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    756 results match your criteria Tracheal Intubation Rapid Sequence Intubation

    1 OF 16

    A comparison of emergency airway management between neuromuscular blockades alone and rapid sequence intubation: an analysis of multicenter prospective study.
    BMC Res Notes 2017 Jan 3;10(1). Epub 2017 Jan 3.
    Departments of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
    Background: Although airway management with neuromuscular blockade (NMB) alone is discouraged in the emergency department (ED), our previous study demonstrated that many patients were intubated using NMBs alone without sedatives. To refute this practice, we sought to compare the intubation success and adverse event rates between NMBs only and rapid sequence intubation (RSI).

    Methods: This is a secondary analysis of the data from a prospective observational study of ED patients in 13 hospitals who underwent emergency airway management from April 2010 to August 2012. Read More

    A randomised controlled trial comparing transnasal humidified rapid insufflation ventilatory exchange (THRIVE) pre-oxygenation with facemask pre-oxygenation in patients undergoing rapid sequence induction of anaesthesia.
    Anaesthesia 2016 Dec 30. Epub 2016 Dec 30.
    Department of Otolaryngology - Head and Neck Surgery, University College Hospital NHS Foundation Trust, London, UK.
    Pre-oxygenation is an essential part of rapid sequence induction of general anaesthesia for emergency surgery, in order to increase the oxygen reservoir in the lungs. We performed a randomised controlled trial of transnasal humidified rapid insufflation ventilatory exchange (THRIVE) pre-oxygenation or facemask pre-oxygenation in patients undergoing emergency surgery. Twenty patients were allocated to each group. Read More

    The All India Difficult Airway Association 2016 guidelines for tracheal intubation in the Intensive Care Unit.
    Indian J Anaesth 2016 Dec;60(12):922-930
    Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Mumbai, Maharashtra, India.
    Tracheal intubation (TI) is a routine procedure in the Intensive Care Unit (ICU) and is often life-saving. In contrast to the controlled conditions in the operating room, critically ill patients with respiratory failure and shock are physiologically unstable. These factors, along with a suboptimal evaluation of the airway and limited oxygen reserves despite adequate pre-oxygenation, are responsible for a high incidence of life-threatening complications such as severe hypoxaemia and cardiovascular collapse during TI in the ICU. Read More

    All India Difficult Airway Association 2016 guidelines for the management of unanticipated difficult tracheal intubation in obstetrics.
    Indian J Anaesth 2016 Dec;60(12):899-905
    Department of Paediatric Anaesthesia, Kanchi Kamakoti CHILDS Trust Hospital, Chennai, Tamil Nadu, India.
    The various physiological changes in pregnancy make the parturient vulnerable for early and rapid desaturation. Severe hypoxaemia during intubation can potentially compromise two lives (mother and foetus). Thus tracheal intubation in the pregnant patient poses unique challenges, and necessitates meticulous planning, ready availability of equipment and expertise to ensure maternal and foetal safety. Read More

    Prevention of aspiration of gastric contents during attempt in tracheal intubation in the semi-lateral and lateral positions.
    World J Emerg Med 2016 ;7(4):285-289
    Department of Anesthesia, Kitakyushu General Hospital, 5-10-10 Yugawa, Kokuraminami, Kitakyushu 800-0295, Japan.
    Background: Pulmonary aspiration of gastric contents during tracheal intubation is a life-threatening complication in emergency patients. Rapid sequence intubation is commonly performed to prevent aspiration but is not associated with low risk of intubation related complications. Although it has been considered that aspiration can be prevented in the lateral position, few studies have evaluated the ability to prevent aspiration. Read More

    Choice of anaesthesia for category-1 caesarean section in women with anticipated difficult tracheal intubation: the use of decision analysis.
    Anaesthesia 2017 Feb 30;72(2):156-171. Epub 2016 Nov 30.
    Department of Anesthesiology and Director, Mother and Child Anesthesia Unit, Hadassah Hebrew University Hospital, Jerusalem, Israel.
    A predicted difficult airway is sometimes considered a contra-indication to rapid sequence induction of general anaesthesia, even in an urgent case such as a category-1 caesarean section for fetal distress. However, formally assessing the risk is difficult because of the rarity and urgency of such cases. We have used decision analysis to quantify the time taken to establish anaesthesia, and probability of failure, of three possible anaesthetic methods, based on a systematic review of the literature. Read More

