318 results match your criteria Bag-Valve-Mask Ventilation


Six Hours of Manual Ventilation With a Bag-Valve-Mask Device Is Feasible and Clinically Consistent.

Crit Care Med 2019 Jan 10. Epub 2019 Jan 10.

County of San Diego, Health & Human Services Agency, Emergency Medical Services, San Diego, CA.

Objectives: Manual ventilation of intubated patients is a common intervention. It requires skill as well as physical effort and is typically restricted to brief periods. Prolonged manual ventilation may be unavoidable in some scenarios, for example, extreme mass casualty incidents. Read More

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http://dx.doi.org/10.1097/CCM.0000000000003632DOI Listing
January 2019

Efficacy, safety, and pharmacokinetics of intravenous midazolam in Japanese children with status epilepticus.

J Neurol Sci 2019 Jan 4;396:150-158. Epub 2018 Oct 4.

Department of Pediatrics, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan. Electronic address:

Background: No dosing regimen has been established for the initial treatment of pediatric status epilepticus with intravenous midazolam. We therefore evaluated the efficacy, safety, and pharmacokinetics of bolus and continuous midazolam infusion.

Methods: This open-label, prospective, multicenter study involved 34 Japanese children with status epilepticus unresponsive to diazepam. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S0022510X183041
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http://dx.doi.org/10.1016/j.jns.2018.09.035DOI Listing
January 2019
10 Reads

Efficacy of Manual Ventilation Techniques During Cardiopulmonary Resuscitation in Dogs.

Front Vet Sci 2018 1;5:239. Epub 2018 Oct 1.

Department of Veterinary Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States.

The efficacy of ventilation of dogs during cardiopulmonary resuscitation (CPR) with a tight fitting face mask or mouth-to-nose rescue breathing has not been evaluated. Twenty-four purpose bred research dogs: Dogs were randomized to be ventilated by cuffed orotracheal tube, tight fitting face mask, mouth-to-nose breathing or compressions only during CPR ( = 6 in all groups). Orotracheal tube and face mask ventilation was performed on room air. Read More

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https://www.frontiersin.org/article/10.3389/fvets.2018.00239
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http://dx.doi.org/10.3389/fvets.2018.00239DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6174302PMC
October 2018
12 Reads

Preferred learning modalities and practice for critical skills: a global survey of paediatric emergency medicine clinicians.

Emerg Med J 2018 Oct 16. Epub 2018 Oct 16.

Paediatric Research in Emergency Departments International Collaborative (PREDICT), Parkville, Victoria, Australia.

Objective: To describe senior paediatric emergency clinician perspectives on the optimal frequency of and preferred modalities for practising critical paediatric procedures.

Methods: Multicentre multicountry cross-sectional survey of senior paediatric emergency clinicians working in 96 EDs affiliated with the Pediatric Emergency Research Network.

Results: 1332/2446 (54%) clinicians provided information on suggested frequency of practice and preferred learning modalities for 18 critical procedures. Read More

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http://emj.bmj.com/lookup/doi/10.1136/emermed-2017-207384
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http://dx.doi.org/10.1136/emermed-2017-207384DOI Listing
October 2018
7 Reads

Does the Number of Fingers on the Bag Influence Volume Delivery? A Randomized Model Study of Bag-Valve-Mask Ventilation in Infants.

Children (Basel) 2018 Sep 21;5(10). Epub 2018 Sep 21.

Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz 8010, Austria.

We sought to compare the effectiveness of two versus five fingers used for bag-valve-mask (BVM) ventilation on effective tidal volume (V) delivery in an infant resuscitation model. In a randomised cross-over study, 40 healthcare professionals ventilated a modified leak-free infant resuscitation manikin with both two and five fingers, using a self-inflating bag. The delivered and effective tidal volumes, ventilation rate, and mask leak were measured and recorded using a respiratory function monitor. Read More

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http://www.mdpi.com/2227-9067/5/10/132
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http://dx.doi.org/10.3390/children5100132DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6209896PMC
September 2018
5 Reads

Updates in emergency airway management.

Curr Opin Crit Care 2018 Dec;24(6):525-530

Department of Emergency Medicine, University of Texas Health Science Center at Houston, Houston, Texas, USA.

Purpose Of Review: Historically, most evidence supporting emergency airway management strategies have been limited to small series, retrospective analyses and extrapolation from other settings (i.e. the operating room). Read More

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http://Insights.ovid.com/crossref?an=00075198-900000000-9915
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http://dx.doi.org/10.1097/MCC.0000000000000552DOI Listing
December 2018
9 Reads

Acute muscle fatigue and CPR quality assisted by visual feedback devices: A randomized-crossover simulation trial.

