841 results match your criteria Tracheal Intubation Rapid Sequence Intubation


Emergency Intubation outside Operating Room/Intensive Care Unit Settings: Are We Following the Recommendations for Safe Practice?

Anesth Essays Res 2018 Oct-Dec;12(4):865-872

Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Context: Although international guidelines have been developed for emergency tracheal intubation (ETI), there is little evidence of their applicability in developing countries.

Aims: The aim of this study was done to evaluate the different methods of ETI that are practiced among anesthetist and anesthesia trainees in India outside operating room (OR)/intensive care unit (ICU) settings.

Settings And Design: This was prospective observational audit did among anesthesia personals managing ETI outside OR and ICU. Read More

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http://dx.doi.org/10.4103/aer.AER_151_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6319052PMC
January 2019
4 Reads

Does the addition of fentanyl to ketamine improve haemodynamics, intubating conditions or mortality in emergency department intubation: A systematic review.

Acta Anaesthesiol Scand 2019 Jan 15. Epub 2019 Jan 15.

South West Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia.

Background: Ketamine is an induction agent frequently used for general anaesthesia in emergency medicine. Generally regarded as haemodynamically stable, it can cause hypertension and tachycardia and may cause or worsen shock. The effects of ketamine may be improved by the addition of fentanyl to the induction regime. Read More

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http://dx.doi.org/10.1111/aas.13314DOI Listing
January 2019
6 Reads

Mask ventilation.

Authors:
Paul Baker

F1000Res 2018 23;7. Epub 2018 Oct 23.

Department of Anaesthesiology, University of Auckland, Auckland, New Zealand.

Effective mask ventilation is an essential skill for any practitioner engaged in airway management. Recent methods to objectively describe mask ventilation using waveform capnography help practitioners to monitor and communicate the effectiveness of mask ventilation. Gentle mask ventilation is now considered acceptable during rapid sequence induction/intubation after loss of consciousness, hence reducing the incidence of hypoxia prior to tracheal intubation. Read More

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https://f1000research.com/articles/7-1683/v1
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http://dx.doi.org/10.12688/f1000research.15742.1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6206602PMC
October 2018
11 Reads

Field Expedient Vasopressors During Aeromedical Evacuation: A Case Series from the Puerto Rico Disaster Response.

Prehosp Disaster Med 2018 Dec 9;33(6):668-672. Epub 2018 Nov 9.

Department of Emergency Medicine,Navy Medical Center Portsmouth,Portsmouth,VirginiaUSA.

IntroductionEmergency physicians are using bolus-dose vasopressors to temporize hypotensive patients until more definitive blood pressure support can be established. Despite a paucity of clinical outcome data, emergency department applications are expanding into the prehospital setting. This series presents two cases of field expedient vasopressor use by emergency medicine providers for preflight stabilization during aeromedical evacuation to a hospital ship as part of the United States Navy disaster response in Puerto Rico. Read More

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https://www.cambridge.org/core/product/identifier/S1049023X1
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http://dx.doi.org/10.1017/S1049023X18000973DOI Listing
December 2018
11 Reads

Effect of Cricoid Pressure Compared With a Sham Procedure in the Rapid Sequence Induction of Anesthesia: The IRIS Randomized Clinical Trial.

JAMA Surg 2018 Oct 17. Epub 2018 Oct 17.

Sorbonne Université, UMR Inserm, Institut hospitalo-universitaire ICAN, Department of Emergency Medicine and Surgery, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France.

Importance: The use of cricoid pressure (Sellick maneuver) during rapid sequence induction (RSI) of anesthesia remains controversial in the absence of a large randomized trial.

Objective: To test the hypothesis that the incidence of pulmonary aspiration is not increased when cricoid pressure is not performed.

Design, Setting, And Participants: Randomized, double-blind, noninferiority trial conducted in 10 academic centers. Read More

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http://archsurg.jamanetwork.com/article.aspx?doi=10.1001/jam
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http://dx.doi.org/10.1001/jamasurg.2018.3577DOI Listing
October 2018
58 Reads

Hemodynamic Effects of Propofol for Induction of Rapid Sequence Intubation in Traumatically Injured Patients.

Am Surg 2018 Sep;84(9):1504-1508

Present guidelines for emergency intubation in traumatically injured patients recommend rapid sequence intubation (RSI) as the preferred method of airway management but specific pharmacologic agents for RSI remain controversial. To evaluate hemodynamic differences between propofol and other induction agents when used for RSI in trauma patients. Single-center, retrospective review of trauma patients intubated in the emergency department. Read More

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September 2018
5 Reads

Propofol Versus Thiopental for Rapid-Sequence Induction in Isolated Systolic Hypertensive Patients: A Factorial Randomized Double-Blind Clinical Trial.

