939 results match your criteria Tracheal Intubation Rapid Sequence Intubation


Is difficult or failed intubation a confounder or an effect modifier for hypoxaemia? Comment on Br J Anaesth; 125: e81-7.

Authors:
Asish Subedi

Br J Anaesth 2020 Jun 28. Epub 2020 Jun 28.

Dharan, Nepal. Electronic address:

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http://dx.doi.org/10.1016/j.bja.2020.05.034DOI Listing

Antral area in the semi-recumbent position to identify a stomach at risk of pulmonary aspiration in the adult non-pregnant patient.

Anaesthesia 2020 05;75(5):694

Hospices Civils de Lyon, Femme Mère Enfant Teaching Hospital, Lyon, France.

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http://dx.doi.org/10.1111/anae.15017DOI Listing

The aerosol box for intubation in coronavirus disease 2019 patients: an in-situ simulation crossover study.

Anaesthesia 2020 May 12. Epub 2020 May 12.

Intensive Care Unit, Cabrini Hospital, Malvern, Vic, Australia.

The coronavirus disease 2019 pandemic has led to the manufacturing of novel devices to protect clinicians from the risk of transmission, including the aerosol box for use during tracheal intubation. We evaluated the impact of two aerosol boxes (an early-generation box and a latest-generation box) on intubations in patients with severe coronavirus disease 2019 with an in-situ simulation crossover study. The simulated process complied with the Safe Airway Society coronavirus disease 2019 airway management guidelines. Read More

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http://dx.doi.org/10.1111/anae.15115DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7273017PMC

Endotracheal Intubation in the Pharmaceutical-Poisoned Patient: a Narrative Review of the Literature.

J Med Toxicol 2020 May 11. Epub 2020 May 11.

Lehigh Valley Health Network Department of Emergency and Hospital Medicine, Division of Medical Toxicology, USF Morsani College of Medicine, Lehigh Valley Campus, Cedar Crest Boulevard & I-78, Allentown, PA, 18101, USA.

Introduction: Endotracheal intubation (ETI) is an essential component of the supportive care provided to the critically ill patient with pharmaceutical poisoning; however, specific nuances surrounding intubation including techniques and complications in the context of pharmaceutical poisoning have not been well elucidated.

Discussion: A search of the available literature on ETI in pharmaceutical-poisoned patients was undertaken using Medline, ERIC, Cochrane database, and PsycINFO using the following MeSH and keyword terms: ("toxicology" OR "poisons" OR "drug overdose" OR "poisoning") AND ("intubation, intratracheal" OR "intubation, endotracheal" OR "airway management" OR "respiration, artificial"). A hand-search was also performed when the literature in the above search required additional conceptual clarification, including using the "Similar Articles" feature of PubMed, along with reviewing articles' reference lists that discussed intubation in the context of a poisoning scenario. Read More

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http://dx.doi.org/10.1007/s13181-020-00779-3DOI Listing

Airway management at Level 1 trauma center in the era of video laryngoscopy.

Int J Crit Illn Inj Sci 2020 Jan-Mar;10(1):20-24. Epub 2020 Mar 6.

Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami Miller School of Medicine, Miami, FL, USA.

Background: Rapid sequence induction and tracheal intubation through direct laryngoscopy (DL) has been the most common approach to secure the airway in trauma patients. The introduction of video laryngoscopy (VL) has changed airway management in many clinical settings. In this retrospective study, we assessed if immediate availability of VL in the trauma suite has changed the approach and outcomes of airway management during acute resuscitation at a dedicated trauma center. Read More

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http://dx.doi.org/10.4103/IJCIIS.IJCIIS_14_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7170343PMC

Paralytic Agents for Intubation in the Out-of-Hospital Setting.

JAMA 2020 04;323(15):1507

Department of Anesthesiology and Intensive Care Medicine, Eberhard-Karls-University, Tuebingen, Germany.

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http://dx.doi.org/10.1001/jama.2020.1452DOI Listing

Paralytic Agents for Intubation in the Out-of-Hospital Setting.