PLoS One 2018 19;13(9):e0203576. Epub 2018 Sep 19.

CLINURSID Research Group, University of Santiago de Compostela, Santiago de Compostela, Spain.

Objective: To analyse the acute muscular fatigue (AMF) in triceps brachii and rectus abdominis during compression-only and standard cardiopulmonary resuscitation (CPR) performed by certified basic life support providers.

Methods: Twenty-six subjects were initially recruited and randomly allocated to two study groups according to the muscles analysed; eighteen finally met the inclusion criteria (nine in each group). Both groups carried out two CPR tests (compression-only and standard CPR) of 10 min divided into five 2-min intermittent periods. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0203576PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6145543PMC
September 2018
9 Reads

Can Altering Grip Technique AND Bag Size Optimize Volume Delivered WITH Bag-Valve-Mask by Emergency Medical Service Providers?

Prehosp Emerg Care 2018 Aug 29:1-5. Epub 2018 Aug 29.

Introduction: Emergency Medical Services (EMS) professionals rely on the bag-valve-mask (BVM) to provide life-saving positive-pressure ventilation in the prehospital setting. Multiple emergency medicine and critical care studies have shown that lung-protective ventilation protocols reduce morbidity and mortality. A recent study has shown that the volumes typically delivered by EMS professionals with the adult BVM are often higher than recommended by lung-protective ventilation protocols. Read More

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http://dx.doi.org/10.1080/10903127.2018.1489020DOI Listing
August 2018
2 Reads

To intubate or not: ventilation is the question. A manikin-based observational study.

BMJ Open Respir Res 2018 17;5(1):e000261. Epub 2018 Jul 17.

Inserm CIC 1431, University Hospital of Besançon, Besancon, France.

Introduction: There is a continuous debate concerning the superiority of endotracheal intubation on bag-valve-mask (BVM) ventilation in patients with cardiac arrest. In this manikin-based observational study, we evaluate and compare the performance of manual ventilation through a facemask (BVM) and an endotracheal tube (ETT).

Methods: One hundred and forty healthcare providers were instructed to manually ventilate a manikin as they would do for a 75 kg adult patient in respiratory arrest. Read More

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http://bmjopenrespres.bmj.com/lookup/doi/10.1136/bmjresp-201
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http://dx.doi.org/10.1136/bmjresp-2017-000261DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6089311PMC
July 2018
13 Reads

The Effect of a Mechanical Compression Device and Supraglottic Airway on Flow Time: A Simulation Study of Out-of-Hospital Cardiac Arrest in a High-Rise Building.

Emerg Med Int 2018 16;2018:7246964. Epub 2018 Jul 16.

Department of Emergency Medical Services, College of Health and Nursing, Kongju National University, Gongju, Chungnam 32588, Republic of Korea.

High-rise buildings present unique challenges to providing high-quality CPR. We investigated the effect of using a mechanical compressor and supraglottic airway on flow time and CPR quality in simulated cardiac arrests occurring within a high-rise building. Twelve teams of EMS providers performed CPR according to 4 scenarios: manual compression and ventilation through bag-valve-mask (MAB) or supraglottic airway (MAS); mechanical compression and ventilation through bag-valve-mask (MEB) or supraglottic airway (MES). Read More

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http://dx.doi.org/10.1155/2018/7246964DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6077538PMC
July 2018
1 Read

Manual ventilation to prevent hypoxaemia during endotracheal intubation of critically ill adults: protocol and statistical analysis plan for a multicentre randomised trial.

BMJ Open 2018 Aug 10;8(8):e022139. Epub 2018 Aug 10.

Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Introduction: Hypoxaemia is the most common complication during endotracheal intubation of critically ill adults, and it increases the risk of cardiac arrest and death. Manual ventilation between induction and intubation has been hypothesised to decrease the incidence of hypoxaemia, but efficacy and safety data are lacking.

Methods And Analysis: The Preventing Hypoxemia with Manual Ventilation during Endotracheal Intubation trial is a prospective, multicentre, non-blinded randomised clinical trial being conducted in seven intensive care units in the USA. Read More

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http://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2018-02213
Publisher Site
http://dx.doi.org/10.1136/bmjopen-2018-022139DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6089322PMC
August 2018
16 Reads

Comparison of ventilation effectiveness of the bag valve mask and the LMA Air-Q SP in nurses during simulated CPR.

Pol Merkur Lekarski 2018 May;44(263):223-226

Medical University of Łódź, Poland: Chair of Anesthesiology and Intensive Care.