Turk J Anaesthesiol Reanim 2018 Sep 17;46(5):367-372. Epub 2018 Aug 17.

Department of Anaesthesiologu and Reanimation, Ankara University School of Medicine, Ankara, Turkey.

Objective: We investigated the effects of four different anaesthesia induction protocols on the haemodynamic response to laryngoscopy and tracheal intubation during rapid-sequence induction (RSI) in systolic hypertensive patients.

Methods: One hundred and twenty hypertensive adult patients (systolic pressure >140 mmHg and diastolic pressure <90 mmHg), classified according to the American Association of Anesthesiologists as Class II and III were randomized into four groups. After pre-oxygenation for 3 minutes, induction and tracheal intubation were performed by blinded investigators, who also scored the intubation. Read More

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http://dx.doi.org/10.5152/TJAR.2018.44442DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6157973PMC
September 2018
11 Reads

An analysis of emergency tracheal intubations in critically ill patients by critical care trainees.

J Intensive Care Soc 2018 Aug 17;19(3):180-187. Epub 2018 Jan 17.

General Intensive Care Unit, St George's University Hospitals NHS Foundation Trust, London, UK.

Introduction: We evaluated intensive care medicine trainees' practice of emergency intubations in the United Kingdom.

Methods: Retrospective analysis of 881 in-hospital emergency intubations over a three-year period using an online trainee logbook.

Results: Emergency intubations out-of-hours were less frequent than in-hours, both on weekdays and weekends. Read More

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http://dx.doi.org/10.1177/1751143717749686DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6110028PMC
August 2018
3 Reads

Difficult tracheal intubation in critically ill.

J Intensive Care 2018 13;6:49. Epub 2018 Aug 13.

2Department of Critical Care Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226014 India.

Background: Endotracheal intubation in critically ill is a high-risk procedure requiring significant expertise in airway handling as well as understanding of pathophysiology of the disease process.

Main Body: Critically ill patients are prone for hypotension and hypoxemia in the immediate post-intubation phase due to blunting of compensatory sympathetic response. Preoxygenation without NIV is frequently suboptimal, as alveolar flooding cause loss of alveolar capillary interface in many of these patients. Read More

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http://dx.doi.org/10.1186/s40560-018-0318-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6090786PMC
August 2018
2 Reads

Maximizing Success With Rapid Sequence Intubations.

Adv Emerg Nurs J 2018 Jul/Sep;40(3):183-193

Vanderbilt LifeFlight, Vanderbilt School of Nursing, Vanderbilt University Medical Center, Nashville, Tennessee.

Within emergency care settings, rapid sequence intubation (RSI) is frequently used to secure a definitive airway (i.e., endotracheal tube) to provide optimal oxygenation and ventilation in critically ill patients of all ages. Read More

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http://dx.doi.org/10.1097/TME.0000000000000204DOI Listing
October 2018
11 Reads

Variation in the accuracy of ultrasound for the detection of intubation by endotracheal tube size.

Am J Emerg Med 2018 Jul 12. Epub 2018 Jul 12.

Department of Emergency Medicine, Feinberg School of Medicine, Northwestern Memorial Hospital, Chicago, IL, United States of America.

Introduction: Rapid and accurate confirmation of endotracheal tube (ETT) placement is a fundamental step in definitive airway management. Multiple techniques with different limitations have been reported. Recent studies have evaluated the accuracy, time to performance, and physician confidence for ultrasound in both cadaveric models and live patients. Read More

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http://dx.doi.org/10.1016/j.ajem.2018.07.026DOI Listing
July 2018
9 Reads

Defining the plateau point: When are further attempts futile in out-of-hospital advanced airway management?

Resuscitation 2018 09 3;130:57-60. Epub 2018 Jul 3.

University of Texas Health Science Center, McGown School of Medicine, 6431 Fannin Street, 4th Floor JJL, Houston, TX 77030, United States.

Background: We sought to characterize the number of attempts required to achieve advanced airway management (AAM) success.

