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1791 papers 1000+ followers Airway Interventions & Management in Emergencies AIME for airway success aimeairway.ca
https://read.qxmd.com/read/31208469/videolaryngoscopy-in-critically-ill-patients
#1
Samir Jaber, Audrey De Jong, Paolo Pelosi, Luca Cabrini, Jean Reignier, Jean Baptiste Lascarrou
Intubation is frequently required for patients in the intensive care unit (ICU) but is associated with high morbidity and mortality mainly in emergency procedures and in the presence of severe organ failures. Improving the intubation procedure is a major goal for all ICU physicians worldwide, and videolaryngoscopy may play a relevant role.Videolaryngoscopes are a heterogeneous entity, including Macintosh blade-shaped optical laryngoscopes, anatomically shaped blade without a tube guide and anatomically shaped blade with a tube guide, which might have theoretical benefits and pitfalls...
June 17, 2019: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/31206383/anesthesia-residency-training-in-airway-management-a-competency-based-model-curriculum
#2
Ursula A Galway, Tracey Straker, Lorraine J Foley, Michael Aziz, Glenn Woodworth
The Accreditation Council for Graduate Medical Education (ACGME) is moving toward competency-based medical education. This educational framework requires the description of educational outcomes based on the knowledge, skills, and behaviors expected of competent trainees. An assessment program is essential to provide formative feedback to trainees as they progress to competency in each outcome. This article describes the development of 2 model curricula for airway management training (basic and advanced) using a competency-based framework...
June 11, 2019: A&A practice
https://read.qxmd.com/read/31211460/the-effect-of-placement-of-a-support-under-the-shoulders-on-laryngeal-visualization-with-a-c-mac-miller-video-laryngoscope-in-children-younger-than-two-years-of-age
#3
Zeynep Koylu Gencay, Zekine Begec, Ulku Ozgul, Cemil Colak
BACKGROUND: We aimed to evaluate glottis visualization and time to intubation in children younger than two years of age during laryngoscopy performed with a C-MAC Miller Video Laryngoscope in a position determined by placing a folded towel under the shoulders to align the oral-pharyngeal and laryngeal axes in the horizontal plane. METHODS: Ninety-six children younger than two years of age, who were classified by the American Society of Anesthesiologists as having a physical status I or II and who were scheduled for elective surgery necessitating endotracheal intubation under general anesthesia, were included in the study...
June 18, 2019: Paediatric Anaesthesia
https://read.qxmd.com/read/31146497/c-mac-video-laryngoscope-versus-conventional-direct-laryngoscopy-for-endotracheal-intubation-during-cardiopulmonary-resuscitation
#4
Byeong Chul Min, Jong Eun Park, Gun Tak Lee, Tae Rim Kim, Hee Yoon, Won Chul Cha, Tae Gun Shin, Keun Jeong Song, Minsu Park, Heewon Han, Sung Yeon Hwang
Background and objectives : To compare the first pass success (FPS) rate of the C-MAC video laryngoscope (C-MAC) and conventional Macintosh-type direct laryngoscopy (DL) during cardiopulmonary resuscitation (CPR) in the emergency department (ED). Materials and Methods : This study was a single-center, retrospective study conducted from April 2014 to July 2018. Patients were categorized into either the C-MAC or DL group, according to the device used on the first endotracheal intubation (ETI) attempt. The primary outcome was the FPS rate...
May 29, 2019: Medicina
https://read.qxmd.com/read/31147349/the-association-of-paramedic-rapid-sequence-intubation-and-survival-in-out-of-hospital-stroke
#5
Pieter Francsois Fouche, Karen Smith, Paul Andrew Jennings, Malcolm Boyle, Stephen Bernard
INTRODUCTION: Ambulance transport of patients with stroke is common, with rapid sequence intubation (RSI) to secure the airway used regularly. Randomised controlled trial evidence exists to support the use of RSI in traumatic brain injuries (TBIs), but it is not clear whether the RSI evidence from TBI can be applied to the patient with stroke. To this end, we analysed a retrospective stroke dataset to compare survival of patients with RSI compared with patients that did not receive RSI...