In a case of sudden cardiac arrest (SCA) in a health facility there is a procedure to summon a resuscitation team. Nurses are obliged to begin cardiopulmonary resuscitation with chest compressions and implement ventilation using the bag valve mask of 30:2 compressionventilation ratio. Nurses are not allowed to implement methods of advanced airway management. Read More

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May 2018
8 Reads

Impact of prehospital airway management on combat mortality.

Am J Emerg Med 2018 Jun 8;36(6):1032-1035. Epub 2018 Feb 8.

US Air Force En Route Care Research Center 59th MDW/ST, Chief Scientist's Office -US Army Institute of Surgical Research, JBSA Ft. Sam Houston, TX, United States; Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, United States.

Introduction: Analysis of modern military conflicts suggests that airway compromise remains the second leading cause of preventable death of combat fatalities. This study compares outcomes of combat casualties that received prehospital airway interventions, specifically bag valve mask (BVM) ventilation, cricothyrotomy, and supraglottic airway (SGA) placement. The goal is to compare the effectiveness of airway management strategies used in the military pre-hospital setting. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07356757183012
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http://dx.doi.org/10.1016/j.ajem.2018.02.007DOI Listing
June 2018
38 Reads

Fast or Slow Rescue Ventilations: A Predictive Model of Gastric Inflation.

Respir Care 2018 May 17;63(5):502-509. Epub 2018 Apr 17.

Department of Emergency Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.

Background: Rescue ventilations are given during respiratory and cardiac arrest. Tidal volume must assure oxygen delivery; however, excessive pressure applied to an unprotected airway can cause gastric inflation, regurgitation, and pulmonary aspiration. The optimal technique provides mouth pressure and breath duration that minimize gastric inflation. Read More

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http://dx.doi.org/10.4187/respcare.05620DOI Listing
May 2018
2 Reads

Delivering Chest Compressions and Ventilations With and Without Men's Lacrosse Equipment.

J Athl Train 2018 Apr 22;53(4):416-422. Epub 2018 Mar 22.

Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill.

Context:   Current management recommendations for equipment-laden athletes in sudden cardiac arrest regarding whether to remove protective sports equipment before delivering cardiopulmonary resuscitation are unclear.

Objective:   To determine the effect of men's lacrosse equipment on chest compression and ventilation quality on patient simulators.

Design:   Cross-sectional study. Read More

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http://dx.doi.org/10.4085/1062-6050-91-17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5967285PMC
April 2018
8 Reads

Higher Mallampati Scores Are Not Associated with More Adverse Events During Pediatric Procedural Sedation and Analgesia.

West J Emerg Med 2018 Mar 26;19(2):430-436. Epub 2018 Feb 26.

Children's Hospital of Pittsburgh of UPMC, Department of Pediatrics, Division of Pediatric Emergency Medicine, Pittsburgh, Pennsylvania.

Introduction: Procedural sedation and analgesia (PSA) is used by non-anesthesiologists (NAs) outside of the operating room for several types of procedures. Adverse events during pediatric PSA that pose the most risk to patient safety involve airway compromise. Higher Mallampati scores may indirectly indicate children at risk for airway compromise. Read More

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http://dx.doi.org/10.5811/westjem.2017.11.35913DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5851522PMC
March 2018
6 Reads

[Ventilation during cardiopulmonary resuscitation in the infant. Mouth to mouth and nose, or bag-valve-mask? A quasi-experimental study].

An Pediatr (Barc) 2018 Nov 21;89(5):272-278. Epub 2018 Feb 21.

CLINURSID, Grupo de Investigación, Facultad de Enfermería, Universidad de Santiago de Compostela, Santiago de Compostela, España.

Introduction: It has been observed that health professionals have difficulty performing quality cardiopulmonary resuscitation (CPR). The aim of this study was to compare the quality of ventilations performed by Nursing students on an infant model using different methods (mouth-to-mouth-and-nose or bag-valve-mask).

Material And Methods: A quasi-experimental cross-sectional study was performed that included 46 second-year Nursing students. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S16954033183001
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http://dx.doi.org/10.1016/j.anpedi.2017.12.014DOI Listing
November 2018
10 Reads

Effect of preoxygenation using non-invasive ventilation before intubation on subsequent organ failures in hypoxaemic patients: a randomised clinical trial.

Br J Anaesth 2018 Feb 23;120(2):361-367. Epub 2017 Nov 23.

Department of Critical Care Medicine and Anesthesiology (DAR B), Saint Eloi University Hospital and Montpellier School of Medicine, Medical Intensive Care Unit, Lapeyronie Teaching Hospital, INSERM U-1046/CNRS U-9234, Montpellier University, Montpellier, France.