    Dose requirements of alfentanil to eliminate autonomic responses during rapid-sequence induction with thiopental 4 mg/kg and rocuronium 0.6 mg/kg.
    J Clin Anesth 2016 Dec 18;35:465-474. Epub 2016 Oct 18.
    Department of Anesthesia, Division of Emergencies and Critical Care Medicine, Oslo University Hospital and University of Oslo, Oslo, Norway. Electronic address:
    Study Objective: Opioids are integral part of anesthesia induction, but information on optimal dosing is limited. We aimed to determine doses of alfentanil needed to eliminate increases in 5 autonomic response variables (plasma concentrations of epinephrine, norepinephrine and vasopressin, arterial blood pressure [ABP], and heart rate) during rapid-sequence induction of anesthesia with thiopental 4 mg/kg and rocuronium 0.6 mg/kg. Read More

    Comparison of rocuronium at two different doses and succinylcholine for endotracheal intubation in adult patients for elective surgeries.
    Saudi J Anaesth 2016 Oct-Dec;10(4):379-383
    Department of Anesthesiology, ESIC Medical College and Hospital, Parippally, Kollam, Kerala, India.
    Background: The effects of rocuronium at two different doses, that is, 0.6 mg/kg (2 × ED95) and 0.9 mg/kg (3 × ED95), were compared with succinylcholine (2 mg/kg) when used for endotracheal intubation in adult patients for elective surgeries under general anesthesia. Read More

    C-MAC videolaryngoscope compared with direct laryngoscopy for rapid sequence intubation in an emergency department: A randomised clinical trial.
    Eur J Anaesthesiol 2016 Dec;33(12):943-948
    From the Institute of Anaesthesiology, University and University Hospital Zurich (SS, DU, MS, MB, DRS, KR), Institute of Physiology, University Zurich, Zurich, Switzerland (MS), Department of Internal Medicine 2, Medical University Vienna, Vienna, Austria (GG), Epidemiology, Biostatistics and Prevention Institute, Department of Biostatistics, University of Zurich, Switzerland (BS), and Department of Outcomes Research; Department of General Anaesthesiology, Anaesthesiology Institute, Cleveland Clinic, Cleveland, Ohio, USA (KR) *Simon Sulser and Dirk Ubmann contributed equally to the writing of this article.
    Background: Airway management in the emergency room can be challenging when patients suffer from life-threatening conditions. Mental stress, ignorance of the patient's medical history, potential cervical injury or immobilisation and the presence of vomit and/or blood may also contribute to a difficult airway. Videolaryngoscopes have been introduced into clinical practice to visualise the airway and ultimately increase the success rate of airway management. Read More

    Anesthesia in pregnant women with HELLP syndrome: case report.
    Braz J Anesthesiol 2016 Nov - Dec;66(6):657-660. Epub 2016 Oct 1.
    Centro de Ensino e Treinamento em Anestesiologia (CET-SBA) da Clínica de Anestesiologia de Ribeirão Preto (CARP), Ribeirão Preto, SP, Brazil.
    Background And Objectives: HELLP syndrome, characterized by hemolysis, high levels of liver enzyme, and low platelet count, is an advanced clinical stage of pre-eclampsia, progressing to high maternal (24%) and perinatal (up 40%) mortality, despite childbirth care in a timely manner. The goal is to describe the anesthetic management of a case with indication to emergency cesarean.

