patient-a-case-report
#38
JOURNAL ARTICLE
Kelsey Billups, Charlotte Collins, Aimee Weber
INTRODUCTION: The use of paralytics during rapid sequence intubation (RSI) in patients with myasthenia gravis (MG) remains a controversial topic in emergency medicine. Due to fewer functional acetylcholine receptors, these patients can be both sensitive and resistant to different types of neuromuscular blocking agents (NMBA). Their atypical sensitivity to non-depolarizing NMBAs such as rocuronium can increase both the duration and depth of paralysis after its use at typical RSI doses...
August 2023: Clinical Practice and Cases in Emergency Medicine
https://read.qxmd.com/read/37594256/rapid-sequence-intubation-is-it-time-to-find-an-alternative-induction-agent-a-narrative-review
#39
REVIEW
Brett A Faine, Elisabeth Carroll, Archit Sharma, Nicholas Mohr
OBJECTIVE: To review the efficacy, safety, and place in therapy of fentanyl as an induction agent for rapid sequence intubation (RSI) in critically ill patients. DATA SOURCES: A comprehensive search of PubMed, EMBASE, and clinical trial registries (1964-June 2021) was performed utilizing the keywords fentanyl, rapid sequence intubation, intubation, induction, anesthesia, hemodynamics, operating room (OR), and emergency. STUDY SELECTION AND DATA EXTRACTION: Only primary literature evaluating fentanyl in combination with a sedative or as the sole induction agent was included in the final analysis...
August 18, 2023: Journal of Pharmacy Practice
https://read.qxmd.com/read/37547539/out-of-hospital-emergency-airway-management-practices-a-nationwide-observational-study-from-aotearoa-new-zealand
#40
JOURNAL ARTICLE
Chris Kibblewhite, Verity F Todd, Graham Howie, Josh Sanders, Craig Ellis, Bryan Dittmer, Elena Garcia, Andy Swain, Tony Smith, Bridget Dicker
BACKGROUND AND OBJECTIVES: Airway management is crucial for emergency care in critically ill patients outside the hospital setting. An Airway Registry is useful in providing essential information for quality improvement purposes. Therefore, this study aimed to develop an out-of-hospital airway registry and describe airway management practices in Aotearoa New Zealand (AoNZ). METHODS: Data from the Aotearoa New Zealand Paramedic Care Collection (ANZPaCC) database were used in a retrospective cohort study covering July 2020 to June 2021...
September 2023: Resuscitation plus
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