Background: Previous data showed that non-invasive ventilation (NIV) applied for 3 min before tracheal intubation ensured better oxygenation compared with using a non-rebreather bag-valve-mask. We aimed to determine whether preoxygenation using NIV is effective in reducing the incidence of organ dysfunction in hypoxaemic, critically ill patients in intensive care.

Methods: A multicentre, randomised, open-label trial evaluating 100% FiO administered with NIV (99 patients) vs with face mask (102 patients) for 3 min before tracheal intubation. Read More

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http://dx.doi.org/10.1016/j.bja.2017.11.067DOI Listing
February 2018
4 Reads

Prehospital Rapid Sequence Intubation by Intensive Care Flight Paramedics.

Prehosp Emerg Care 2018 Sep-Oct;22(5):595-601. Epub 2018 Feb 6.

Objective: Rapid sequence intubation (RSI) is an advanced airway procedure for critically ill or injured patients. Paramedic-performed RSI in the prehospital setting remains controversial, as unsuccessful or poorly conducted RSI is known to result in significant complications. In Victoria, intensive care flight paramedics (ICFPs) have a broad scope of practice including RSI in both the adult and pediatric population. Read More

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http://dx.doi.org/10.1080/10903127.2018.1426666DOI Listing
February 2018
8 Reads

Differences in Return of Spontaneous Circulation in Early vs Late Endotracheal Intubation among Patients in Hospital Cardiac Arrest.

J Nepal Health Res Counc 2018 Jan 1;15(3):286-289. Epub 2018 Jan 1.

Shahid Gangalal National Heart Center, Kathmandu, Nepal.

Background: Common airway management strategies during cardiopulmonary resuscitation are bag- mask-valve ventilation followed by endotracheal intubation. Timing of endotracheal intubation is controversial. This study was designed to compare the effect of early vs late endotracheal intubation in terms of return of spontaneous circulation. Read More

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January 2018
3 Reads

Feasibility of single- vs two-physician procedural sedation in a small community emergency department.

Am J Emerg Med 2018 Jun 3;36(6):977-982. Epub 2017 Nov 3.

The Permanente Medical Group, the Kaiser Permanente Division of Research, and the KP CREST Network, Oakland, CA, United States; Kaiser Permanente Sacramento Medical Center, Sacramento, CA, United States.

Objective: Sedation is commonly required for painful procedures in the emergency department (ED). Some facilities mandate two physicians be present for deep sedation cases. Evidence is lacking, however, that a two-physician approach improves safety outcomes. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07356757173091
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http://dx.doi.org/10.1016/j.ajem.2017.11.003DOI Listing
June 2018
51 Reads

Bag Valve Mask Ventilation as a Perceptual-Cognitive Skill.

Hum Factors 2018 03 4;60(2):212-221. Epub 2017 Dec 4.

Navicent Health, Macon, Georgia.

Objective This study used a high-fidelity infant mannequin to examine the relationship between the quality of bag valve mask ventilation (BVMV) and how providers of varying levels of experience use visual feedback (e.g., electronic vital signs) to guide their performance. Read More

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http://dx.doi.org/10.1177/0018720817744729DOI Listing
March 2018
5 Reads

Donohue syndrome: A review of literature, case series, and anesthetic considerations.

Paediatr Anaesth 2018 Jan 17;28(1):23-27. Epub 2017 Nov 17.

Department of Anaesthesia, Great Ormond Street Hospital, London, UK.

Background: Donohue syndrome is a rare autosomal recessive disorder of insulin resistance, causing a functional defect in insulin receptor function, and affecting the ability of the insulin to bind the receptor. Features include severe hyperinsulinism and fasting hypoglycemia, along with severe failure to thrive despite feeding. An accelerated fasting state results in muscle wasting, decreased subcutaneous fat, and an excess of thick skin. Read More

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http://dx.doi.org/10.1111/pan.13273DOI Listing
January 2018
8 Reads

Tracheal agenesis: optimization of computed tomography diagnosis by airway ventilation.

Pediatr Radiol 2018 03 17;48(3):427-432. Epub 2017 Nov 17.

Department of Pediatric Radiology, University Hospital of Geneva, Geneva, Switzerland.

Tracheal agenesis is a rare and often lethal congenital defect that leads to airway emergency at birth. Computed tomography (CT) is the modality of choice to evaluate anomalous tracheal anatomy. The absence of spontaneous aeration of the tracheobronchial tree in children with tracheal agenesis makes CT interpretation difficult. Read More

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http://dx.doi.org/10.1007/s00247-017-4024-5DOI Listing
March 2018
7 Reads

Preoxygenation With Flush Rate Oxygen: Comparing the Nonrebreather Mask With the Bag-Valve Mask.

