Tag: intubation
Efficacy and Safety of a Paired Sedation and Ventilator Weaning Protocol in ICU
Approaches to removal of sedation and mechanical ventilation for critically ill patients vary widely. Our aim was to assess a protocol that paired spontaneous awakening trials (SATs)—ie, daily interruption of sedatives—with... read more
Computer Tomographic Assessment of Gastric Volume in Major Trauma Patients
In major trauma patients, overall stomach volume deriving from food, fluids and air must be expected to be around 400–500 mL. Gastric dilation caused by air is common but not typically associated with pre-hospital airway... read more
Respiratory Strategies for Patients with Suspected or Proven COVID-19 Respiratory Failure
The trial objective is to determine if Continuous Positive Airway Pressure (CPAP) or High-Flow Nasal Oxygen (HFNO) is clinically effective compared to standard oxygen therapy in patients with confirmed or suspected COVID-19. The... read more
High Breath-by-Breath Variability Is Associated With Extubation Failure in Children
High respiratory variability during spontaneous breathing trials is independently associated with extubation failure in children, with very high rates of extubation failure when these children develop postextubation upper... read more
Bedside PUG Tube Placement by Critical Care Physicians
Critically ill patients often require gastrostomy tubes. Percutaneous endoscopic gastrostomy has become the most common method of placement but is not widely performed by critical care physicians, in part due to their lack... read more
COVID-19: Airborne Particle Contamination Increased Substantially Using the Aerosol Box
Study shows that aerosol box used to protect healthcare workers during COVID intubation increases, rather than decreases, exposure to airborne particles. A new study shows that aerosol boxes that have been manufactured... read more
Cardiovascular Phenotypes in Ventilated Patients with COVID-19 ARDS
Approximately two-thirds of patients admitted to the intensive care unit (ICU) for coronavirus disease-19 (COVID-19) pneumonia present with the acute respiratory distress syndrome (ARDS). COVID-19-associated acute cardiac... read more
Difficult Bag-Mask Ventilation in Critically Ill Children Is Independently Associated With Adverse Events
Difficult bag-mask ventilation is reported in approximately one in 10 PICU patients undergoing tracheal intubation. Given its association with adverse procedure–related events and oxygen desaturation, future study is warranted... read more
Perhaps something isn’t always better than nothing
It is not unreasonable to say the COVID-19 pandemic caught most of us by surprise. We did not know how infectious the Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) virus leading to COVID-19 disease was, nor... read more
Exhaled Air Dispersion During Bag-mask Ventilation and Sputum Suctioning
Mask ventilation and coughing during oro-tracheal suctioning produce aerosols that enhance nosocomial transmission of respiratory infections. We examined the extent of exhaled air dispersion from a human-patient-simulator... read more
Cardiopulmonary Resuscitation in the Emergency Department During COVID-19
Emergency medical services (EMS) is called for a 65-year-old man with a 1-week history of cough, fever, and mild shortness of breath now reporting chest pain. Vitals on scene were HR 110, BP 135/90, SpO2 88% on room air.... read more
Safe Airway Management for the Patient with COVID-19
In this presentation, Dr Ravi Bhagrath, Consultant Anaesthetist at Bart’s Health, London asks Dr Kariem El-Boghdadly, Consultant in Anaesthesia at Guy's and St Thomas' NHS Foundation Trust, London about the IntubateCOVID... read more
Tube Thoracostomy during the COVID-19 Pandemic
This document provides guidance for trauma and acute care surgeons surrounding the placement, management and removal of chest tubes during the COVID-19 pandemic. Tube thoracostomy for a traumatic hemothorax or pneumothorax... read more
How to Intubate the Critically Ill Like a Boss
Despite decades of experience with endotracheal intubation, we continue to find approaches to improving the process of how we intubate. In today's post we are not only going to talk about how to avoid post intubation cardiac... read more
Is Locoregional Anesthesia a Functional Option for Major Abdominal Surgeries in the COVID-19 Era?
Based on our preliminary case series, awake open surgery has resulted feasible and safe. This approach has allowed to perform undelayable major abdominal surgeries on fragile patients when intensive care beds were not available.... read more
Simulated COVID-19 Contamination of Health Care Workers After Endotracheal Intubation of Manikins
Despite personal protective equipment, fluorescent markers were found on the uncovered skin, hair, and shoes of participants after simulations of emergency department management of patients experiencing respiratory distress.... read more
A Transdisciplinary COVID-19 Early Respiratory Intervention Protocol
In the days after COVID-19 arrived in our region, there were many such stories of patients sent to the floor from the Emergency Department who were intubated shortly after admission. Many of those patients subsequently... read more
Awake Proning for COVID-19
Prone positioning improves oxygenation in spontaneous breathing nonintubated patients with hypoxemic acute respiratory failure: A retrospective study. This is a retrospective case series describing 15 non-intubated patients... read more
High Risk of Thrombosis in Patients with Severe COVID-19
Despite anticoagulation, a high number of patients with ARDS secondary to COVID-19 developed life-threatening thrombotic complications. Higher anticoagulation targets than in usual critically ill patients should therefore... read more
COVID-19: Tube Exchange
Emergency physicians rarely are involved in tube exchanges; I can't remember the last time I had to do one. However, during the COVID19 surge, we found ourselves boarding intubated patients for days and even weeks as our... read more
What’s Working for COVID-19 Patients in the Epicenter
Our large tertiary care ED in Queens, NY, usually sees more than 100,000 adults a year. As we write this, we have 850 COVID-19-likely or -positive patients (several hundred above our bed capacity just one month ago), more... read more
COVID-19 NIV: Helmet vs Mask
Over the past few weeks there has been a shift in the management of critically ill COVID-19 patients. Many seem to have moved away from an intubate early strategy to the use of high flow nasal cannula (HFNC) and noninvasive... read more