May 30, 2019: Emergency Medicine Journal: EMJ
https://read.qxmd.com/read/31162158/nasolaryngeal-distances-in-the-adult-population-and-an-evaluation-of-commercially-available-nasotracheal-tubes
#6
Christina Massoth, Christoph Schülke, Jeanette Köppe, Raphael Weiss, Daniel Pöpping, Michael Dahrmann, Alexander Zarbock, Manuel Wenk
BACKGROUND: Preformed nasal endotracheal tubes (NETs) come with a predefined insertion depth due to their curved design. While size indication refers to internal diameter, there is a considerable variability in the corresponding lengths and proportions of same-sized tubes of different manufacturers which is probably based on the lack of data of nasolaryngeal distances (NLDs) in the adult population. Choosing the best-fitting NET is therefore difficult and carries the risk of endobronchial intubation or, on the contrary, cuff inflation at the vocal cord level...
May 30, 2019: Anesthesia and Analgesia
https://read.qxmd.com/read/31162351/tracheal-intubations-for-critically-ill-children-outside-specialized-centers-in-the-united-kingdom-patient-provider-practice-factors-and-adverse-events
#7
Ron Sanders, Lauren Edwards, Akira Nishisaki
No abstract text is available yet for this article.
June 2019: Pediatric Critical Care Medicine
https://read.qxmd.com/read/31162669/frequency-distribution-of-modified-cormack-lehane-views-a-retrospective-audit-of-tracheal-intubation-in-children-with-normal-airways
#8
Kathrin Schmid, Philipp K Buehler, Achim Schmitz, Christian P Both, Markus Weiss
BACKGROUND: Paediatric patients with an unanticipated poor grade of laryngoscopic view during tracheal intubation represent a challenging situation potentially associated with increased morbidity and mortality. The aim of this study was to investigate the frequency of modified Cormack-Lehane (MCL) views and to elucidate variables for poor views in a large collective of children without anticipated airway difficulties. METHODS: The departmental anaesthesia patient database was searched for patients who had undergone general anaesthesia with tracheal intubation between January 2007 and March 2017...
June 4, 2019: Acta Anaesthesiologica Scandinavica
https://read.qxmd.com/read/31165475/time-to-oxygenation-for-cannula-and-scalpel-based-techniques-for-emergency-front-of-neck-access-a-wet-lab-simulation-using-an-ovine-model
#9
K A Rees, L J O'Halloran, J B Wawryk, R Gotmaker, E K Cameron, H D J Woonton
Emergency front-of-neck access to achieve a percutaneous airway can be a life-saving intervention, but there is debate about the preferred technique. This prospective, observational study was designed to compare the two most common emergency surgical airway techniques in a wet lab simulation using an ovine model. Forty-three doctors participated. After providing standardised reading, a lecture and dry lab benchtop training, participants progressed to a high-fidelity wet lab simulation. Participants entered an operating theatre where a 'cannot intubate, cannot oxygenate' situation had been declared and were directed to perform emergency front-of-neck access: first with a cannula technique (14-gauge cannula insertion with ventilation using a Rapid-O2® cricothyroidotomy insufflation device); and subsequently, a scalpel-bougie technique (surgical incision, bougie insertion into trachea and then tracheal tube passed over bougie, with ventilation using a self-inflating bag)...