Ann Emerg Med 2018 03 28;71(3):381-386. Epub 2017 Oct 28.

Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN; Division of Pulmonary/Critical Care, Department of Medicine, Hennepin County Medical Center, Minneapolis, MN.

Study Objective: Nonrebreather masks and bag-valve masks are used for preoxygenation before emergency intubation. Flush rate oxygen delivered with a nonrebreather mask is noninferior to bag-valve mask oxygen at 15 L/min. We seek to compare the nonrebreather mask with flush rate oxygen to a bag-valve mask with flush rate oxygen (with and without inspiratory assistance) and determine whether the efficacy of bag-valve mask with flush rate oxygen is compromised by a simulated mask leak. Read More

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http://dx.doi.org/10.1016/j.annemergmed.2017.09.017DOI Listing
March 2018
3 Reads

Can Providers Use Clinical Skills to Assess the Adequacy of Ventilation in Children During Bag-Valve Mask Ventilation?

Pediatr Emerg Care 2017 Oct 27. Epub 2017 Oct 27.

From the *Department of Emergency Medicine, Bridgeport Hospital; †Section of Pediatric Emergency Medicine, Department of Pediatrics, and ‡Section of Pediatric Emergency Medicine, Department of Emergency Medicine, Yale University School of Medicine.

Objective: Bag-valve mask (BVM) ventilation requires both manual skill and clinical assessment of minute ventilation. Subjective factors can make supplying appropriate ventilation difficult. Capnography is not routinely used when ventilating nonintubated patients. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001314DOI Listing
October 2017
9 Reads

EMT-led laryngeal tube vs. face-mask ventilation during cardiopulmonary resuscitation - a multicenter prospective randomized trial.

Scand J Trauma Resusc Emerg Med 2017 Oct 26;25(1):104. Epub 2017 Oct 26.

Department of Anaesthesiology and Intensive Care Medicine, Hospitallers Brothers Hospital, Teaching Hospital of the Paracelsus Private Medical University Salzburg, Salzburg, Austria.

Background: Laryngeal tube (LT) application by rescue personnel as an alternate airway during the early stages of out-of-hospital cardiac arrest (OHCA) is still subject of debate. We evaluated ease of handling and efficacy of ventilation administered by emergency medical technicians (EMTs) using LT and bag-valve-mask (BVM) during cardiopulmonary resuscitation of patients with OHCA.

Methods: An open prospective randomized multicenter study was conducted at six emergency medical services centers over 18 months. Read More

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http://dx.doi.org/10.1186/s13049-017-0446-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5658918PMC
October 2017
22 Reads

The Effect of Successful Intubation on Patient Outcomes After Out-of-Hospital Cardiac Arrest in Taipei.

Ann Emerg Med 2018 03 28;71(3):387-396.e2. Epub 2017 Sep 28.

Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Emergency Medicine, National Taiwan University Hospital, Yun-Lin Branch, Yun-Lin County, Taiwan. Electronic address:

Study Objective: The effect of out-of-hospital intubation in patients with out-of-hospital cardiac arrest remains controversial. The Taipei City paramedics are the earliest authorized to perform out-of-hospital intubation among Asian areas. This study evaluates the association between successful intubation and out-of-hospital cardiac arrest survival in Taipei. Read More

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http://dx.doi.org/10.1016/j.annemergmed.2017.08.008DOI Listing
March 2018
23 Reads

A Comparison of Ventilation Rates Between a Standard Bag-Valve-Mask and a New Design in a Prehospital Setting During Training Simulations.

J Spec Oper Med Fall 2017;17(3):59-63

Background: Excessive ventilation of sick and injured patients is associated with increased morbidity and mortality. Combat Medical Systems® (CMS) is developing a new bag-valve-mask (BVM) designed to limit ventilation rates. The purpose of this study was to compare ventilation rates between a standard BVM device and the CMS device. Read More

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December 2017
5 Reads

Prehospital Cricothyrotomy Kits Used in Combat.

J Spec Oper Med Fall 2017;17(3):18-20

Background: Surgical cricothyrotomy remains the only definitive airway management modality for the tactical setting recommended by Tactical Combat Casualty Care guidelines. Some units have fielded commercial cricothyrotomy kits to assist Combat Medics with surgical cricothyrotomy. To our knowledge, no previous publications report data on the use of these kits in combat settings. Read More

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December 2017
23 Reads

Evaluation of the Augmented Infant Resuscitator: A Monitoring Device for Neonatal Bag-Valve-Mask Resuscitation.

Anesth Analg 2018 03;126(3):947-955

From the Department of Respiratory Care, Massachusetts General Hospital, Boston, Massachusetts.