Methods: Using 4 years of data from a national EMS electronic health record system, we examined the following subsets of attempted AAM: 1) cardiac arrest intubation (CA-ETI), 2) non-arrest medical intubation (MED-ETI), 3) non-arrest trauma intubation (TRA-ETI), 4) rapid-sequence intubation (RSI), 5) sedation-assisted ETI (SAI), and 6) supraglottic airway (SGA). We determined the first pass and overall success rates, as well as the point of additional attempt futility ("plateau point"). Read More

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http://dx.doi.org/10.1016/j.resuscitation.2018.07.002DOI Listing
September 2018
1 Read

Integration of Point-of-care Ultrasound during Rapid Sequence Intubation in Trauma Resuscitation.

J Emerg Trauma Shock 2018 Apr-Jun;11(2):92-97

Department of Emergency Medicine, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India.

Introduction: Airway and breathing management play critical role in trauma resuscitation. Early identification of esophageal intubation and detection of fatal events is critical. Authors studied the utility of integration of point-of-care ultrasound (POCUS) during different phases of rapid sequence intubation (RSI) in trauma resuscitation. Read More

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http://dx.doi.org/10.4103/JETS.JETS_56_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5994849PMC
June 2018
15 Reads

Prehospital emergency anaesthesia: an updated survey of UK practice with emphasis on the role of standardisation and checklists.

Emerg Med J 2018 Sep 24;35(9):532-537. Epub 2018 May 24.

Centre for Trauma Sciences, Queen Mary University of London, London, UK.

Introduction: Prehospital emergency anaesthesia (PHEA or 'prehospital rapid sequence intubation') is a high-risk procedure. Standard operating procedures (SOPs) and checklists within healthcare systems have been demonstrated to reduce human error and improve patient safety. We aimed to describe the current practice of PHEA in the UK, determine the use of checklists for PHEA and describe the content, format and layout of any such checklists currently used in the UK. Read More

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http://dx.doi.org/10.1136/emermed-2017-206592DOI Listing
September 2018
6 Reads
1 Citation
1.780 Impact Factor

Airway Management in a Patient With Tracheal Disruption due to Penetrating Neck Trauma With Hollow Point Ammunition: A Case Report.

A A Pract 2018 May;10(9):242-245

Department of Otolaryngology, University Hospitals Cleveland Medical Center, Cleveland, Ohio.

Rapid sequence induction and intubation was performed for a patient in respiratory distress after a gunshot wound to the neck. Resistance was noted distal to vocal cords. With a bronchoscope unavailable, the endotracheal tube was advanced with a corkscrew maneuver. Read More

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http://dx.doi.org/10.1213/XAA.0000000000000675DOI Listing
May 2018
5 Reads

Pre-hospital advanced airway management by anaesthetist and nurse anaesthetist critical care teams: a prospective observational study of 2028 pre-hospital tracheal intubations.

Br J Anaesth 2018 May;120(5):1103-1109

Department of Research and Development, Norwegian Air Ambulance Foundation, Drøbak, Norway; Department of Health Sciences, University of Stavanger, Stavanger, Norway.

Background: Pre-hospital tracheal intubation success and complication rates vary considerably among provider categories. The purpose of this study was to estimate the success and complication rates of pre-hospital tracheal intubation performed by physician anaesthetist or nurse anaesthetist pre-hospital critical care teams.

Methods: Data were prospectively collected from critical care teams staffed with a physician anaesthetist or a nurse anaesthetist according to the Utstein template for pre-hospital advanced airway management. Read More

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http://dx.doi.org/10.1016/j.bja.2017.12.036DOI Listing
May 2018
3 Reads

Nasal Cannula Apneic Oxygenation Prevents Desaturation During Endotracheal Intubation: An Integrative Literature Review.

West J Emerg Med 2018 Mar 22;19(2):403-411. Epub 2018 Feb 22.

University of California Irvine Health, Department of Emergency Medicine, Orange, California.

Patients requiring emergency airway management may be at greater risk of acute hypoxemic events because of underlying lung pathology, high metabolic demands, insufficient respiratory drive, obesity, or the inability to protect their airway against aspiration. Emergency tracheal intubation is often required before complete information needed to assess the risk of procedural hypoxia is acquired (i.e. Read More

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http://dx.doi.org/10.5811/westjem.2017.12.34699DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5851518PMC
March 2018
3 Reads

Video laryngoscopy-assisted tracheal intubation in airway management.

Expert Rev Med Devices 2018 Apr 12;15(4):265-275. Epub 2018 Mar 12.

a Department of Anesthesiology , Chang Gung Memorial Hospital , Taoyuan , Taiwan.

