Tag: intubation
Rapid Sequence Intubation With Video Laryngoscopy Common for Difficult Airways
Predicted difficult airways in one emergency department are managed most often using rapid sequence intubation (RSI) and video laryngoscopy (VL), a recent study has found. Although difficult airways occur frequently in emergency... read more
Tracheal extubation with a predicted difficult airway
Management of the difficult airway is an important, but as yet poorly-studied, component of intensive care management. Although there has been a strong emphasis on prediction and intubation of the difficult airway, safe extubation... read more
Sevoflurane for the treatment of refractory status epilepticus in the critical care unit
A 50-year-old woman with liver failure was admitted to critical care for refractory status epilepticus (RSE). Following tracheal intubation, sevoflurane was administered via the MIRUS system (Pall Medical, Dreieich, Germany).... read more
Intubation in Special Patient Populations: Intracranial Hemorrhage
Lidocaine has weak evidence to support its ICP blunting effects. Fentanyl may be a better choice. Ketamine is a reasonable alternative to etomidate during induction. No differnce in mortality exists between usage of succinylcholine... read more
Lighter Emergency Breathing Tubes Associated with Higher Survival After OHCA
In the LT group, 18.3% of patients survived 72 hours in the hospital, compared to 15.4% in the intubation group. From the LT group, 10.8% survived to hospital discharge, and only 8.1% in the intubation group. The proportion... read more
A Nightmare Airway with Rob Bryant
In terms of airway management, cricothyrotomy is one of the most advanced airway procedures an ED physician will perform. It is a last resort procedure when a patient is not able to be ventilated/oxygenated and/or intubated.... read more
Looking for a Better Way to Treat Hypoxia in the Emergency Department? Reach for High-Flow Nasal Cannula
High-flow nasal cannula should be considered a first-line therapy in all patients with hypoxemic respiratory failure not from cardiogenic pulmonary edema and without concomitant hypercapnia. The high flow rate of HFNC offers... read more
Effect of Use of a Bougie vs Endotracheal Tube and Stylet on First-Attempt Intubation Success Among Patients With Difficult Airways Undergoing Emergency Intubation
In this emergency department, use of a bougie compared with an endotracheal tube + stylet resulted in significantly higher first-attempt intubation success among patients undergoing emergency endotracheal intubation.... read more
Resuscitation Sequence Intubation – Hypoxemia Kills
This blog post is the second part of a series of 3, on a recent lecture I was asked to give on Critical Care Updates: Resuscitation Sequence Intubation. This talk was mostly derived from a podcast by Scott Weingart (Twitter:... read more
Airway Management Techniques during Massive Regurgitation, Emesis, or Bleeding
Friend to the show, Jim DuCanto has been obsessed with SALAD. Not the leafy greens delicately touched with a tart emulsion, but with Suction Assisted Laryngoscopy and Airway Decontamination (SALAD). Jim DuCanto, MD is an... read more
The A1 Sedation Package: Better Care for Intubated Patients
You are called to the scene of a 56-year-old male found unresponsive in his garage workshop. Upon examining him you find him minimally responsive to painful stimulus, moaning and groaning. His family tells you he has high... read more
Pre-hospital advanced airway management by anaesthetist and nurse anaesthetist critical care teams
When performed by experienced physician anaesthetists and nurse anaesthetists, pre-hospital tracheal intubation was completed rapidly with high success rates and a low incidence of complications. The critical care teams attended... read more
Techniques for the Difficult Airway
A systematic approach to intubation that emphasizes planning and teamwork can reduce intubation complications. Early use of an EGA or cricothyroidotomy may reduce complications when oxygenation is inadequate. Use of a gum... read more
Fluid Bolus Over 15-20 Versus 5-10 Minutes Each in the First Hour of Resuscitation in Children With Septic Shock
Children receiving fluid boluses over 5–10 minutes each had a higher risk of intubation than those receiving boluses over 15–20 minutes each. Notwithstanding the lack of difference in risk of mortality and the possibility... read more
When to Withdraw Resuscitation in the ED
When can and should we withdraw from continuing resuscitation in the Emergency Department? We are here to save lives. I would argue the Emergency Medicine is a very pure expression of a Doctor's role: we meet a patient, we... read more
One-Year Outcomes in Patients With ARDS
Poor functional recovery after invasive mechanical ventilation for acute respiratory distress syndrome is common. Helmet noninvasive ventilation may be the first intervention that mitigates the long-term complications that... read more
Papers of the Month March 2018
Gavin Denton and I get together again to review a couple of recent papers that have some bearing on our practice. Welcome to the Papers of the month. This month we cover Check Up- Position- “A Multicenter, Randomized Trial... read more
Apneic Oxygenation in the ICU
Hypoxemia is the most common complication of endotracheal intubation in the critically ill and the strongest risk factor for periprocedural cardiac arrest and death. The traditional approach to avoiding desaturation during... read more
Hemorrhagic Shock: Pearls and Pitfalls for the Resuscitation Room
Hemorrhagic shock is a state of systemic hypoperfusion secondary to acute blood loss which may have either traumatic or atraumatic etiologies. While gastrointestinal and traumatic etiologies are some of the most common causes... read more
Videographic Assessment of Pediatric Tracheal Intubation Technique During Emergency Airway Management
Intubators commonly exhibited suboptimal technique during tracheal intubation such as bending deeply at the waist, having their eyes close to the patient's mouth, failing to widely open the patient's mouth, and not elevating... read more
Noninvasive Ventilation in Patients With Do-Not-Intubate and Comfort-Measures-Only Orders
A large proportion of patients with do-not-intubate orders who received noninvasive ventilation survived to hospital discharge and at 1 year, with limited data showing no decrease in quality of life in survivors. Provision... read more
Comparison of Etomidate and Ketamine for Induction During Rapid Sequence Intubation of Adult Trauma Patients
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... read more