June 4, 2019: Anaesthesia
https://read.qxmd.com/read/31174573/pre-hospital-emergent-intubation-in-trauma-patients-the-influence-of-etomidate-on-mortality-morbidity-and-healthcare-resource-utilization
#10
Michael Gäßler, Matthias Ruppert, Rolf Lefering, Bertil Bouillon, Arasch Wafaisade
BACKGROUND: Due to its favorable hemodynamic characteristics and by providing good intubation conditions etomidate is often used for induction of general anesthesia in trauma patients. It has been linked to temporary adrenal cortical dysfunction. The clinical relevance of this finding after a single-dose is still lacking appropriate evidence. METHODS: This retrospective multi-centre study is based on merged data from a German Helicopter Emergency Medical Service (HEMS) database and a large trauma patient registry...
June 7, 2019: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://read.qxmd.com/read/31142245/a-practice-survey-of-airway-management-in-australian-and-new-zealand-intensive-care-units
#11
Michael Toolis, Ravindranath Tiruvoipati, John Botha, Cameron Green, Ashwin Subramaniam
OBJECTIVE: To characterise intubation practices in Australian and New Zealand intensive care units (ICUs) and investigate clinician support for establishing airway management guidelines in Australian and New Zealand ICUs. DESIGN: An online survey was designed, piloted and distributed to members of the mailing list of the Australian and New Zealand Intensive Care Society (ANZICS), with medical members invited to participate. Respondents were excluded if their primary practice was in paediatric ICUs...
June 2019: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://read.qxmd.com/read/31169409/learner-and-educator-experiences-and-priorities-in-paediatric-airway-education-a-qualitative-study
#12
Andrew D Weatherall, Minal Menezes, Su May Koh, Michelle D Lazarus
Paediatric airway management is a challenging area of anaesthesia practice to learn. Techniques and skills required need modification from adult practice and gaining experience through exposure takes considerable time. Preparation to manage airway emergencies can be particularly difficult as these events are rare in paediatric practice. This study aimed to examine what educational approaches health professionals of varying backgrounds find useful when learning or teaching paediatric airway management. This qualitative study involved the conduct of five interdisciplinary focus groups; each group consisted of four to six health professionals from nursing, anaesthetic, simulation and critical care backgrounds...
June 6, 2019: Anaesthesia and Intensive Care
https://read.qxmd.com/read/31171627/confirmed-cardiac-output-on-emergency-medical-services-arrival-as-confounding-by-indication-an-observational-study-of-prehospital-airway-management-in-patients-with-out-of-hospital-cardiac-arrest
#13
Atsushi Sakurai, Kosaku Kinoshita, Yukihiro Maeda, Yosuke Homma, Yoshio Tahara, Naohiro Yonemoto, Ken Nagao, Arino Yaguchi, Naoto Morimura
OBJECTIVES: Many registry studies on patients with out-of-hospital cardiac arrest (OHCA) have reported that conventional bag-valve-mask (BVM) ventilation is independently associated with favourable outcomes. This study aimed to compare the data of patients with OCHA with confirmed cardiac output on emergency medical services (EMS) arrival and consider the confounding factors in prehospital airway management studies. METHODS: This was a cohort study using the registry data for survivors after out-of hospital cardiac arrest in the Kanto region at 2012 in Japan (SOS-KANTO 2012)...
June 6, 2019: Emergency Medicine Journal: EMJ
https://read.qxmd.com/read/31093966/removal-methods-of-rigid-stylets-to-minimise-adverse-force-and-tracheal-tube-movement-a-mathematical-and-in-vitro-analysis-in-manikins
#14
M Kotoda, T Oguchi, K Mitsui, S Hishiyama, K Ueda, A Kawakami, T Matsukawa
This study investigated displacement of the tracheal tube caused by different methods of intubating stylet removal, using in-vitro experiments and mathematical analysis. In the first in-vitro experiment, we measured the distance travelled by the tube tip during stylet extraction. Then, we investigated the ideal technique for stylet extraction using mathematical analysis, which would cause minimal tube displacement. Then, using a training manikin, we measured the force applied to the vocal cords and stylet extraction force during tracheal intubation...