Introduction: Video laryngoscopy-assisted tracheal intubation devices have become alternatives to traditional laryngoscopes in recent years. This review will provide information on commonly used video laryngoscopes and their clinical applications in airway management. Areas covered: In this review, the differences between video laryngoscopy and direct laryngoscopy, and the utilization of video laryngoscopes in specific clinical settings are discussed. Read More

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http://dx.doi.org/10.1080/17434440.2018.1448267DOI Listing
April 2018
16 Reads

Efficacy of pre-hospital rapid sequence intubation in paediatric traumatic brain injury: A 9-year observational study.

Injury 2018 May 12;49(5):916-920. Epub 2018 Feb 12.

Ambulance Victoria, Melbourne, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Department of Community Emergency Health and Paramedic Practice, Monash University, Melbourne, Victoria, Australia.

Introduction: Prehospital airway management of the paediatric patient with traumatic brain injury (TBI) is controversial. Endotracheal intubation of children in the field requires specific skills and has potential benefits but also carries potentially serious complications. We aimed to compare mortality and functional outcomes after six months between children with TBI who either underwent prehospital rapid sequence intubation (RSI) by trained Intensive Care paramedics (ICP) or received no intubation. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00201383183006
Publisher Site
http://dx.doi.org/10.1016/j.injury.2018.02.013DOI Listing
May 2018
9 Reads

Guidelines for the management of tracheal intubation in critically ill adults.

Br J Anaesth 2018 Feb 26;120(2):323-352. Epub 2017 Nov 26.

Anaesthesia and Intensive Care Medicine, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK(12).

These guidelines describe a comprehensive strategy to optimize oxygenation, airway management, and tracheal intubation in critically ill patients, in all hospital locations. They are a direct response to the 4 National Audit Project of the Royal College of Anaesthetists and Difficult Airway Society, which highlighted deficient management of these extremely vulnerable patients leading to major complications and avoidable deaths. They are founded on robust evidence where available, supplemented by expert consensus opinion where it is not. Read More

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http://dx.doi.org/10.1016/j.bja.2017.10.021DOI Listing
February 2018
8 Reads

Assessing Advanced Airway Management Performance in a National Cohort of Emergency Medical Services Agencies.

Ann Emerg Med 2018 05 17;71(5):597-607.e3. Epub 2018 Jan 17.

Williamson County Emergency Medical Services, Georgetown, TX, and Texas A&M Health Science Center, Temple, TX.

Study Objective: Although often the focus of quality improvement efforts, emergency medical services (EMS) advanced airway management performance has few national comparisons, nor are there many assessments with benchmarks accounting for differences in agency volume or patient mix. We seek to assess variations in advanced airway management and conventional intubation performance in a national cohort of EMS agencies.

Methods: We used EMS data from ESO Solutions, a national EMS electronic health record system. Read More

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http://dx.doi.org/10.1016/j.annemergmed.2017.12.012DOI Listing
May 2018
8 Reads

A Novel Difficult-Airway Prediction Tool for Emergency Airway Management: Validation of the HEAVEN Criteria in a Large Air Medical Cohort.

J Emerg Med 2018 04 10;54(4):395-401. Epub 2018 Jan 10.

Department of Emergency Medicine, Arrowhead Regional Medical Center, Colton, California; Air Methods Corporation, Englewood, Colorado; California University of Science and Medicine, San Bernardino, California.

Background: Difficult-airway prediction tools help identify optimal airway techniques, but were derived in elective surgery patients and may not be applicable to emergency rapid sequence intubation (RSI). The HEAVEN criteria (Hypoxemia, Extremes of size, Anatomic abnormalities, Vomit/blood/fluid, Exsanguination, Neck mobility issues) may be more relevant to emergency RSI patients.

Objective: To validate the HEAVEN criteria for difficult-airway prediction in emergency RSI using a large air medical cohort. Read More

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http://dx.doi.org/10.1016/j.jemermed.2017.12.005DOI Listing
April 2018
6 Reads

A before-and-after observational study of a protocol for use of the C-MAC videolaryngoscope with a Frova introducer in pre-hospital rapid sequence intubation.

Anaesthesia 2018 Mar 8;73(3):348-355. Epub 2018 Jan 8.

Emergency Medicine and Services, Helsinki University Hospital and Department of Emergency Medicine, University of Helsinki, Finland.

Results using videolaryngoscopy in pre-hospital rapid sequence intubation are mixed. A bougie is not commonly used with videolaryngoscopy. We hypothesised that using videolaryngoscopy and a bougie as core elements of a standardised protocol that includes a drugs and a laryngoscopy algorithm would result in a high first-pass tracheal intubation success rate. Read More

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http://dx.doi.org/10.1111/anae.14182DOI Listing
March 2018
7 Reads

The effect of pre-operative gastric ultrasound examination on the choice of general anaesthetic induction technique for non-elective paediatric surgery. A prospective cohort study.