Background: Annually, 6 million newborns require bag-valve-mask resuscitation, and providing live feedback has the potential to improve the quality of resuscitation. The Augmented Infant Resuscitator (AIR), a real-time feedback device, has been designed to identify leaks, obstructions, and inappropriate breath rates during bag-valve-mask resuscitation. However, its function has not been evaluated. Read More

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http://dx.doi.org/10.1213/ANE.0000000000002432DOI Listing
March 2018
29 Reads

A comparison of pediatric airway management techniques during out-of-hospital cardiac arrest using the CARES database.

Resuscitation 2017 11 22;120:51-56. Epub 2017 Aug 22.

Center for Policy and Research in Emergency Medicine, Oregon Health & Science University, United States.

Objective: To compare odds of survival to hospital discharge among pediatric out-of-hospital cardiac arrest (OHCA) patients receiving either bag-valve-mask ventilation (BVM), supraglottic airway (SGA) or endotracheal intubation (ETI), after adjusting for the propensity to receive a given airway intervention.

Methods: Retrospective cohort study using the Cardiac Arrest Registry to Enhance Survival (CARES) database from January 1 201-December 31, 2015. The CARES registry includes data on cardiac arrests from 17 statewide registries and approximately 55 additional US cities. Read More

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http://dx.doi.org/10.1016/j.resuscitation.2017.08.015DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5660668PMC
November 2017
9 Reads

The Pediatric Submersion Score Predicts Children at Low Risk for Injury Following Submersions.

Acad Emerg Med 2017 12 23;24(12):1491-1500. Epub 2017 Sep 23.

Department of Pediatrics, Baylor College of Medicine, Houston, TX.

Objectives: Pediatric submersion victims often require admission. We wanted to identify a cohort of children at low risk for submersion-related injury who can be safely discharged from the emergency department (ED) after a period of observation.

Methods: This was a single-center retrospective derivation/validation cross-sectional study of children (0-18 years) who presented postsubmersion to a tertiary care, children's hospital ED from 2008 to 2015. Read More

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http://dx.doi.org/10.1111/acem.13278DOI Listing
December 2017
15 Reads

Single Rescuer Ventilation Using a Bag Valve Mask with Removable External Handle: A Randomized Crossover Trial.

Prehosp Disaster Med 2017 Dec 15;32(6):625-630. Epub 2017 Aug 15.

Department of Emergency Medicine,San Antonio Uniformed Services Health Education Consortium,San Antonio,TexasUSA.

Introduction Ventilation with a bag valve mask (BVM) is a challenging but critical skill for airway management in the prehospital setting. Hypothesis Tidal volumes received during single rescuer ventilation with a modified BVM with supplemental external handle will be higher than those delivered using a standard BVM among health care volunteers in a manikin model.

Methods: This study was a randomized crossover trial of adult health care providers performing ventilation on a manikin. Read More

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http://dx.doi.org/10.1017/S1049023X17006860DOI Listing
December 2017
8 Reads

Benefits of Manometer in Non-Invasive Ventilatory Support.

Prehosp Disaster Med 2017 Dec 26;32(6):615-620. Epub 2017 Jul 26.

1Department of Emergency Medical Services-Fire Academy,Escola Superior de Bombeiros-Polícia Militar do Estado de São Paulo,Franco da Rocha,Brazil.

Introduction Effective ventilation during cardiopulmonary resuscitation (CPR) is essential to reduce morbidity and mortality rates in cardiac arrest. Hyperventilation during CPR reduces the efficiency of compressions and coronary perfusion. Problem How could ventilation in CPR be optimized? The objective of this study was to evaluate non-invasive ventilator support using different devices. Read More

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http://dx.doi.org/10.1017/S1049023X17006719DOI Listing
December 2017
6 Reads

Respiratory support techniques to avoid desaturation in critically ill patients requiring endotracheal intubation: A systematic review and meta-analysis.

J Crit Care 2017 10 8;41:98-106. Epub 2017 May 8.

Department of Biopathology and Medical Biotechnologies (DIBIMED), Section of Anesthesia, Analgesia, Intensive Care and Emergency, University Hospital Paolo Giaccone, University of Palermo, Via del vespro 129, 90127 Palermo, Italy.

Purpose: To evaluate which respiratory support method for critically ill patients undergoing endotracheal intubation (ETI) is associated with less desaturation.

Methods: We searched PubMed, Cochrane Library, Scopus and CINAHL databases. We included randomized (RCT) and non-randomized (non-RCT) studies investigating any method of respiratory support before/during ETI compared to a reference control. Read More

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http://dx.doi.org/10.1016/j.jcrc.2017.05.003DOI Listing
October 2017
40 Reads

No small matter: pediatric resuscitation.