Authors:
Asad E Patanwala

JAMA 2020 04;323(15):1506-1507

Sydney Pharmacy School, University of Sydney, Sydney, Australia.

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http://dx.doi.org/10.1001/jama.2020.1443DOI Listing

Emergency tracheal intubation in 202 patients with COVID-19 in Wuhan, China: lessons learnt and international expert recommendations.

Br J Anaesth 2020 07 10;125(1):e28-e37. Epub 2020 Apr 10.

Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, PA, USA. Electronic address:

Tracheal intubation in coronavirus disease 2019 (COVID-19) patients creates a risk to physiologically compromised patients and to attending healthcare providers. Clinical information on airway management and expert recommendations in these patients are urgently needed. By analysing a two-centre retrospective observational case series from Wuhan, China, a panel of international airway management experts discussed the results and formulated consensus recommendations for the management of tracheal intubation in COVID-19 patients. Read More

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http://dx.doi.org/10.1016/j.bja.2020.03.026DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7151238PMC
July 2020
4.853 Impact Factor

[Effectiveness of magnesium sulfate compared to rocuronium for rapid sequence tracheal intubation in adults: clinical randomized trial].

Rev Bras Anestesiol 2020 Jan - Feb;70(1):42-47. Epub 2020 Feb 19.

Universidade Federal de Alagoas, Maceió, AL, Brasil.

Introduction And Objectives: Magnesium sulfate has been used in anesthesia because it has relevant clinical features such as: analgesia, autonomic response control and muscle relaxation. Using the agent to establish adequate conditions for tracheal intubation remains controversial. The aim of the study was to compare the effectiveness of magnesium sulfate and rocuronium for rapid sequence tracheal intubation in adults. Read More

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http://dx.doi.org/10.1016/j.bjan.2019.12.002DOI Listing
February 2020

Intubation and Ventilation amid the COVID-19 Outbreak: Wuhan's Experience.

Anesthesiology 2020 06;132(6):1317-1332

From the Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut (L.M., R.D.) the Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China (H.Q.) the Department of Anesthesiology, Tongji Hospital, Tongji Medical College Huazhong University of Science and Technology, Wuhan, Hubei, China (L.W.) the Departments of Critical Care Medicine (Y.A., L.Z.) Anesthesiology (Q.G.) Respiratory Medicine (J.M.), Xiangya Hospital, Central South University, Changsha, Hunan Province, China the Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai, China (Z.X.) the Department of Anesthesiology, Wake Forest University, Winston-Salem, North Carolina (C.T.) the Department of Anesthesiology and Pain Medicine, University of California Davis, Sacramento, California (H.L.) the Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People's Hospital, Tongji University School of Medicine, Shanghai, China (L.X.).

The COVID-19 outbreak has led to 80,409 diagnosed cases and 3,012 deaths in mainland China based on the data released on March 4, 2020. Approximately 3.2% of patients with COVID-19 required intubation and invasive ventilation at some point in the disease course. Read More

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http://dx.doi.org/10.1097/ALN.0000000000003296DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7155908PMC

Foreign body aspiration in a rare tracheal anomaly: A case report.

Int J Surg Case Rep 2020 15;68:203-207. Epub 2020 Feb 15.

Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, King Abdulaziz Medical City and King Abdullah Specialist Children's Hospital, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.

Introduction: Tracheal bronchus is a rare anomaly in which an accessory bronchial branch originates superior to the tracheal bifurcation. It is usually incidentally found in patients with recurrent chest infection, persistent stridor and less commonly due to foreign body aspiration.

Presentation Of Case: A 6-year-old medically and surgically free boy presented to the Emergency Department with severe shortness of breath. Read More

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http://dx.doi.org/10.1016/j.ijscr.2020.02.024DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7078452PMC
February 2020

Determination of dose and efficacy of atracurium for rapid sequence induction of anesthesia: A randomised prospective study.

J Anaesthesiol Clin Pharmacol 2020 Jan-Mar;36(1):37-42. Epub 2020 Feb 18.