    Case Report: Female patient, 36 years old, gestational age of 24 weeks, with hypertensive crisis (BP 180/100mmHg) and severe headache, was admitted to the operating room for a cesarean section after diagnosis of HELLP syndrome. Read More

    [Anesthesia in pregnant women with HELLP syndrome: case report].
    Rev Bras Anestesiol 2016 Nov - Dec;66(6):657-660. Epub 2014 Nov 27.
    Centro de Ensino e Treinamento em Anestesiologia (CET-SBA) da Clínica de Anestesiologia de Ribeirão Preto (CARP), Ribeirão Preto, SP, Brasil.
    Background And Objectives: HELLP syndrome, characterized by hemolysis, high levels of liver enzyme, and low platelet count, is an advanced clinical stage of pre-eclampsia, progressing to high maternal (24%) and perinatal (up 40%) mortality, despite childbirth care in a timely manner. The goal is to describe the anesthetic management of a case with indication to emergency caesarean.

    Case Report: Female patient, 36 years old, gestational age of 24 weeks, with hypertensive crisis (BP 180/100 mmHg) and severe headache, was admitted to the operating room for a cesarean section after diagnosis of HELLP syndrome. Read More

    Hazards of intubation in the ICU: role of nasal high flow oxygen therapy for preoxygenation and apneic oxygenation to prevent desaturation.
    Minerva Anestesiol 2016 Oct 6;82(10):1098-1106. Epub 2016 May 6.
    AP-HP, Hôpital Louis Mourier, Service de Réanimation Médico-Chirurgicale, Colombes, France -
    Acute respiratory failure is one the most common motives for intensive care unit admission. Although results from recent studies with high flow nasal oxygen have challenged our current management of these patients, a substantial number of them will require invasive mechanical ventilation and tracheal intubation. Life-threatening hypoxemia is the most frequent complication of these intubations. Read More

    Perioperative management of a morbidly obese pregnant patient undergoing cesarean section under general anesthesia - case report.
    Braz J Anesthesiol 2016 Jul-Aug;66(4):418-22. Epub 2016 Apr 30.
    Centro de Ensino e Treinamento da Sociedade Brasileira de Anestesiologia (CET/SBA), Cuiabá, MT, Brazil.
    Background And Objectives: The increased prevalence of obesity in the general population extends to women of reproductive age. The aim of this study is to report the perioperative management of a morbidly obese pregnant woman, body mass index >50kg/m(2), who underwent cesarean section under general anesthesia.

    Case Report: Pregnant woman in labor, 35 years of age, body mass index 59. Read More

    Human factors in the emergency department: Is physician perception of time to intubation and desaturation rate accurate?
    Emerg Med Australas 2016 Jun 13;28(3):295-9. Epub 2016 Apr 13.
    Department of Emergency Medicine, Lincoln Medical and Mental Health Center, Bronx, New York, USA.
    Objective: The main objective of the present study was to examine the perceived versus actual time to intubation (TTI) as an indication to help determine the situational awareness of Emergency Physicians during rapid sequence intubation and, additionally, to determine the physician's perception of desaturation events.

    Methods: A timed, observation prospective cohort study was conducted. A post-intubation survey was administered to the intubating physician. Read More

    [Anesthetic Management of a Pediatric Case of Blue Rubber Bleb Nevi Syndrome Combined with Small-intestinal Intussusception].
    Masui 2016 Apr;65(4):384-6
    We report the anesthetic management of a pediatric case of blue rubber bleb nevi syndrome combined with small-intestinal intussusception. A 2-year-old girl was transferred to our hospital for small-intestinal intussusception. Emergent ablation of the upper gastrointestinal tract nevus under general anesthesia was planned. Read More

    Comparison of the C-MAC video laryngoscope to a flexible fiberoptic scope for intubation with cervical spine immobilization.
    J Clin Anesth 2016 Jun 22;31:46-52. Epub 2016 Mar 22.
    Department of Anesthesiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
    Study Objective: To compare the C-MAC video laryngoscope to the standard flexible fiberoptic scope (FFS) with an eye piece (but without a camera or a video screen) for intubation of patients undergoing cervical spine surgery with manual inline stabilization. The primary end point was the time to achieve successful tracheal intubation. Secondary end points included glottic view at intubation and number of intubation attempts. Read More

    A survey of a population of anaesthesiologists from South India regarding practices for rapid sequence intubation in patients with head injury.
    Indian J Anaesth 2016 Apr;60(4):258-63
    Department of Anaesthesiology and Critical Care, JIPMER, Puducherry, India.
    Background And Aims: Evidence and utility of the individual steps of the rapid sequence induction and tracheal intubation protocols have been debated, especially in the setting of traumatic brain injury. The purpose of this survey was to determine preferences in the current approach to rapid sequence intubation (RSI) in head injury patients among a population of anaesthesiologists from South India.