Curr Opin Crit Care 2017 Jun;23(3):193-198

aDepartment of Emergency Medicine, Denver Health Medical Center, Denver, Colorado bDepartment of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado cDepartments of Emergency Medicine, Internal Medicine, School of Public Health and Office of Health System Affairs, The University of Texas Southwestern Medical Center, Dallas, Texas, USA.

Purpose Of Review: To present advancements in pediatric cardiac arrest research, highlighting articles most relevant to clinical practice published since the latest international guidelines for cardiopulmonary resuscitation (CPR).

Recent Findings: Clinical trials examining targeted temperature management in children support avoidance of hyperthermia for both pediatric in-hospital cardiac arrest (PIHCA) and out-of-hospital cardiac arrest (POHCA), but no statistically significant outcome differences were confirmed comparing 33 and 36 °C in the limited populations studied. Retrospective analyses of population-based POHCA registries revealed several associations: both bystander CPR and public-access defibrillation were associated with improved POHCA outcomes; conflicting results overshadow the benefits of conventional versus compression-only CPR; extracorporeal CPR was associated with improved PIHCA outcomes regardless of cause; intubation in PIHCA was associated with decreased survival, whereas there were no significant differences in outcomes between advanced airway management and bag-valve-mask ventilation in POHCA; and early epinephrine delivery in nonshockable rhythms during PIHCA was associated with improved outcomes. Read More

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http://dx.doi.org/10.1097/MCC.0000000000000410DOI Listing
June 2017
3 Reads

A prospective, randomised trial of pre-oxygenation strategies available in the pre-hospital environment.

Anaesthesia 2017 May 14;72(5):580-584. Epub 2017 Mar 14.

London's Air Ambulance, Bart's Health NHS Trust, London, UK.

Pre-oxygenation before tracheal intubation aims to increase safe apnoea duration by denitrogenation of the functional residual capacity of the lungs, and increasing oxygen stores at the onset of apnoea. Pre-oxygenation options in the pre-hospital environment are limited due to oxygen availability and equipment portability. The aim of this study was to evaluate the effectiveness of strategies available in this setting. Read More

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http://dx.doi.org/10.1111/anae.13852DOI Listing
May 2017
1 Read

Obstructed Infradiaphragmatic Total Anomalous Pulmonary Venous Return in a 13-Day-Old Infant Presenting Acutely to the Emergency Department: A Case Report.

J Emerg Med 2017 Jun 10;52(6):e239-e243. Epub 2017 Mar 10.

Department of Emergency Medicine, University of Arizona College of Medicine, Tucson, Arizona; Department of Pediatrics, University of Arizona College of Medicine, Tucson, Arizona.

Background: Total anomalous pulmonary venous return (TAPVR) is an uncommon congenital heart defect. Obstructed forms are more severe, and typically present earlier in life, usually in the immediate newborn period, with symptoms of severe cyanosis and respiratory failure.

Case Report: A 13-day-old boy presented to the emergency department (ED) with respiratory extremis. Read More

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http://dx.doi.org/10.1016/j.jemermed.2017.01.051DOI Listing
June 2017
9 Reads

Effect of prehospital advanced airway management for pediatric out-of-hospital cardiac arrest.

Resuscitation 2017 05 4;114:66-72. Epub 2017 Mar 4.

Department of Emergency and Critical Care Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.

Background: Respiratory care may be important in pediatric out-of-hospital cardiac arrest (OHCA) due to the asphyxial nature of the majority of events. However, evidence of the effect of prehospital advanced airway management (AAM) for pediatric OHCA is scarce.

Methods: This was a nationwide population-based study of pediatric OHCA in Japan from 2011 to 2012 based on data from the All-Japan Utstein Registry. Read More

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http://dx.doi.org/10.1016/j.resuscitation.2017.03.002DOI Listing
May 2017
6 Reads

Comparison of four techniques on facility of two-hand Bag-valve-mask (BVM) ventilation: E-C, Thenar Eminence, Thenar Eminence (Dominant hand)-E-C (non-dominant hand) and Thenar Eminence (non-dominant hand) - E-C (dominant hand).

J Cardiovasc Thorac Res 2016 27;8(4):147-151. Epub 2016 Dec 27.

Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

Bag-valve-mask (BVM) ventilation is the first and important part of the airway management. The aim of present study was to evaluate the quality of four different BVM ventilation techniques - E-C, Thenar Eminence, Thenar Eminence (Dominant hand)-E-C (Non dominant hand), and Thenar Eminence (Non dominant hand)-E-C (Dominant hand) - among two novice and experienced groups. In a case-control and mannequin based study that was conducted in Tabriz University of medical sciences, 120 volunteers were recruited and divided into two groups. Read More

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http://dx.doi.org/10.15171/jcvtr.2016.30DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5304096PMC
December 2016
16 Reads

Respiratory adverse events during upper digestive endoscopies in children under Ketamine sedation.