Pain Management Research Unit, Department of Anesthesiology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.

Background And Aims: Succinylcholine and high dose rocuronium are neuromuscular blocking agents commonly used for rapid sequence induction of anesthesia. Their usage is limited or contraindicated in some circumstances. The aim of this study is to determine the dosage and efficacy of atracurium without priming for rapid sequence induction of anesthesia. Read More

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http://dx.doi.org/10.4103/joacp.JOACP_36_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7047700PMC
February 2020

Neuromuscular monitoring during modified rapid sequence induction: A comparison of TOF-Cuff® and TOF-Scan®.

Australas Emerg Care 2020 Mar 12. Epub 2020 Mar 12.

Institute for Anesthesia and Intensive Care Medicine, Spital Thurgau Frauenfeld, Frauenfeld, Switzerland. Electronic address:

Background: Acceleromyometry is the clinical standard for quantitative neuromuscular monitoring, mostly using the stimulation pattern train-of-four (TOF). TOF-Cuff®, a recently introduced neuromuscular monitor with stimulating electrodes integrated within a blood pressure cuff, assesses the muscular response in the upper arm.

Methods: The time from administration of a neuromuscular blocking agent to TOF-ratio 0% during modified rapid sequence induction was compared between TOF-Cuff® and acceleromyometry (TOF-Scan®). Read More

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http://dx.doi.org/10.1016/j.auec.2020.02.005DOI Listing

The optimal dose of succinylcholine for rapid sequence induction: a systematic review and meta-analysis of randomized trials.

BMC Anesthesiol 2020 Mar 2;20(1):54. Epub 2020 Mar 2.

Division of Anaesthesiology, Department of Anaesthesiology, Pharmacology, Intensive Care and Emergency Medicine, Geneva University Hospitals, 4 Rue Gabrielle Perret-Gentil, 1205, Geneva, Switzerland.

Background: The evidence base for the widely accepted standard regimen of succinylcholine for rapid sequence induction (1.0 mg kg) remains unclear.

Methods: We performed a systematic review and meta-analysis of randomized trials comparing any succinylcholine regimen with the standard regimen (1. Read More

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http://dx.doi.org/10.1186/s12871-020-00968-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7053066PMC

Expert Recommendations for Tracheal Intubation in Critically ill Patients with Noval Coronavirus Disease 2019.

Chin Med Sci J 2020 Feb 27. Epub 2020 Feb 27.

Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730 China.

Coronavirus Disease 2019 (COVID-19), caused by a novel coronavirus (SARS-CoV-2), is a highly contagious disease. It firstly appeared in Wuhan, Hubei province of China in December 2019. During the next two months, it moved rapidly throughout China and spread to multiple countries through infected persons travelling by air. Read More

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http://dx.doi.org/10.24920/003724DOI Listing
February 2020

Video Laryngoscopy Compared to Augmented Direct Laryngoscopy in Adult Emergency Department Tracheal Intubations: A National Emergency Airway Registry (NEAR) Study.

Acad Emerg Med 2020 02 20;27(2):100-108. Epub 2020 Jan 20.

Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA.

Objective: The objective was to compare first-attempt intubation success using direct laryngoscopy augmented by laryngeal manipulation, ramped patient positioning, and use of a bougie (A-DL) with unaided video laryngoscopy (VL) in adult emergency department (ED) intubations.

Methods: This study was a secondary analysis of a multicenter prospective observational database of ED intubations from the National Emergency Airway Registry (NEAR). We compared all VL procedures to seven exploratory permutations of A-DL using multivariable regression models. Read More

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http://dx.doi.org/10.1111/acem.13851DOI Listing
February 2020

Rapid sequence induction: Are useful muscle relaxants the same from out-door to in-door hospital setting?

Anaesth Crit Care Pain Med 2020 02 7;39(1):25-26. Epub 2020 Jan 7.

Service d'anesthésie et de réanimation, hôpital Saint-Louis, université de Paris, Assistance publique-Hôpitaux de Paris, 1, avenue Claude-Vellefaux, 75010 Paris, France.