    Methods: A questionnaire was E-mailed to all the members of the Indian Society of Anaesthesiologists' South Zone Chapter to ascertain their preferences, experience and comfort level with regard to their use of rapid sequence intubation techniques in adult patients with head injury. Read More

    Adolescent tracheal intubation in an adult urban emergency department: a retrospective, observational study.
    Eur J Emerg Med 2016 Apr 1. Epub 2016 Apr 1.
    aDepartment of Anaesthesia, Pain and Critical Care, Western General Hospital bDepartment of Emergency Medicine, Anaesthesia and Critical Care, Royal Infirmary of Edinburgh, Edinburgh, UK.
    Objectives: Tracheal intubation is the cornerstone of advanced emergency airway management in children and adults and there is good-quality data characterizing intubation in both groups. There are, however, few published studies on emergency tracheal intubation in adolescents. We carried out an observational study to characterize tracheal intubation in adolescents. Read More

    [Prophylaxis of Pulmonary Aspiration during General Anesthesia].
    Masui 2016 Jan;65(1):42-9
    Pulmonary aspiration of gastric or esophageal contents is uncommon; however, it is one of the most severe complications in the perioperative period. The aspiration is associated with possible clinical outcomes, ranging from mild asymptomatic limited episodes of bronchial injury up to the development of a severe acute respiratory distress syndrome. To reduce the incidence of pulmonary aspiration, rapid sequence induction and intubation and awake tracheal intubation are commonly chosen anesthetic techniques for the management of patients at risk of aspiration of gastric or esophageal contents. Read More

    Tracheal ultrasonography and ultrasonographic lung sliding for confirming endotracheal tube placement: Speed and Reliability.
    Am J Emerg Med 2016 Jun 26;34(6):953-6. Epub 2016 Jan 26.
    Kartal Dr Lutfi Kırdar Training and Research Hospital EM Dept, Istanbul, Turkey. Electronic address:
    Background: In this study we aimed to evaluate the success of ultrasonography (USG) for confirming the tube placement and timeliness by tracheal USG and ultrasonographic lung sliding in resuscitation and rapid sequence intubation.

    Materials And Methods: This study was a prospective, single-center, observational study conducted in the emergency department of a tertiary care hospital. Patients were prospectively enrolled in the study. Read More

    Low-Dose or High-Dose Rocuronium Reversed with Neostigmine or Sugammadex for Cesarean Delivery Anesthesia: A Randomized Controlled Noninferiority Trial of Time to Tracheal Intubation and Extubation.
    Anesth Analg 2016 May;122(5):1536-45
    From the *Department of Pediatric Anesthesiology and Intensive Care Medicine, University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czech Republic; †Department of Anesthesiology and Intensive Care Medicine, University Hospital Olomouc, and Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic; ‡2nd Anesthesiological Department, University Hospital Brno, Brno, Czech Republic; §Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic; ‖Department of Obstetrics and Gynecology, University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czech Republic; ¶Department of Anesthesiology and Intensive Care Medicine, University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czech Republic; #Department of Obstetrics and Gynecology, University Hospital Olomouc, and Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic; and **Department of Anesthesiology and Intensive Care Medicine, University Hospital Ostrava, and Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic.
    Background: Rocuronium for cesarean delivery under general anesthesia is an alternative to succinylcholine for rapid-sequence induction of anesthesia because of the availability of sugammadex for reversal of neuromuscular blockade. However, there are no large well-controlled studies in women undergoing general anesthesia for cesarean delivery. The aim of this noninferiority trial was to determine whether rocuronium and sugammadex confer benefit in time to tracheal intubation (primary outcome) and other neuromuscular blockade outcomes compared with succinylcholine, rocuronium, and neostigmine in women undergoing general anesthesia for cesarean delivery. Read More

    Factors Associated with First-Pass Success in Pediatric Intubation in the Emergency Department.
    West J Emerg Med 2016 Mar 2;17(2):129-34. Epub 2016 Mar 2.
    Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts.
    Introduction: The objective of this study was to investigate the factors associated with first-pass success in pediatric intubation in the emergency department (ED).