Anaesthesia 2018 Mar 19;73(3):304-312. Epub 2017 Dec 19.

Department of Anaesthesia and Intensive Care, Hôpital Femme Mère Enfant, Bron, France.

Ultrasound examination of the gastric antrum is a non-invasive tool that allows reliable estimation of gastric contents. We performed this prospective cohort study in non-elective paediatric surgery to assess whether gastric ultrasound may help to determine the best anaesthetic induction technique, whether rapid sequence or routine. The primary outcome was the reduction of inappropriate induction technique. Read More

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http://dx.doi.org/10.1111/anae.14179DOI Listing
March 2018
19 Reads

Ultra-modified Rapid Sequence Induction.

Paediatr Anaesth 2017 12;27(12):1278

Department of Anesthesiology, Seth GS Medical College and KEM Hospital, Mumbai, India.

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http://dx.doi.org/10.1111/pan.13259DOI Listing
December 2017
19 Reads

The Effect of Apneic Oxygenation on Reducing Hypoxemia During Rapid Sequence Induction and Intubation in the Acutely Ill or Injured.

Authors:
Autumn Riddell

Adv Emerg Nurs J 2017 Oct/Dec;39(4):309-317

Emergency Department, Naval Medical Center Portsmouth, Portsmouth, Virginia.

Apneic oxygenation during intubation is the application of oxygen via a nasal cannula, which is left in place throughout laryngoscopy. The flow rate of oxygen is set to at least 15 L/min and theoretically reduces the risk of oxygen desaturation and hypoxemia during the procedure. Over the last 5 years, there have been several studies published on this topic with differing results. Read More

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http://dx.doi.org/10.1097/TME.0000000000000168DOI Listing
June 2018
17 Reads

Changing the Emergency Department's Practice of Rapid Sequence Intubation to Reduce the Incidence of Hypoxia.

Adv Emerg Nurs J 2017 Oct/Dec;39(4):266-279

Vanderbilt University School of Nursing and Vanderbilt University Medical Center-LifeFlight, Nashville, Tennessee (Dr Gooch); TeamHealth at Maury Regional Medical Center, Columbia, Tennessee (Dr Gooch); Middle Tennessee School of Anesthesia, Madison, Tennessee (Dr Gooch); and Loyola University Chicago Marcella Niehoff School of Nursing, Chicago, Illinois (Dr Roberts).

Rapid sequence intubation (RSI) is an advanced procedure performed by nurse practitioners in the emergency department (ED). Hypoxia is one of the most common complications associated with RSI, which may lead to serious sequela, including death. Hypoxia may result from medications that are given to facilitate the procedure or the underlying disease process. Read More

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http://dx.doi.org/10.1097/TME.0000000000000164DOI Listing
June 2018
14 Reads

Anaesthesia and orphan disease: airway and anaesthetic management in Huntington's disease.

BMJ Case Rep 2017 Oct 19;2017. Epub 2017 Oct 19.

Department of Anaesthesia, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.

We present a case that highlights the issues surrounding the delivery of a safe general anaesthetic to a patient with Huntington's disease (HD) and bulbar dysfunction. In the case of a 46-year-old patient undergoing laparoscopic percutaneous endoscopic gastrostomy tube insertion, we discuss the rationale behind our chosen method and anaesthetic agents as well as airway issues specific to HD. In a patient whose condition would not allow for an awake fibreoptic intubation, we opted for a modified rapid sequence induction. Read More

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http://dx.doi.org/10.1136/bcr-2017-221354DOI Listing
October 2017
5 Reads

Waveform capnography: an alternative to physician gestalt in determining optimal intubating conditions after administration of paralytic agents.

Emerg Med J 2018 Jan 10;35(1):62-64. Epub 2017 Oct 10.

Department of Emergency Medicine, Lincoln Medical Center, New York City, New York, USA.

Purpose: We sought to evaluate the utility of waveform capnography (WC) in detecting paralysis, by using apnoea as a surrogate determinant, as compared with clinical gestalt during rapid sequence intubation. Additionally, we sought to determine if this improves the time to intubation and first pass success rates through more consistent and expedient means of detecting optimal intubating conditions (ie, paralysis).

