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1692 papers 1000+ followers Airway Interventions & Management in Emergencies AIME for airway success
P J Le Fevre, C Gough, B J Hearne, L Corbett, C Seller, T M Cook, F E Kelly
Conventional emergency front of neck airway training manikins mimic slim patients and are associated with unrealistic procedural ease. We have described previously a pork belly-modified manikin that more realistically simulated an obese patient's neck. In this study, we compared a novel obese-synthetic manikin (obese-synthetic manikin) with a pork belly-modified manikin (obese-meat manikin) and a conventional slim manikin (slim manikin). Thirty-three experienced anaesthetists undertook simulated emergency front of neck airway procedures on each manikin (total 99 procedures)...
January 17, 2019: Anaesthesia
Nicolò Maria Vanoni, Manuela Carugati, Noemi Borsa, Giovanni Sotgiu, Laura Saderi, Andrea Gori, Marco Mantero, Stefano Aliberti, Francesco Blasi
Community-acquired pneumonia (CAP) is a leading cause of mortality worldwide. CAP mortality is driven by the development of sepsis and acute respiratory failure (ARF). We performed a systematic review of the available English literature published in the period 1 January 1997 to 31 August 2017 and focused on ARF in CAP. The database searches identified 189 articles-of these, only 29 were retained for data extraction. Of these 29 articles, 12 addressed ARF in CAP without discussing its ventilatory management, while 17 evaluated the ventilatory management of ARF in CAP...
January 14, 2019: Medical Sciences: Open Access Journal
Dowon Lee, Jiseok Baik, Giyoung Yun, Eunsoo Kim
BACKGROUND: Fiberoptic bronchoscopic intubation is the gold standard for endotracheal intubation in difficult or compromised airway situations. However, oxygen insufflation through the working channel of a fiberscope is a controversial method because of the possibility of gastric distention and rupture during an awake fiberoptic bronchoscopic intubation, despite the advantages of preventing fogging of the fiberoptic bronchoscopic lens, blowing oral secretions away, and oxygenation of patients...
December 26, 2018: World Journal of Clinical Cases
Kate A Hodgson, Peter G Davis, Louise S Owen
Nasal high flow (nHF) therapy is a commonly used method of providing non-invasive respiratory support for neonates. It has several potential mechanisms of action: continuous distending pressure, nasopharyngeal dead space washout, provision of heated and humidified gases and reduction of work of breathing. nHF is used in a number of clinical scenarios for preterm and term infants, including primary respiratory and post-extubation support. In recent years, large trials have generated evidence pertinent to these indications...
January 7, 2019: Journal of Paediatrics and Child Health
Tiffany S Moon, Pamela E Fox, Alwin Somasundaram, Abu Minhajuddin, Michael X Gonzales, Taylor J Pak, Babatunde Ogunnaike
PURPOSE: To determine the influence of morbid obesity on the incidence of difficult mask ventilation and difficult intubation. METHODS: Over a 6-year period, all tracheal intubations in the operating room of a large tertiary teaching hospital were analyzed. A modified version of the intubation difficulty scale (mIDS) was used to define easy versus difficult intubation, where a score of two or greater was defined as difficult intubation. Difficult mask ventilation was defined as the use of one or more adjuncts to achieve successful mask ventilation...
January 8, 2019: Journal of Anesthesia
Rosh K V Sethi, Dara Khatib, Maxwell Kligerman, Elliott D Kozin, Stacey T Gray, Matthew R Naunheim
OBJECTIVES/HYPOTHESIS: There are limited data on laryngeal fracture presentation and management in US emergency departments (EDs). We aimed to characterize patients who are diagnosed with laryngeal fractures in the ED and identify management patterns. STUDY DESIGN: Retrospective review of the Nationwide Emergency Department Sample (NEDS) from 2009 to 2011. METHODS: The NEDS was queried for patient visits with a primary diagnosis of open or closed laryngeal fracture (International Classification of Diseases, Ninth Revision codes 807...
