Tag: intubation

Upvote Story 5
Among patients with out-of-hospital cardiorespiratory arrest (OHCA), the use of BMV compared with ETI failed to demonstrate noninferiority or inferiority for survival with favorable 28-day neurological function, an inconclusive result. A determination of equivalence or superiority between these techniques requires further research. This study has several limitations. First, the presence of a physician in the ambulance team may make the results of this study less... Read More | Comment
Upvote Story 4
Pre-preparation of Preparation on Pre-hospital Emergency (PHEA) equipment and drugs resulted in safer performance of PHEA and has the potential to reduce on-scene time by up to a third. In total 23 experiments were completed, 12 using experimental method and 11 using standard practice. Time required to perform PHEA using the experimental method was significantly shorter than with standard practice (11,45 versus 20:59) minutes: seconds;... Read More | Comment
Upvote Story 4
When used in intensive care units, video laryngoscopy did not improve the chances of successful intubation on the first try, compared with direct laryngoscopy, and was associated with a significantly higher risk of severe life-threatening complications, researchers reported. The view during video laryngoscopy can also create a cognitive blind spot: laryngoscopists may fail to abort a laryngoscopy attempt in a timely manner because they have... Read More | Comment
Upvote Story 11
There were both similarities and differences in tracheal intubation practice and outcomes across international PICUs. Fewer adverse tracheal intubation–associated events were reported from International versus North American PICUs. International PICUs used cuffed endotracheal tube less often and had higher proportion of endotracheal tube change. Adverse tracheal intubation–associated events and desaturation occurrence (oxygen saturation < 80%) were evaluated. A total of 1,134 and 9,376 TIs from... Read More | Comment
Upvote Story 7
The safety of cuffed endotracheal tubes in the neonatal and critically ill pediatric population continues to be questioned due to the theoretical risk of acquired subglottic stenosis. The incidence of acquired subglottic stenosis in the high-risk mixed surgical and medical critically ill pediatric cohort using high-volume, low-pressure cuffed endotracheal tube policy has not yet been described. We report no single case of acquired subglottic stenosis... Read More | Comment
Upvote Story 18
Here is the Alfred ICU intubation checklist. We invite you to take it and adopt it whole, or, even better, to modify it to your own department’s needs. We have spent considerable time and thought developing it, as well as testing it in repeated simulations prior to clinical use. We wanted to create a checklist that goes beyond ensuring that equipment is ready and team... Read More | Comment
Upvote Story 6
This large randomized clinical trial performed in patients undergoing anesthesia with RSI failed to demonstrate the noninferiority of the sham procedure in preventing pulmonary aspiration. Further studies are required in pregnant women and outside the operating room. Of 3472 patients randomized, mean (SD) age was 51 (19) years and 1777 (51%) were men. The primary end point, pulmonary aspiration, occurred in 10 patients (0.6%) in... Read More | Comment
Upvote Story 5
The mortality rate is lower among children admitted to specialist pediatric intensive care units (ICUs) than among those admitted to mixed adult and pediatric units in non-tertiary hospitals. In the UK, however, few children receive intensive care in specialist pediatric units. We compared the ICU mortality rate in children from the area of the Trent Health Authority, UK, with the rate in children from Victoria,... Read More | Comment
Upvote Story 10
This book discusses mechanical ventilation in emergency settings, covering the management of patients from the time of intubation until transfer to the ICU. It provides an introduction to key concepts of physiology pertinent to mechanical ventilation as well as a review of the core evidence-based principles of ventilation. The text highlights the management of mechanical ventilation for critically ill patients with several conditions commonly encountered... Read More | Comment
Upvote Story 7
Mr. Jackson is a 36-year-old man whom you are caring for in the intensive care unit (ICU). Before this hospitalization, he was healthy and took no medications. He has never smoked, and he drinks three or four beers every week. A week ago, a couple of coworkers in his office had respiratory illnesses, and a day later, he started having fever, chills, cough, and generalized... Read More | Comment
Upvote Story 7
Laryngeal injury from intubation is common in the ICU setting. Guidelines for laryngeal assessment and postextubation surveillance do not exist. A systematic approach to more robust investigations could increase knowledge of the association between particular injuries and corresponding functional impairments, improving understanding of both time course and prognosis for resolution of injury. Our findings identify targets for future research and highlight the long-known, but understudied,... Read More | Comment
Upvote Story 9
In patients requiring intubation from acute salicylate toxicity, hemodialysis should be considered as part of management, as this is associated with decreased mortality. Salicylates are common substances that can be purchased over the counter. They are readily available, and in the setting of an overdose, can be fatal. Initially, as salicylates are metabolized, they can induce a respiratory alklalosis. This is then followed by an... Read More | Comment
Upvote Story 6
Emergency physicians (EPs) are experts in emergent airway management and thus must be confident managing mechanical ventilation. Hospital-wide bed shortages mean that EPs will be managing admitted patients for longer periods of time, and if you work in a hospital without intensivist coverage you must be the ventilator expert. A recent study suggests implementing a ventilator protocol in the emergency department can improve mortality in... Read More | Comment
Upvote Story 9
The American Society of Anesthesiologists (ASA) difficult airway algorithm recommends that if initial attempts at tracheal intubation after the induction of general anesthesia are unsuccessful, the practitioner should “consider the advisability of awakening the patient”. With respect to the use of muscle relaxants, “awakening” is assumed to mean return to an unparalyzed state that permits life-sustaining spontaneous ventilation (hereafter referred to as functional recovery). The... Read More | Comment
Upvote Story 8
Thai schoolboys were rescued from the cave using dissociative ketamine plus positive-pressure facemask ventilation (to prevent water from leaking into their masks), so they basically used delayed sequence intubation strategy. The schoolboys rescued from a flooded cave system in Thailand were dosed with an anti-anxiety drug to stop them panicking during the terrifying underwater mission, the country’s prime minister has admitted. The rescue was carried... Read More | Comment