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http://dx.doi.org/10.1016/j.accpm.2020.01.003DOI Listing
February 2020

Tracheal Intubation in the Critically Ill. Where We Came from and Where We Should Go.

Am J Respir Crit Care Med 2020 04;201(7):775-788

Department of Critical Care Medicine, University of Alberta, Edmonton, Alberta, Canada.

Tracheal intubation is commonly performed in critically ill patients. Unfortunately, this procedure also carries a high risk of complications; half of critically ill patients with difficult airways experience life-threatening complications. The high complication rates stem from difficulty with laryngoscopy and tube placement, consequences of physiologic derangement, and human factors, including failure to recognize and reluctance to manage the failed airway. Read More

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http://dx.doi.org/10.1164/rccm.201908-1636CIDOI Listing

Effect of Rocuronium vs Succinylcholine on Endotracheal Intubation Success Rate Among Patients Undergoing Out-of-Hospital Rapid Sequence Intubation: A Randomized Clinical Trial.

JAMA 2019 12;322(23):2303-2312

Department of Emergency, CHU de la Réunion, Université de la Réunion, Réunion, France.

Importance: Rocuronium and succinylcholine are often used for rapid sequence intubation, although the comparative efficacy of these paralytic agents for achieving successful intubation in an emergency setting has not been evaluated in clinical trials. Succinylcholine use has been associated with several adverse events not reported with rocuronium.

Objective: To assess the noninferiority of rocuronium vs succinylcholine for tracheal intubation in out-of-hospital emergency situations. Read More

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http://dx.doi.org/10.1001/jama.2019.18254DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6990819PMC
December 2019

The electronic medical record: Big data, little information?

J Crit Care 2019 12;54:298-299

Department of Intensive Care, Ghent University Hospital, Ghent, Belgium.

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http://dx.doi.org/10.1016/j.jcrc.2019.09.005DOI Listing
December 2019

Advanced airway management success rates in a national cohort of emergency medical services agencies.

Resuscitation 2020 01 20;146:43-49. Epub 2019 Nov 20.

Department of Emergency Medicine, The University of Texas Health Science Center at Houston, Houston, TX, United States. Electronic address:

Objective: Despite its important role in care of the critically ill, there have been few large-scale descriptions of the epidemiology of Emergency Medical Services (EMS) advanced airway management (AAM) and the variations in care with different patient subsets. We sought to characterize AAM performance in a national cohort of EMS agencies.

Methods: We used data from ESO Solutions, Inc. Read More

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http://dx.doi.org/10.1016/j.resuscitation.2019.11.006DOI Listing
January 2020

An international survey about rapid sequence intubation of 10,003 anaesthetists and 16 airway experts.

Anaesthesia 2020 03 30;75(3):313-322. Epub 2019 Oct 30.

Department of Anesthesiology, Critical Care and Pain Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Pulmonary aspiration of gastric content is a significant cause of anaesthesia-related morbidity and mortality. High-quality prospective randomised evidence to support prevention strategies, such as rapid sequence intubation, is difficult to generate due to well-described practical, ethical and methodological barriers. We aimed to generate an understanding of worldwide practice through surveying clinically practicing anaesthetists and airway experts. Read More

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http://dx.doi.org/10.1111/anae.14867DOI Listing
March 2020
1 Read

Time for consensus on rapid sequence intubation?

Anaesthesia 2020 03 30;75(3):298-300. Epub 2019 Oct 30.

Department of Anaesthesia, Guy's and St. Thomas' NHS Foundation Trust and Honorary Senior Lecturer, King's College, London, UK.

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http://dx.doi.org/10.1111/anae.14906DOI Listing

In Reply.

Acad Emerg Med 2020 04 24;27(4):347-348. Epub 2019 Nov 24.

Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN.

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http://dx.doi.org/10.1111/acem.13875DOI Listing

Paralysis Before Sedation for Rapid Sequence Intubation.

Acad Emerg Med 2020 04 24;27(4):346. Epub 2019 Nov 24.