Methods: A prospective observational cohort study of consecutively enrolled patients was conducted from April to June 2016 at an academic, urban, level 1 trauma centre in New York City. Read More

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http://dx.doi.org/10.1136/emermed-2017-206922DOI Listing
January 2018
6 Reads

Ideal Cricoid Pressure Is Biomechanically Impossible During Laryngoscopy.

Acad Emerg Med 2018 Jan 3;25(1):94-98. Epub 2017 Nov 3.

Pathology North, Tamworth Rural Referral Hospital, Tamworth, NSW, Australia.

Objective: This study was a prospective, randomized controlled trial of rapid sequence intubation (RSI) with cricoid pressure (CP) within the emergency department (ED). The primary aim of the study was to examine the link between ideal CP and the incidence of aspiration.

Method: Patients > 18 years of age undergoing RSI in the ED of two hospitals in New South Wales, Australia, were randomly assigned to receive measured CP using weighing scales to target the ideal CP range (3. Read More

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http://dx.doi.org/10.1111/acem.13326DOI Listing
January 2018
13 Reads

Usefulness of oxygen reserve index (ORi™), a new parameter of oxygenation reserve potential, for rapid sequence induction of general anesthesia.

J Clin Monit Comput 2018 Aug 27;32(4):687-691. Epub 2017 Sep 27.

Department of Anesthesiology, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima City, 960-1295, Japan.

The oxygen reserve index (ORi™) is a new parameter for monitoring oxygen reserve noninvasively. The aim of this study was to examine the usefulness of ORi for rapid sequence induction (RSI). Twenty adult patients who were scheduled for surgical procedures under general anesthesia were enrolled. Read More

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http://dx.doi.org/10.1007/s10877-017-0068-1DOI Listing
August 2018
128 Reads

Effects of intravenous administration of fentanyl and lidocaine on hemodynamic responses following endotracheal intubation.

Am J Emerg Med 2018 Feb 21;36(2):197-201. Epub 2017 Jul 21.

Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Electronic address:

Objectives: To compare the effects of intravenous fentanyl and lidocaine on hemodynamic changes following endotracheal intubation in patients requiring Rapid Sequence Intubation (RSI) in the emergency department (ED).

Methods: A single-centered, prospective, simple non-randomized, double-blind clinical trial was conducted on 96 patients who needed RSI in Edalatian ED. They were randomly divided into three groups (fentanyl group (F), lidocaine group (L), and fentanyl plus lidocaine (M) as our control group). Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07356757173061
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http://dx.doi.org/10.1016/j.ajem.2017.07.069DOI Listing
February 2018
3 Reads

Effect of patient weight on first pass success and neuromuscular blocking agent dosing for rapid sequence intubation in the emergency department.

Emerg Med J 2017 Nov 16;34(11):739-743. Epub 2017 Aug 16.

Department of Emergency Medicine, College of Medicine, The University of Arizona, Tucson, Arizona, USA.

Objectives: The primary objective of this study was to determine the association between patient weight and first pass success (FPS) during rapid sequence intubation (RSI) in the ED. The secondary objective was to evaluate the association between patient weight and neuromuscular blocking agent (NMBA) dosing.

Methods: This was a retrospective cohort study conducted in a tertiary care academic ED. Read More

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http://dx.doi.org/10.1136/emermed-2017-206762DOI Listing
November 2017
40 Reads

A sequential case series of 23 intubations in a rural emergency department in New Zealand.

Aust J Rural Health 2018 Feb 10;26(1):48-55. Epub 2017 Aug 10.

Emergency Department, Whanganui District Hospital, Whanganui, New Zealand.

Objective: To describe the practice and procedure of emergency intubation in Whanganui Emergency Department, New Zealand and determine whether intubation can be carried out effectively in the rural setting.

Method: A prospective observational study using the Australia and New Zealand Airway Registry proforma to collect data on the indication, lead intubator, first-pass success rate and peri-procedural complications. Data were also collected on whether a formal airway assessment was carried out and whether a checklist was used. Read More

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http://dx.doi.org/10.1111/ajr.12366DOI Listing
February 2018
10 Reads

Maintenance of Oxygenation During Rapid Sequence Intubation in the Emergency Department.

Authors:
John C Sakles

Acad Emerg Med 2017 11 13;24(11):1395-1404. Epub 2017 Oct 13.

Department of Emergency Medicine, University of Arizona College of Medicine, Tucson, AZ.

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http://dx.doi.org/10.1111/acem.13271DOI Listing
November 2017
5 Reads

Emergency Department use of Apneic Oxygenation Versus Usual Care During Rapid Sequence Intubation: A Randomized Controlled Trial (The ENDAO Trial).