January 8, 2019: Laryngoscope
Adam James Smith, Ken Jackimczyk, Bruce Horwood, Daniel Christenson
In the prehospital setting, many providers advocate for video laryngoscopy as the initial method of intubation to improve the likelihood of a successful first attempt. However, bright ambient light can worsen visualization of the video laryngoscope liquid crystal display (LCD).Case ReportA patient involved in a motor vehicle accident was evaluated by an Emergency Medical Services (EMS) crew. Initial endotracheal intubation attempt using video laryngoscopy was aborted after the patient desaturated. The primary reason for the failure was poor visualization of the video laryngoscope LCD, despite attempts to block direct sunlight...
January 10, 2019: Prehospital and Disaster Medicine
Tzu-Yao Hung, Li-Wei Lin, Yu-Hang Yeh, Yung-Cheng Su, Chieh-Hung Lin, Ten-Fang Yang
BACKGROUND: The Cormack-Lehane (C-L) grade III airway is considered to be a challenging airway to intubate and is associated with a poor intubation success rate. The purpose of this study was to investigate whether the holding position, shapes, bend angles of the endotracheal tube (ET) and the stylet-assisted lifting of the epiglottis could improve the success rate of intubation. METHODS: Thirty-two participants, 26 physicians, 2 residents, and 4 nurse practitioners, with 12...
January 10, 2019: BMC Anesthesiology
Samantha R Warnakulasuriya, Rachel Harvey, Alistair F McNarry
BACKGROUND: Addressing themes raised by the Royal College of Anaesthetists National Audit Project 4, we introduced new training programmes to improve the knowledge and skills necessary for the management of airway crises. A further large-scale multimodal training programme was introduced to implement guidelines published in 2015 by the Difficult Airway Society (DAS). METHODS: In 2014, questionnaires were used to assess the knowledge necessary to manage the unanticipated difficult airway before and after high-fidelity simulation sessions...
January 8, 2019: Clinical Teacher
Cyril Sahyoun, Christina Siliciano, David Kessler
BACKGROUND: Capnography and cardiopulmonary resuscitation (CPR) feedback devices have been shown to improve resuscitation outcomes, with the American Heart Association recommending their use during advanced life support (ALS). Little is known about the availability of these devices, their protocoled use, and the attitudes toward them in the prehospital setting. OBJECTIVES: The objectives of this study were to assess the availability of capnography and CPR feedback devices among prehospital ALS agencies in New York State (NYS), to describe the protocoled use of these devices, and to evaluate the attitudes of providers toward the use of these devices...
December 27, 2018: Pediatric Emergency Care
Sandy Kirolos, Joyce E O'Shea
Neonatal intubation is an essential but difficult skill to learn. Videolaryngoscopy allows the airway view to be shared by the intubator and supervisor and improves intubation success. Ideally, a videolaryngoscope (VL) should be usable as a conventional laryngoscope (CL). The aims of this report were to describe differences in the shape of currently available CL and VL blades and to compare the direct airway view obtainable on a neonatal manikin with different laryngoscope blades.Three main differences were observed; compared with CL, the VL blades have a reduced vertical height, a curved tip and curved body...
January 3, 2019: Archives of Disease in Childhood. Fetal and Neonatal Edition
Bianca M Wahlen, Ayman El-Menyar, Mohammad Asim, Hassan Al-Thani
BACKGROUND: We aimed to describe the current practice of emergency physicians and anaesthesiologists in the selection of drugs for rapid-sequence induction (RSI) among trauma patients. METHODS: A prospective survey audit was conducted based on a self-administered questionnaire among two intubating specialties. The preferred type and dose of hypnotics, opioids, and muscle relaxants used for RSI in trauma patients were sought in the questionnaire. Data were compared for the use of induction agent, opioid use and muscle relaxant among stable and unstable trauma patients by the intubating specialties...
2019: World Journal of Emergency Medicine
Vinciya Pandian, Gooi Zhen, Stanola Stanley, Marco Oldsman, Elliott Haut, Lynette Mark, Christina Miller, Alexander Hillel
OBJECTIVE: The objective of our study was to assess the impact of a multidisciplinary difficult airway response team (DART), a quality improvement program, in the management of patients with difficult airway associated with oropharyngeal angioedema patients. METHODS: Individual retrospective cohort study. Retrospective review of patient charts from July 2003 to June 2008 (pre-DART) and retrospective review of prospectively collected data from July 2008 to June 2013 (post-DART)...