    Methods: We analyzed the data from two multicenter prospective studies of ED intubation in 17 EDs between April 2010 and September 2014. The studies prospectively measured patient's age, sex, principal indication for intubation, methods (e. Read More

    How important is the butyrylcholinesterase level for cesarean section?
    Pregnancy Hypertens 2016 Jan 4;6(1):26-9. Epub 2016 Feb 4.
    Gulhane Military Medical Academy, Department of Anesthesiology, Ankara, Turkey. Electronic address:
    Objectives: Butyrylcholinesterase (BChE), commonly known as pseudocholinesterase or non-neural cholinesterase, hydrolyzes neuromuscular blocker agents containing choline esters such as succinylcholine that is widely used in rapid sequence induction (RSI) for general anesthesia. The aim of this study is to compare plasma BChE levels and investigate the affects and relationship of succinylcholine on BChE levels in preeclamptic, gestational diabetic and healthy pregnants.

    Study Design: We designed a prospective, controlled, pilot single-center study. Read More

    Difficult Intubation Factors in Prehospital Rapid Sequence Intubation by an Australian Helicopter Emergency Medical Service.
    Air Med J 2016 Jan-Feb;35(1):28-32
    Greater Sydney Area Helicopter Emergency Medical Service, NSW Ambulance; Discipline of Emergency Medicine, Sydney University.
    Objective: Prehospital rapid sequence intubation (RSI) of critically ill trauma patients is a high-risk procedure that may be associated with an increased rate of severe complications such as failed intubation, failure of oxygenation, hypoxia, hypotension, or need for surgical airway. The objective of this study was to describe the factors associated with difficult intubation in prehospital RSI as defined by more than a single look at laryngoscopy to achieve tracheal intubation.

    Methods: This is an observational study using prospectively collected data. Read More

    Verification of endotracheal tube placement using electrical stimulation through electrodes placed on the endotracheal tube cuff.
    Acta Anaesthesiol Scand 2016 Jul 5;60(6):747-55. Epub 2016 Feb 5.
    Department of Emergency Medicine, Chonnam National University Medical School, Gwangju, Korea.
    Background: Current methods for verification of endotracheal intubation can fail, particularly in emergency settings. We investigated whether a verification method using electrical stimulation through electrodes placed on the endotracheal tube cuff could distinguish endotracheal and esophageal intubations in an experimental setting.

    Methods: During three sequential sessions simulating emergency intubation without paralysis, rapid sequence intubation (RSI) with neuromuscular blockade, and intubation during cardiopulmonary resuscitation, eight pigs were intubated with an endotracheal tube fitted with two electrodes exposed on the cuff of the tube, first in the esophagus and next in the trachea or in reverse sequence. Read More

    Airway management and training in obstetric anaesthesia.
    Curr Opin Anaesthesiol 2016 Jun;29(3):261-7
    Department of Anaesthesia, University Hospitals of Leicester, United Kingdom.
    Purpose Of Review: Airway management and failed intubation in the pregnant woman requires unique considerations, which differ from the nonpregnant patient. Factors that influence airway management in this setting include anatomical and physiological changes in pregnancy, environmental factors as well as training matters. In addition, surgery is often being performed with extreme urgency, which requires rapid decision-making process that takes into account safe outcome of mother and baby. Read More

    First Pass Success Without Hypoxemia Is Increased With the Use of Apneic Oxygenation During Rapid Sequence Intubation in the Emergency Department.
    Acad Emerg Med 2016 Jun 13;23(6):703-10. Epub 2016 May 13.
    University of Arizona College of Medicine, Tucson, AZ.
    Objectives: The objective was to determine the effect of apneic oxygenation (AP OX) on first pass success without hypoxemia (FPS-H) in adult patients undergoing rapid sequence intubation (RSI) in the emergency department (ED).