Department of Emergency Medicine, E-Da Hospital, Kaohsiung, Taiwan.

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http://dx.doi.org/10.1111/acem.13876DOI Listing

[Anaesthesia Induction in Non-fasting Patients - the Example of Pregnant Women and Children].

Anasthesiol Intensivmed Notfallmed Schmerzther 2019 Oct 22;54(10):617-628. Epub 2019 Oct 22.

Aspiration during anesthesia induction is no triviality, but can lead to serious complications and mortality. The classic technique of rapid sequence induction (RSI) is a fundamental form of anesthesia induction in non-fasting patients to prevent pulmonary aspiration of gastric contents.Pregnant women and children pose a special challenge due to their hypoxia risk; the classical RSI concept "induction - apnea - (cricoid pressure -) intubation" can lead to hypoxia and therefore must be modified in favor of a controlled technique with preservation of oxygenation in this patient group. Read More

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http://dx.doi.org/10.1055/a-0720-3936DOI Listing
October 2019

[Rapid Sequence Induction - Which Medication Should Be Used?]

Anasthesiol Intensivmed Notfallmed Schmerzther 2019 Oct 22;54(10):604-615. Epub 2019 Oct 22.

The rapid sequence induction (RSI) is a not evidence-based technique designed to minimize the chance of pulmonary aspiration in high-risk patients requiring general anesthesia. Primary aim of this anesthetic technique is, therefore, a fast airway protection with an endotracheal tube to reduce the chance of passive or active regurgitation. This article discusses the anesthetic management of patients with an increased risk of aspiration, and, particularly, refers to the medications required for RSI. Read More

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http://dx.doi.org/10.1055/a-0720-3880DOI Listing
October 2019

[Anaesthesiologic Techniques for Patients at Risk of Aspiration].

Anasthesiol Intensivmed Notfallmed Schmerzther 2019 Oct 22;54(10):589-602. Epub 2019 Oct 22.

Rapid sequence induction and intubation (RSII) is the appropriate method of inducing general anaesthesia in patients who are at a risk of aspiration. The classical RSII is limited to a few treatment recommendations which are rarely based on evidence-based findings. New techniques (e. Read More

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http://dx.doi.org/10.1055/a-0720-3923DOI Listing
October 2019

Rethinking rapid sequence induction of anaesthesia in critically ill adults.

Lancet Respir Med 2019 12 1;7(12):997-999. Epub 2019 Oct 1.

Department of Emergency Care, Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK. Electronic address:

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http://dx.doi.org/10.1016/S2213-2600(19)30275-9DOI Listing
December 2019

Classical versus controlled rapid sequence induction and intubation in children with bleeding tonsils (a retrospective audit).

Acta Anaesthesiol Scand 2020 01 10;64(1):41-47. Epub 2019 Oct 10.

Department of Anaesthesia, University Children's Hospital, Zurich, Switzerland.

Purpose: To determine whether bag-mask ventilation between induction of anaesthesia and tracheal intubation in children with post-tonsillectomy bleeding reduces the incidence of hypoxaemia and difficult direct laryngoscopy without increasing perioperative respiratory complications.

Methods: Medical records, anaesthesia protocols and vital sign data were analysed from February 2005 to March 2017 for patients undergoing anaesthesia for surgical revision of bleeding tonsils. Type of rapid sequence induction and intubation (RSII; classical, ie, apnoeic, vs controlled, ie, with gentle bag-mask ventilation) was noted. Read More

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http://dx.doi.org/10.1111/aas.13473DOI Listing
January 2020
6 Reads

A survey of cricoid pressure application in a single institution in Ethiopia.

BMC Res Notes 2019 Aug 28;12(1):546. Epub 2019 Aug 28.

Mekelle University, Mekelle, Tigray Region, Ethiopia.

Objective: The aim of this survey is to determine the standard of practice of cricoid pressure application on rapid sequence induction in Ayder comprehensive specialized hospital from April 3 to May 3, 2019.