December 26, 2018: Laryngoscope
Andrew Rotando, Lindsey Picard, Samantha Delibert, Karin Chase, Courtney M C Jones, Nicole M Acquisto
PURPOSE: Evaluate push dose vasopressor (PDP) practice patterns, efficacy, and safety in critically ill patients. METHODS: Critically ill patients receiving phenylephrine or ephedrine PDP from November 2015-March 2017 were included. Patient demographics, medication administration details, vital signs pre- and post-administration, adverse effects, and medications errors were collected. Descriptive data are presented and comparisons were made with paired samples t-test, Wilcoxon Rank Sum and Chi-squared analysis or Fisher's Exact Test as appropriate...
December 3, 2018: American Journal of Emergency Medicine
Aysun Ankay Yilbas, Ozgur Canbay, Basak Akca, Filiz Uzumcugil, Asli Melek, Mert Calis, İbrahim Vargel
INTRODUCTION: The effect on hand-eye coordination and visuospatial skills made videogames popular for training in laparoscopic surgery. Although similar effects may be true for fiberoptic intubation (FOI), it hasn't been studied before. The aim of this study was to investigate the effect of playing videogames with gamepad on FOI skills. METHODS: After obtaining ethical approval and informed consent, 36 anaesthesia residents with no experience on fiberoptic intubation were divided into two groups...
December 20, 2018: Anaesthesia, Critical Care & Pain Medicine
Elena-Laura Lemaitre, Laurent Tritsch, Eric Noll, Pierre Diemunsch, Nicolas Meyer
AIM OF THE STUDY: The role of supraglottic devices in airway management in out-of-hospital cardiac arrest (OHCA) remains controversial. The aim of this study was to evaluate the feasibility and effectiveness of intubation through the Intubating Laryngeal Mask Airway (ILMA) when used by prehospital emergency nurses in the setting of OHCA. METHODS: We conducted a prospective, observational trial during 12 years by the Fire Department and prehospital emergency service of the health district of Strasbourg, France...
December 17, 2018: Resuscitation
E McGrenaghan, A F Smith
No abstract text is available yet for this article.
December 21, 2018: Anaesthesia
Kenneth W Dodd, Matthew E Prekker, Aaron E Robinson, Ryan Buckley, Robert F Reardon, Brian E Driver
STUDY OBJECTIVES: Direct laryngoscopy (DL) is the traditional approach for emergency intubation but video laryngoscopy (VL) is gaining popularity. Some studies have demonstrated higher first-attempt success with VL, particularly in difficult airways. In real-world settings, physicians choose whether or not to view the video screen when utilizing VL devices for tracheal intubation. Therefore, we sought to determine whether screen viewing is associated with higher intubation first-attempt success in clinical practice...
October 16, 2018: American Journal of Emergency Medicine
Elizabeth E Foglia, Anne Ades, Taylor Sawyer, Kristen M Glass, Neetu Singh, Philipp Jung, Bin Huey Quek, Lindsay C Johnston, James Barry, Jeanne Zenge, Ahmed Moussa, Jae H Kim, Stephen D DeMeo, Natalie Napolitano, Vinay Nadkarni, Akira Nishisaki
BACKGROUND AND OBJECTIVES: Neonatal tracheal intubation is a critical but potentially dangerous procedure. We sought to characterize intubation practice and outcomes in the NICU and delivery room (DR) settings and to identify potentially modifiable factors to improve neonatal intubation safety. METHODS: We developed the National Emergency Airway Registry for Neonates and collected standardized data for patients, providers, practices, and outcomes of neonatal intubation...
January 2019: Pediatrics
Sung Yeon Hwang, Se Uk Lee, Tae Rim Lee, Hee Yoon, Joo Hyun Park, Won Chul Cha, Min Seob Sim, Ik Joon Jo, Keun Jeong Song, Seonwoo Kim, Sun-Young Baek, Tae Gun Shin
OBJECTIVES: We determined the usefulness of C-MAC video laryngoscope (C-MAC) as a safe training tool for the direct laryngoscopy technique in the emergency department. METHODS: We retrospectively analyzed an institutional airway registry of adult (≥18 years old) patients from April 2014 through October 2016. In this study, the operator used C-MAC as a direct laryngoscope (DL) with limited access to the screen, and the supervisor instructed the operator via verbal feedback while watching the screen...
2018: PloS One
2018-12-15 20:44:42
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