May 15, 2019: Anaesthesia
https://read.qxmd.com/read/31094759/comparison-of-tracheal-intubation-conditions-in-operating-room-and-intensive-care-unit-a-prospective-observational-study-erratum
#15
(no author information available yet)
No abstract text is available yet for this article.
May 14, 2019: Anesthesiology
https://read.qxmd.com/read/31094798/effect-of-dynamic-versus-stylet-guided-intubation-on-first-attempt-success-in-difficult-airways-undergoing-glidescope-laryngoscopy-a-randomized-controlled-trial
#16
Guido Mazzinari, Lucas Rovira, Liliana Henao, Juan Ortega, Alma Casasempere, Yolanda Fernandez, Mariana Acosta, Moncef Belaouchi, José Miguel Esparza-Miñana
BACKGROUND: Tracheal intubation failure in patients with difficult airway is still not uncommon. While videolaryngoscopes such as the Glidescope offer better glottic vision due to an acute-angled blade, this advantage does not always lead to an increased success rate because successful insertion of the tube through the vocal cords may be the limiting factor. We hypothesize that combined use of Glidescope and fiberscope used only as a dynamic guide facilitates tracheal intubation compared to a conventional Glidescope technique with a preshaped nondynamic stylet...
June 2019: Anesthesia and Analgesia
https://read.qxmd.com/read/31096995/how-i-manage-a-difficult-intubation
#17
EDITORIAL
Jonathan D Casey, Matthew W Semler, Kevin High, Wesley H Self
No abstract text is available yet for this article.
May 16, 2019: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/31107352/reintubation-in-the-icu-following-cardiac-surgery-is-it-more-difficult-than-first-time-intubation-in-the-operating-room-a-prospective-observational-study
#18
Manuel Taboada, Raúl Rey, Susana Martínez, Rosa Soto-Jove, Paula Mirón, Salome Selas, María Eiras, Adrian Martínez, María Rial, Agustin Cariñena, Irene Rodríguez, Sonia Veiras, Julián Álvarez, Aurora Baluja, Peter G Atanassoff
BACKGROUND: After cardiac surgery, a patient's trachea is usually extubated; however, 2 to 13% of cardiac surgery patients require reintubation in the ICU. OBJECTIVE: The objective of this study was to compare the initial intubation in the cardiac operating room with reintubation (if required) in the ICU following cardiac surgery. DESIGN: A prospective, observational study. SETTING: Department of Anesthesiology and Intensive Care Medicine, Clinical Hospital of Santiago, Spain...
May 15, 2019: European Journal of Anaesthesiology
https://read.qxmd.com/read/31110032/ventilator-induced-lung-injury-classic-and-novel-concepts
#19
Bhushan H Katira
Ventilator-induced lung injury (VILI) is a central confounder to improving outcomes from use of positive-pressure ventilation in critical illness. Therefore, with increasing use of positive-pressure ventilation, awareness to prevent VILI has grown. Because VILI cannot be diagnosed at the bedside, its prevention can only be attained by identifying the clinical mechanisms of harm, such as high tidal volume, high plateau pressure, and so forth, which, in turn, are derived from decades of laboratory work. The practice of positive-pressure ventilation has undergone a significant change; most important in the past decade is the preference to use noninvasive ventilation...
June 2019: Respiratory Care
https://read.qxmd.com/read/31110033/noninvasive-respiratory-support-in-acute-hypoxemic-respiratory-failure
#20
Thomas Piraino
For more than 40 years, noninvasive ventilation has been the first-line preferred therapy for acute-on-chronic conditions, such as COPD and cardiogenic pulmonary edema. The use of noninvasive ventilation in the treatment of hypoxemic respiratory failure, however, has been met with mixed results associated with higher risks of intubation (failure of therapy) and with higher risks of mortality. The purpose of this review was to describe the current evidence and important considerations when patients with hypoxemic respiratory failure are managed with noninvasive ventilation...
June 2019: Respiratory Care
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