Results: A total of 30 anesthetists were involved in the study with a response rate of 87%. Ninety percent of the respondents do not mask ventilate during rapid sequence induction and they do aspirate the naso-gastric tube if present. Read More

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http://dx.doi.org/10.1186/s13104-019-4586-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6712642PMC

Rocuronium Bromide Intravenous Solution Maruishi® is more suitable than ESLAX Intravenous® during rapid-sequence induction of anesthesia.

J Anesth 2019 Oct 21;33(5):600-603. Epub 2019 Aug 21.

Department of Anesthesiology, Dokkyo Medical University Saitama Medical Center, 2-1-50 Minamikoshigaya, Koshigaya City, 343-8555, Saitama, Japan.

Purpose: Rocuronium Bromide Intravenous Solution® (Maruishi Pharmaceutical Co., Ltd, Osaka, Japan) is a newly developed generic drug and we have noticed that compared with conventional rocuronium formulations [e.g. Read More

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http://dx.doi.org/10.1007/s00540-019-02673-xDOI Listing
October 2019
2 Reads

Improvement in the Safety of Rapid Sequence Intubation in the Emergency Department with the Use of an Airway Continuous Quality Improvement Program.

West J Emerg Med 2019 Jul 3;20(4):610-618. Epub 2019 Jun 3.

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

Introduction: Airway management in the critically ill is associated with a high prevalence of failed first attempts and adverse events which negatively impacts patient care. The purpose of this investigation is to describe an airway continuous quality improvement (CQI) program and its effect on the safety of rapid sequence intubation (RSI) in the emergency department (ED) over a 10-year period.

Methods: An airway CQI program with an ongoing airway registry was initiated in our ED on July 1, 2007 (Academic Year 1) and continued through June 30, 2017 (Academic Year 10). Read More

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http://dx.doi.org/10.5811/westjem.2019.4.42343DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6625676PMC
July 2019
9 Reads

The association of paramedic rapid sequence intubation and survival in out-of-hospital stroke.

Emerg Med J 2019 Jul 30;36(7):416-422. Epub 2019 May 30.

Research and Evaluation, Ambulance Victoria, Melbourne, Victoria, Australia.

Introduction: Ambulance transport of patients with stroke is common, with rapid sequence intubation (RSI) to secure the airway used regularly. Randomised controlled trial evidence exists to support the use of RSI in traumatic brain injuries (TBIs), but it is not clear whether the RSI evidence from TBI can be applied to the patient with stroke. To this end, we analysed a retrospective stroke dataset to compare survival of patients with RSI compared with patients that did not receive RSI. Read More

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http://dx.doi.org/10.1136/emermed-2019-208613DOI Listing
July 2019
8 Reads

Comparison of Intravenous Dexmedetomidine versus Esmolol for Attenuation of Hemodynamic Response to Tracheal Intubation after Rapid Sequence Induction: A Systematic Review and Meta-Analysis.

Biomed Res Int 2019 17;2019:6791971. Epub 2019 Apr 17.

Department of Anesthesiology, East Hospital, Tongji University School of Medicine, Shanghai 200120, China.

The present study aims to investigate whether intravenous dexmedetomidine shows superiority to esmolol for hemodynamic response to tracheal intubation after rapid sequence induction. In the present meta-analysis, PubMed, EMBASE, and the Cochrane Library were searched for trials comparing dexmedetomidine with esmolol for the attenuation of the hemodynamic response to intubation. Ten trials were selected in the present meta-analysis. Read More

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http://dx.doi.org/10.1155/2019/6791971DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6500701PMC
November 2019
5 Reads

Factors associated with post-intubation sedation after emergency department intubation: A Report from The National Emergency Airway Registry.

Am J Emerg Med 2020 03 6;38(3):466-470. Epub 2019 May 6.

Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, United States of America; Harvard Medical School, Boston, MA, United States of America.

Background: Previous work has suggested low rates of post-intubation sedation in patients undergoing endotracheal intubation (ETI) in the emergency department (ED) with limited data examining factors associated with sedation use. Utilizing a national database; we sought to determine the frequency of post-intubation sedation and associated factors.