    Methods: Continuous quality improvement data were prospectively collected on all patients intubated in an academic ED from July 1, 2013, to June 30, 2015. During this period the use of AP OX was introduced and encouraged for all patients undergoing RSI in the ED. Read More

    Succinylcholine Is Associated with Increased Mortality When Used for Rapid Sequence Intubation of Severely Brain Injured Patients in the Emergency Department.
    Pharmacotherapy 2016 Jan;36(1):57-63
    Department of Emergency Medicine, College of Medicine, The University of Arizona, Tucson, Arizona.
    Objective: To compare succinylcholine and rocuronium regarding mortality in patients with traumatic brain injury (TBI) who are intubated in the emergency department (ED).

    Methods: This was a retrospective cohort study conducted in an academic ED in the United States. Adult patients with TBI who underwent rapid sequence intubation (RSI) in the ED with rocuronium or succinylcholine between October 2010 and October 2014 were included. Read More

    Apneic preoxygenation without nasal prongs: the "Hungarian Air Ambulance method".
    Scand J Trauma Resusc Emerg Med 2016 Jan 21;24. Epub 2016 Jan 21.
    Hungarian Air Ambulance Nonprofit Ltd., Legimentok utca 8, Budaors, H-2040, Hungary.
    The Hungarian Air Ambulance has recently adopted oxygen supplementation during laryngoscopy, also known as apneic preoxygenation, to prevent desaturation during rapid sequence intubation. Despite its simplicity the nasal cannula method has some limitations relevant to our practice. First, the cannula can dislodge if the head is manipulated during preparation or intubation, especially if nasopharyngeal airways are chosen to maximise preoxygenation. Read More

    Controversies in Pediatric Perioperative Airways.
    Biomed Res Int 2015 22;2015:368761. Epub 2015 Nov 22.
    Department of Anesthesiology and Intensive Care Medicine, Medical Faculty of Masaryk University and University Hospital Brno, Jihlavska 20, 625 00 Brno, Czech Republic.
    Pediatric airway management is a challenge in routine anesthesia practice. Any airway-related complication due to improper procedure can have catastrophic consequences in pediatric patients. The authors reviewed the current relevant literature using the following data bases: Google Scholar, PubMed, Medline (OVID SP), and Dynamed, and the following keywords: Airway/s, Children, Pediatric, Difficult Airways, and Controversies. Read More

    [A Case of Penetrating Injury of the Neck in Which It Was Difficult to Secure the Airway].
    Masui 2015 Oct;64(10):1052-5
    A 76-year-old man sustained a penetrating neck injury caused by a metal rake following an accidental fall. On admission, he showed clear consciousness and no dyspnea. CT revealed that the tips of three prongs of the rake were located close to the vertebral artery and trachea. Read More

    Comparison of the effect of rocuronium dosing based on corrected or lean body weight on rapid sequence induction and neuromuscular blockade duration in obese female patients.
    Saudi Med J 2016 Jan;37(1):60-5
    Department of Anesthesiology and Reanimation, Tatvan State Hospital, Bitlis, Turkey. E-mail.
    Objectives: To compare onset time, duration of action, and tracheal intubation conditions in obese patients when the intubation dose of rocuronium was based on corrected body weight (CBW) versus lean body weight (LBW) for rapid sequence induction. 

    Methods: This prospective study was carried out at Numune Education and Research Hospital, Ankara, Turkey between August 2013 and May 2014. Forty female obese patients scheduled for laparoscopic surgery under general anesthesia were randomized into 2 groups. Read More

    Prehospital rapid sequence induction following trauma in the era of regional networks for major trauma.
    Eur J Emerg Med 2015 Mar 30. Epub 2015 Mar 30.
    aNational Institute for Health Research, Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital bAcademic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham cMidlands Air Ambulance, Stourbridge, West Midlands, UK.
    Objective: Rapid sequence induction (RSI) provides prompt airway control during emergency evacuation of trauma patients. Physicians may be tasked to travel with paramedic ambulance crews to the scene of injury when RSI is more likely to be required. This study investigates whether there are any differences in the practice of prehospital RSI during emergency retrievals for trauma since the establishment of the regional Major Trauma Network (MTN) in March 2012. Read More