Acad Emerg Med 2017 11 23;24(11):1387-1394. Epub 2017 Sep 23.

Department of Emergency Medicine, Weill Medical College of Cornell University, Lincoln Medical Center, Bronx, NY.

Objectives: Desaturation leading to hypoxemia may occur during rapid sequence intubation (RSI). Apneic oxygenation (AO) was developed to prevent the occurrence of oxygen desaturation during the apnea period. The purpose of this study was to determine if the application of AO increases the average lowest oxygen saturation during RSI when compared to usual care (UC) in the emergency setting. Read More

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http://dx.doi.org/10.1111/acem.13274DOI Listing
November 2017
32 Reads

Rocuronium is more hepatotoxic than succinylcholine in vitro.

Eur J Anaesthesiol 2017 09;34(9):623-627

From the Department of Anesthesiology and Intensive Care Medicine, University Hospital of Rostock (MS, IP, CH, GR, GN-S, TM); and Fraunhofer Institut for Cell Therapy and Immunology, Project Group EXIM, Rostock, Germany (MS, MM).

Background: The development of liver failure is a major problem in critically ill patients. The hepatotoxicity of many drugs, as one important reason for liver failure, is poorly screened for in human models. Rocuronium and succinylcholine are neuromuscular blocking agents used for tracheal intubation and for rapid-sequence induction. Read More

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http://dx.doi.org/10.1097/EJA.0000000000000666DOI Listing
September 2017
26 Reads

A systematic review and meta-analysis comparing mortality in pre-hospital tracheal intubation to emergency department intubation in trauma patients.

Crit Care 2017 Jul 31;21(1):192. Epub 2017 Jul 31.

Department of Research and Development, Norwegian Air Ambulance Foundation, Drøbak, Norway.

Background: Pre-hospital endotracheal intubation is frequently used for trauma patients in many emergency medical systems. Despite a wide range of publications in the field, it is debated whether the intervention is associated with a favourable outcome, when compared to more conservative airway measures.

Methods: A systematic literature search was conducted to identify interventional and observational studies where the mortality rates of adult trauma patients undergoing pre-hospital endotracheal intubation were compared to those undergoing emergency department intubation. Read More

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http://dx.doi.org/10.1186/s13054-017-1787-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5535283PMC
July 2017
27 Reads

The (Continued) Challenges of Out-of-Hospital Rapid Sequence Intubation.

Authors:
Henry E Wang

Ann Emerg Med 2017 10 26;70(4):460-462. Epub 2017 Jul 26.

Department of Emergency Medicine, University of Alabama at Birmingham, Birmingham, AL. Electronic address:

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http://dx.doi.org/10.1016/j.annemergmed.2017.04.010DOI Listing
October 2017
19 Reads

HEAVEN Criteria: Derivation of a New Difficult Airway Prediction Tool.

Air Med J 2017 Jul - Aug;36(4):195-197. Epub 2017 Apr 26.

Clinical Education Manager, Air Methods Corporation, Englewood, CO.

Objective: Airway management is vitally important in the management of critically ill and injured patients. Current tools to predict the difficult airway have limited application in the emergency airway situation. The aim of this study was to derive a novel difficult airway prediction tool for emergency intubation. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S1067991X163035
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http://dx.doi.org/10.1016/j.amj.2017.04.001DOI Listing
May 2018
32 Reads

Rocuronium vs. succinylcholine for rapid sequence intubation: a Cochrane systematic review.

Anaesthesia 2017 Jun;72(6):765-777

School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa Heart Institute, Ottawa.

This systemic review was performed to determine whether rocuronium creates intubating conditions comparable to those of succinylcholine during rapid sequence intubation of the trachea. We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2015, Issue 2), MEDLINE (1966 to February Week 2 2015), and EMBASE (1988 to February 14 2015) for any randomised controlled trials or controlled clinical trials that reported intubating conditions comparing rocuronium and succinylcholine for rapid or modified rapid sequence intubation. The dose of rocuronium was at least 0. Read More

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http://dx.doi.org/10.1111/anae.13903DOI Listing
June 2017
10 Reads

Apneic oxygenation reduces the incidence of hypoxemia during emergency intubation: A systematic review and meta-analysis.

Am J Emerg Med 2017 Aug 15;35(8):1184-1189. Epub 2017 Jun 15.

Division of Emergency Critical Care, Stony Brook Hospital, Stony Brook, NY, USA.