Methods: We performed a retrospective analysis of a prospectively collected database (National Emergency Airway Registry (NEAR) from 25 EDs from January 1, 2016 to December 31, 2017). Read More

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http://dx.doi.org/10.1016/j.ajem.2019.05.010DOI Listing
March 2020
2 Reads

Alternatives to Rapid Sequence Intubation: Contemporary Airway Management with Ketamine.

West J Emerg Med 2019 May 26;20(3):466-471. Epub 2019 Apr 26.

Maimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York.

Endotracheal intubation (ETI) is a high-risk procedure commonly performed in emergency medicine, critical care, and the prehospital setting. Traditional rapid sequence intubation (RSI), the simultaneous administration of an induction agent and muscle relaxant, is more likely to harm patients who do not allow appropriate preparation and preoxygenation, have concerning airway anatomy, or severe hypoxia, acidemia, or hypotension. Ketamine, a dissociative anesthetic, can be used to facilitate two alternatives to RSI to augment airway safety in these scenarios: delayed sequence intubation - the use of ketamine to allow airway preparation and preoxygenation in the agitated patient; and ketamine-only breathing intubation, in which ketamine is used without a paralytic to facilitate ETI as the patient continues to breathe spontaneously. Read More

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http://dx.doi.org/10.5811/westjem.2019.4.42753DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6526883PMC
May 2019
22 Reads

Long-term Effectiveness of the Airway Registry at Sydney Helicopter Emergency Medical Service.

Air Med J 2019 May - Jun;38(3):161-164. Epub 2019 Feb 22.

Greater Sydney Area Helicopter Emergency Medical Service, New South Wales Ambulance, Bankstown Airport, New South Wales, Australia; Department of Anesthesiology, Amsterdam University Medical Centres, location AMC, Amsterdam Zuidoost, The Netherlands(3) Sydney Medical School, Sydney University.

Objective: Prehospital rapid sequence intubation (RSI) is prone to suboptimal documentation. The Greater Sydney Area Helicopter Emergency Medical Service (GSA-HEMS) uses a dedicated Airway Registry (AR) to aid documentation. The AR was only evaluated shortly after its introduction. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S1067991X183033
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http://dx.doi.org/10.1016/j.amj.2019.01.006DOI Listing
May 2020
12 Reads

In Reply.

Acad Emerg Med 2019 09 12;26(9):1108. Epub 2019 Jun 12.

Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN.

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http://dx.doi.org/10.1111/acem.13806DOI Listing
September 2019
4 Reads

Measuring Intubation in the Emergency Department: Is It Time to Include End-tidal Carbon Dioxide to Determine the Onset of Apnea?

Authors:
Jason R West

Acad Emerg Med 2019 09 11;26(9):1106-1107. Epub 2019 Jun 11.

Department of Emergency Medicine, Lincoln Medical and Mental Health Center, Bronx, NY.

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http://dx.doi.org/10.1111/acem.13804DOI Listing
September 2019
3 Reads

Response: Inclined versus supine position for endotracheal intubation.

Am J Emerg Med 2019 08 15;37(8):1588. Epub 2019 May 15.

Department of Emergency Medicine, University of Washington, Seattle, WA, USA; Seattle Fire Department, Seattle, WA, USA.

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http://dx.doi.org/10.1016/j.ajem.2019.05.028DOI Listing
August 2019
1 Read

Procedural Challenges During Intubation in Patients With Oropharyngeal Masses: A Prospective Observational Study.

Anesth Analg 2019 06;128(6):1256-1263

Department of Anesthesia and Critical Care, University of Chicago, Chicago, Illinois.

Background: In patients who undergo surgery for oropharyngeal masses, intubation is almost always successful. However, technical aspects of airway management, including bag mask ventilation and oxygenation, may still be difficult. Although rates of airway difficulty and intubation success in these patients have been studied, these data may not reflect difficulty with individual components of the intubation process. Read More

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http://dx.doi.org/10.1213/ANE.0000000000004089DOI Listing

The HEAVEN criteria predict laryngoscopic view and intubation success for both direct and video laryngoscopy: a cohort analysis.