Minerva Pediatr 2017 02 7. Epub 2017 Feb 7.

Pediatric Gastroenterology Unit, Puerta del Mar University Hospital, Cadiz, Spain.

Background: There is no evidence of the need for oxygen supplementation during upper digestive endoscopies under Ketamine sedation in children, and the latest recommendations specifically state that it is not mandatory for the procedure. The aim of our study is to assess the incidence of respiratory adverse events during upper digestive endoscopies in children under Ketamine sedation when performed without oxygen supplementation, in accordance with the latest recommendations.

Methods: 88 children undergoingketamine sedation for programmed upper digestive endoscopy at our Pediatric Intensive Care Unit were included. Read More

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http://dx.doi.org/10.23736/S0026-4946.16.04758-7DOI Listing
February 2017
10 Reads

Competence in the use of supraglottic airways by Australian surf lifesavers for cardiac arrest ventilation in a manikin.

Emerg Med Australas 2017 Feb 11;29(1):63-68. Epub 2017 Jan 11.

Life Saving Victoria, Melbourne, Victoria, Australia.

Objectives: Lifesavers in Australia are taught to use pocket mask (PM) rescue breathing and bag valve mask (BVM) ventilation, despite evidence that first responders might struggle with these devices. Novices have successfully used the Laryngeal Mask Airway (LMA) Supreme and iGel devices previously, but there has been no previous comparison of the ability to train lifesavers to use the supraglottic airways compared to standard techniques for cardiac arrest ventilation.

Methods: The study is a prospective educational intervention whereby 113 lifesavers were trained to use the LMA and iGel supraglottic airways. Read More

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http://dx.doi.org/10.1111/1742-6723.12719DOI Listing
February 2017
13 Reads

Analysis of out-of-hospital cardiac arrest in Croatia - survival, bystander cardiopulmonary resuscitation, and impact of physician's experience on cardiac arrest management: a single center observational study.

Croat Med J 2016 Dec;57(6):591-600

Anita Lukic, V. Sokola 19, Varazdin, HR42000, Croatia,

Aim: To analyze the initial rhythm, bystander cardiopulmonary resuscitation (CPR) rate, and survival after out-of-hospital cardiac arrests (OHCA) in Varaľdin County (Croatia), and to investigate whether physician's inexperience in emergency medical services (EMS) has an impact on resuscitation management.

Methods: We reviewed clinical records and Revised Utstein cardiac arrest forms of all out-of-hospital resuscitations performed by EMS Varaľdin (EMSVz), Croatia, from 2007-2013. To analyze the impact of physician's inexperience in EMS (<1 year in EMS) on resuscitation management, we assessed physician's turnover in EMSVz, as well as OHCA survival, airway management, and adherence to resuscitation guidelines in regard to physician's EMS experience. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5209925PMC
December 2016
23 Reads

Patient safety events in out-of-hospital paediatric airway management: a medical record review by the CSI-EMS.

BMJ Open 2016 11 11;6(11):e012259. Epub 2016 Nov 11.

Department of Emergency Medicine, Oregon Health & Science University, Portland, Oregon, USA.

Objective: To describe the frequency and characterise the nature of patient safety events in paediatric out-of-hospital airway management.

Methods: We conducted a retrospective cross-sectional medical record review of all 'lights and sirens' emergency medicine services transports from 2008 to 2011 in patients <18 years of age in the Portland Oregon metropolitan area. A chart review tool (see online supplementary appendix) was adapted from landmark patient safety studies and revised after pilot testing. Read More

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http://dx.doi.org/10.1136/bmjopen-2016-012259DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5128842PMC
November 2016
11 Reads

Fatal Fentanyl: One Pill Can Kill.

Acad Emerg Med 2017 01 31;24(1):106-113. Epub 2016 Oct 31.

Veterans Affairs Northern California, Mather, CA.

Objective: The current national opioid epidemic is a public health emergency. We have identified an outbreak of exaggerated opioid toxicity caused by fentanyl adulterated tablets purchased on the street as hydrocodone/acetaminophen.

Methods: Over an 8-day period in late March 2016, a total of 18 patients presented to our institution with exaggerated opioid toxicity. Read More

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http://dx.doi.org/10.1111/acem.13034DOI Listing
January 2017
40 Reads
5 Citations
2.010 Impact Factor