Tag: intubation
Trying Not to Intubate Early & Why ARDSnet may be the Wrong Ventilator Paradigm
Many of us have been working under the paradigm that COVID-19 PNA eventually develops into ARDS in the sickest patients. It appears to me that these patients don’t fit into this paradigm. Many have normal to high compliance... read more
Patient Self-proning with HFNC Improves Oxygenation in COVID-19 Pneumonia
A high-flow nasal cannula (HFNC) is commonly used in the management of hypoxic respiratory failure, and is associated with more ventilator-free days and lower mortality compared with standard oxygen therapy or non-invasive... read more
Constantly Shifting Strategies for COVID-19
We are all learning as we go, but we are seeing more than 200 COVID-19 patients every day in our emergency department in Queens, NY, and this is what we are doing to evaluate and treat patients, keep everyone safe, and boost... read more
Understanding Happy Hypoxemia Physiology During COVID-19
Happy hypoxemia is severe hypoxemia (poorly responsive to supplemental oxygen) without dyspnea. This isn't anything especially new – we have occasionally seen this since time immemorial. However, COVID is causing us to... read more
Oxygen Escalation Therapy and Noninvasive Ventilation During COVID-19
We are in the midst of the COVID-19 pandemic. Many parts of the world have been ravaged by this virus, but disease severity varies significantly. There are several types of patients with COVID-19: those who have mild disease... read more
Pediatric Airway Management in COVID-19 Patients
The severe acute respiratory syndrome coronavirus 2 (COVID-19) pandemic has challenged medical systems and clinicians globally to unforeseen levels. COVID-19's rapid spread has forced clinicians to care for patients with... read more
The Walls Manual of Emergency Airway Management
The Walls Manual of Emergency Airway Management is the world's most trusted reference on emergency airway management, and is the foundation text in the nationally recognized The Difficult Airway Course: Emergency and The... read more
Restoring Humanity In The ICU During COVID-19
Machines, tubes, wires, drugs, isolation, confusion... how can we protect the dignity and sanity of our patients when they're at their most vulnerable? Dr. Wes Ely is a Vanderbilt professor and critical care doc who can... read more
Top 5 COVID-19 Online Training Courses For Nurses
Nurses all around the country are being cross-trained to work in higher acuity or critical care patient areas as fast as possible to maximize efforts against COVID-19. But as nurses step out of their comfort zones, there... read more
COVID-19 Evolving Indications for Intubation
Hypoxemia and tachypnea should not be the sole indications for intubation, but rather a complete clinical assessment including work of breathing, mental status and increasing PaCO2 and/or acidosis. Based on experience... read more
COVID-19 Emergency Intubation Simulation Guidance
Glenfield Hospital have produced a simulation based on the above joint guidance which may be helpful for teaching and familiarisation. Small modifications have been made based on local resources and feedback. Thanks to the... read more
Safe Airway Society Principles of Airway Management and Tracheal Intubation Specific to the COVID-19
Transmission of COVID-19 is primarily through droplet spread. These droplets are affected by gravity and may cause direct transmission from close contact or contribute to surface contamination (where the virus may remain... read more
Impact of Paralytic Agent on Postintubation Sedation
The aim of this study was to evaluate the difference in the time to postintubation sedation between patients receiving etomidate and either succinylcholine or rocuronium in the prehospital setting. This study suggests... read more
Holding Intubated Infants Well Tolerated and Safe
Critically ill infants who are old enough to move on their own but too young to cooperate with care instructions have been among the last to benefit from patient mobility initiatives. Results from a holding intervention... read more
High Flow Nasal Cannula Benefits and Pitfalls
Emergency physicians should be familiar with the benefits and pitfalls of high-flow nasal cannula (HFNC). HFNC is well tolerated by patients, and its use contributes to superior outcomes for patients with pure hypoxemic... read more
Bougies for all intubations led to high success rates, even on difficult airways
In a randomized trial, the routine use of bougies on every DL intubation led to a higher rate of first-pass intubation success. And even allowing for the two-step technique (bougie insertion followed by ET tube insertion),... read more
Video Laryngoscopy Does Not Improve Intubation Outcomes in Critical Patients
On the basis of the results of this study, we conclude that, compared with direct laryngoscopy, video laryngoscopy does not improve intubation outcomes in emergency and critical patients. Prehospital intubation is even worsened... read more
Apneic Oxygenation As a Quality Improvement Intervention in an Academic PICU
Implementation of apneic oxygenation in PICU was feasible, and was associated with significant reduction in moderate and severe oxygen desaturation. Use of apneic oxygenation should be considered when intubating critically... read more
Prehospital Rapid Sequence Intubation Improves Functional Outcome for Patients with Severe TBI
In adults with severe traumatic brain injury (TBI), prehospital rapid sequence intubation by paramedics increases the rate of favorable neurologic outcome at 6 months compared with intubation in the hospital. A total of... read more
Newer Drug Fails Quick Prehospital Intubation
Among patients undergoing endotracheal intubation in an out-of-hospital emergency setting, rocuronium, compared with succinylcholine, failed to demonstrate noninferiority with regard to first-attempt intubation success rate. Among... read more
Vasopressin for Acute Hemorrhage?
Vasoactive medications are one of the pillars of management of shock in Emergency Departments. Inopressors, namely Norepinephrine and Epinephrine, are the two most commonly used pressors in US Emergency Departments, used... read more
PICU Up! A Multicomponent Early Mobility Intervention for Critically Ill Children
Pediatric intensive units traditionally have had a culture where critically ill children are intubated and mechanically ventilated, immobilized, and highly sedated. This practice is primarily driven by a focus on safety... read more