Study Objective: Apneic oxygenation has been advocated for the prevention of hypoxemia during emergency endotracheal intubation. Because of conflicting results from recent trials, the efficacy of apneic oxygenation remains unclear. We performed a systematic review and meta-analysis to investigate the effect of apneic oxygenation on the incidence of clinically significant hypoxemia during emergency endotracheal intubation. Read More

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http://dx.doi.org/10.1016/j.ajem.2017.06.029DOI Listing
August 2017
12 Reads

Survival in Out-of-hospital Rapid Sequence Intubation of Non-Traumatic Brain Pathologies.

Prehosp Emerg Care 2017 Nov-Dec;21(6):700-708. Epub 2017 Jun 16.

Introduction: Rapid sequence intubation (RSI) is not only used in traumatic brain injuries in the out-of-hospital setting, but also for non-traumatic brain pathologies (NTBP) such as brain tumors, meningitis, encephalitis, hypoxic/anoxic brain injury, stroke, arteriovenous malformations, tumors, aneurysms, brain hemorrhage, as well as brain injury due to diabetes, seizures and toxicity, metabolic conditions, and alcohol and drug overdose. Previous research suggests that RSI is common in non-traumatic coma, but with an unknown prevalence of NTBP in those that receive RSI. If NTBP is common and if brain trauma RSI evidence is not valid for NTBP then a sizable proportion of NTBP receive this treatment without evidence of benefit. Read More

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http://dx.doi.org/10.1080/10903127.2017.1325952DOI Listing
July 2018
35 Reads

Rocuronium Should Be the Default Paralytic in Rapid Sequence Intubation.

Ann Emerg Med 2018 Mar 23;71(3):397-398. Epub 2017 Jun 23.

Cooper Medical School of Rowan University, Camden, NJ.

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http://dx.doi.org/10.1016/j.annemergmed.2017.04.039DOI Listing
March 2018
16 Reads

Emergency airway management in Australian and New Zealand emergency departments: A multicentre descriptive study of 3710 emergency intubations.

Emerg Med Australas 2017 Oct 5;29(5):499-508. Epub 2017 Jun 5.

Emergency Department, Royal North Shore Hospital, Sydney, New South Wales, Australia.

Objective: The aim of this study was to describe the practice of endotracheal intubation across a range of Australasian EDs.

Methods: We established a multicentre airway registry (The Australian and New Zealand Emergency Department Airway Registry [ANZEDAR]) prospectively capturing intubations from 43 Australian and New Zealand EDs over 24 months using the ANZEDAR form. Information recorded included patient demographics, intubation indications, predicted difficulty, rapid sequence induction and endotracheal intubation preparation technique, induction drugs, airway adjuncts and complications. Read More

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http://dx.doi.org/10.1111/1742-6723.12815DOI Listing
October 2017
9 Reads

Nonphysician Out-of-Hospital Rapid Sequence Intubation Success and Adverse Events: A Systematic Review and Meta-Analysis.

Ann Emerg Med 2017 Oct 27;70(4):449-459.e20. Epub 2017 May 27.

College of Medicine, Qatar University, Doha, Qatar.

Study Objective: Rapid sequence intubation performed by nonphysicians such as paramedics or nurses has become increasingly common in many countries; however, concerns have been stated in regard to the safe use and appropriateness of rapid sequence intubation when performed by these health care providers. The aim of our study is to compare rapid sequence intubation success and adverse events between nonphysician and physician in the out-of-hospital setting.

Methods: A systematic literature search of key databases including MEDLINE, EMBASE, and the Cochrane Library was conducted. Read More

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http://dx.doi.org/10.1016/j.annemergmed.2017.03.026DOI Listing
October 2017
23 Reads

Analysis of Out-of-Hospital Pediatric Intubation by an Australian Helicopter Emergency Medical Service.

Ann Emerg Med 2017 Dec 29;70(6):773-782.e4. Epub 2017 Apr 29.

Greater Sydney Area Helicopter Emergency Medical Service, New South Wales Ambulance, Sydney, NSW, Australia; Discipline of Emergency Medicine, Sydney Medical School, Sydney, NSW, Australia.

Study Objective: We examine first-look success in emergency pediatric intubation by a physician-staffed helicopter emergency medical service (EMS).

Methods: A database analysis of all pediatric (<16 years) intubations during a 64-month period was undertaken, using data from a prospectively enrolled electronic airway registry form. Recorded findings included patient demographics, operator background, airway intervention including intubation attempts, complications, and critical timings. Read More

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http://dx.doi.org/10.1016/j.annemergmed.2017.03.020DOI Listing
December 2017
7 Reads