Scand J Trauma Resusc Emerg Med 2019 Apr 24;27(1):50. Epub 2019 Apr 24.

Department of Medical Education, California University of Science & Medicine, School of Medicine, 217 E Club Center Dr Suite A, San Bernardino, CA, 92408, USA.

Background: Existing difficult airway prediction tools are not practical for emergency intubation and do not incorporate physiological data. The HEAVEN criteria (Hypoxaemia, Extremes of size, Anatomic challenges, Vomit/blood/fluid, Exsanguination, Neck mobility) may be more relevant for emergency rapid sequence intubation (RSI).

Methods: A retrospective analysis included air medical RSI patients. Read More

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http://dx.doi.org/10.1186/s13049-019-0614-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6480652PMC
April 2019
7 Reads

Rapid sequence induction: an old concept with new paradigms.

Br J Hosp Med (Lond) 2019 Apr;80(4):C58-C61

Specialist Registrar in Anaesthesia and Intensive Care, Department of Anaesthesia, University College Hospital NHS Foundation Trust, London.

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http://dx.doi.org/10.12968/hmed.2019.80.4.C58DOI Listing

Pre- and Apnoeic high flow oxygenation for RApid sequence intubation in The Emergency department (Pre-AeRATE): study protocol for a multicentre, randomised controlled trial.

Trials 2019 Apr 4;20(1):195. Epub 2019 Apr 4.

Emergency Medicine Department, National University Hospital, National University Health System, Level 4, 9 Lower Kent Ridge Road, Singapore, 119085, Singapore.

Background: Maintaining adequate oxygenation during rapid sequence intubation (RSI) is imperative to prevent peri-intubation adverse events that can lead to increased duration of hospital and intensive care unit stay, or a prolonged vegetative state requiring long-term institutionalisation. Despite employing current best practices during RSI, desaturation during intubation still occurs. High-flow nasal cannula (HFNC) oxygenation may potentially improve oxygenation during pre- and apnoeic oxygenation to allow a longer safe apnoeic time for RSI. Read More

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http://dx.doi.org/10.1186/s13063-019-3305-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6449991PMC
April 2019
2 Reads

Use of End Tidal Oxygen Monitoring to Assess Preoxygenation During Rapid Sequence Intubation in the Emergency Department.

Ann Emerg Med 2019 09 14;74(3):410-415. Epub 2019 Mar 14.

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

Study Objective: Preoxygenation is important to prevent oxygen desaturation during emergency airway management. The purpose of this study is to describe the use of end tidal oxygen (eto) during rapid sequence intubation in the emergency department.

Methods: This study was carried out in 2 academic centers in Sydney, Australia, and New York City. Read More

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http://dx.doi.org/10.1016/j.annemergmed.2019.01.038DOI Listing
September 2019
8 Reads

Better understanding of the effectiveness of cricoid pressure and the rapid sequence induction.

Acta Anaesthesiol Scand 2019 07 12;63(6):837-838. Epub 2019 Mar 12.

Department of Anesthesiology, Advocate Illinois Masonic Medical Center Chicago, Chicago, Illinois.

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http://doi.wiley.com/10.1111/aas.13348
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http://dx.doi.org/10.1111/aas.13348DOI Listing
July 2019
16 Reads

Drug Order in Rapid Sequence Intubation.

Acad Emerg Med 2019 09 19;26(9):1014-1021. Epub 2019 Mar 19.

Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN.

Background: The optimal order of drug administration (sedative first vs. neuromuscular blocking agent first) in rapid sequence intubation (RSI) is debated.

Objective: We sought to determine if RSI drug order was associated with the time elapsed from administration of the first RSI drug to the end of a successful first intubation attempt. Read More

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http://doi.wiley.com/10.1111/acem.13723
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http://dx.doi.org/10.1111/acem.13723DOI Listing
September 2019
119 Reads