    Airway management of a life-threatening post-thyroidectomy haematoma.
    BMJ Case Rep 2015 Dec 15;2015. Epub 2015 Dec 15.
    Department of Medicine, Northwick Park Hospital, London, UK.
    Neck haematomas are rare but potentially life-threatening complications of thyroid surgery. Postoperative monitoring, early diagnosis and immediate management are critical, as this condition can rapidly lead to compression and obstruction of the upper airway. We present a case of a 69-year-old woman who suffered respiratory failure resulting from a post-thyroidectomy haematoma with airway obstruction and severe haemodynamic compromise, presenting a difficult anaesthetic challenge. Read More

    Airway Management of Respiratory Failure.
    Emerg Med Clin North Am 2016 Feb;34(1):97-127
    Department of Emergency Medicine, University of Colorado School of Medicine, Mail Stop B215, Leprino Building 12401, East 17th Avenue Room 712, Aurora, CO 80045, USA. Electronic address:
    Patients in respiratory distress often require airway management, including endotracheal intubation. It takes a methodical approach to transition from an unstable patient in distress with an unsecured airway, to a stable, sedated patient with a definitive airway. Through a deliberate course of advanced preparation, the emergency physician can tailor the approach to the individual clinical situation and optimize the chance of first-pass success. Read More

    Effectiveness and risks of cricoid pressure during rapid sequence induction for endotracheal intubation.
    Cochrane Database Syst Rev 2015 Nov 18(11):CD011656. Epub 2015 Nov 18.
    Department of Anaesthesia & Pain Medicine, Western Health, Gordon Street, Footscray, Locked Bag 2, Footscray, Victoria, Australia, 3011.
    Background: Rapid sequence induction (RSI) for endotracheal intubation is a technique widely used in anaesthesia, emergency and intensive care medicine to secure an airway in patients deemed at risk of pulmonary aspiration. Cricoid pressure is conceptually used to reduce the risk of aspiration by compressing the oesophagus.

    Objectives: To identify and evaluate all randomized controlled trials (RCTs) involving participants undergoing elective or emergency airway management via RSI and compare participants who have cricoid pressure administered with participants who do not have cricoid pressure administered. Read More

    Difficult Airway Society 2015 guidelines for management of unanticipated difficult intubation in adults.
    Br J Anaesth 2015 Dec 10;115(6):827-48. Epub 2015 Nov 10.
    Department of Anaesthesia, Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London SE1 9RT, UK.
    These guidelines provide a strategy to manage unanticipated difficulty with tracheal intubation. They are founded on published evidence. Where evidence is lacking, they have been directed by feedback from members of the Difficult Airway Society and based on expert opinion. Read More

    Use of a Flexible Intubating Scope in Combination with a Channeled Video Laryngoscope for Managing a Difficult Airway in the Emergency Department.
    J Emerg Med 2016 Feb 31;50(2):315-9. Epub 2015 Oct 31.
    Department of Emergency Medicine, Dalhousie University, Halifax, Nova Scotia.
    Background: Difficulty with intubation is not uncommon in the emergency setting. Video laryngoscopes (VLs) are commonly used to manage the difficult airway in the emergency department (ED). Intubation using a flexible bronchoscope, while considered the gold standard for managing the anticipated difficult airway in the operating room, is not commonly used in the ED. Read More

    Intubation after rapid sequence induction performed by non-medical personnel during space exploration missions: a simulation pilot study in a Mars analogue environment.
    Extrem Physiol Med 2015 1;4:19. Epub 2015 Nov 1.
    University of Leicester, Maurice Shock Building, University Rd, Leicester, LE1 9HN UK.
    Background: The question of the safety of anaesthetic procedures performed by non anaesthetists or even by non physicians has long been debated. We explore here this question in the hypothetical context of an exploration mission to Mars. During future interplanetary space missions, the risk of medical conditions requiring surgery and anaesthetic techniques will be significant. Read More

    Rocuronium versus succinylcholine for rapid sequence induction intubation.
    Cochrane Database Syst Rev 2015 Oct 29(10):CD002788. Epub 2015 Oct 29.
    Division of Cardiac Anesthesiology, Department of Anesthesia, The University of Ottawa Heart Institute, 40 Ruskin St, Ottawa, ON, Canada, K1Y 4W7.
    Background: Patients often require a rapid sequence induction (RSI) endotracheal intubation technique during emergencies or electively to protect against aspiration, increased intracranial pressure, or to facilitate intubation. Traditionally succinylcholine has been the most commonly used muscle relaxant for this purpose because of its fast onset and short duration; unfortunately, it can have serious side effects. Rocuronium has been suggested as an alternative to succinylcholine for intubation. Read More

    [Rapid Sequence Intubation with the McGRATH MAC Videolaryngoscope in the Sitting Position for a Patient with Restricted Mouth Opening].
    Masui 2015 Jun;64(6):632-4
    Here we report successful rapid-sequence inubation with the McGRATH MAC videolaryngscope (McGRATH) in the face to face sitting position for a patient with severe ileus and restricted mouse opening. A 46-year-old woman with advanced bladder cancer had developed ileus. Ileus tube and octreotide did not relieve her symptoms, and emergency colostomy was planned. Read More

    Impact of Clinical Pharmacists on Initiation of Postintubation Analgesia in the Emergency Department.
    J Emerg Med 2016 Feb;50(2):308-14
    Department of Pharmacy, Mercy Hospital and Medical Center, Chicago, Illinois.
    Background: Pain and anxiety are common in mechanically ventilated patients, and frequently undertreated in the emergency department (ED) setting.

    Objective: We sought to compare the rate of initiation of postintubation analgesia in the ED before and after intervention by pharmacists specialized in emergency medicine.

    Methods: This was a retrospective cohort study of patients who underwent rapid sequence intubation (RSI) in the ED. Read More

    Intubation of the Neurologically Injured Patient.
    J Emerg Med 2015 Dec 26;49(6):920-7. Epub 2015 Sep 26.
    University of Texas Southwestern Medical Center, Dallas, Texas.
    Background: Intubation of the neurologically injured patient is a critical procedure that must be done in a manner to prevent further neurologic injury. Although many different medications and techniques have been used to meet specific needs, there is little to no evidence to support many claims.

    Objective: To review the literature regarding important topics relating to intubating patients with neurologic injury. Read More

    The Influence of Hypovolemia and Fluid Resuscitation During Hemorrhagic Shock on Apneic Oxygen Desaturation After Preoxygenation in a Swine Model.
    Anesth Analg 2015 Dec;121(6):1555-61
    From the Department of Anesthesiology and Intensive Care, Hamamatsu University School of Medicine, Hamamatsu, Japan.
    Background: Patients experiencing major bleeding often require both aggressive fluid resuscitation and rapid sequence tracheal intubation. The influence of hemorrhage-induced hypovolemia, and/or subsequent fluid resuscitation, on the time until critical oxygen desaturation is not well described. We studied the time to oxygen desaturation in a pig model of hemorrhage shock and colloid resuscitation. Read More

    The effect of single dose etomidate during emergency intubation on hemodynamics and adrenal cortex.
    Ulus Travma Acil Cerrahi Derg 2015 Sep;21(5):358-65
    Department of Anesthesiology and Reanimation, Istanbul University Cerrahpasa Faculty of Medicine, Istanbul, Turkey.
    Background: The study aimed to evaluate and compare the effects of a single dose of etomidate and the use of a steroid injection prior to etomidate during rapid sequence intubation on hemodynamics and cortisol levels.

    Methods: Sixty patients were divided into three groups (n=20). Before intubation, and at 4 and 24 hours, blood samples were taken for cortisol measurements and hemodynamic parameters (systolic-diastolic-mean arterial pressure, heart rate), and SOFA scores were recorded. Read More

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