Definition of Rapid Sequence Intubation in the Financial Dictionary - by Free online English dictionary and encyclopedia. What is Rapid Sequence Intubation? Meaning of Rapid Sequence Intubation as a finance term. What does Rapid Sequence Intubation mean in finance?
Orotracheal intubation following general anesthesia requires blades to be performed. The risk of patients contamination with infectious agents related to reusable metal blades leads to promote single-use blades. Some of these latter are plastic and this material may need more strength to lift the jaw and expose the larynx before orotracheal intubation. Sometimes, change of blade, from plastic to metal, during the procedure is necessary to increase the larynx exposure. This change of blade may increase the frequency of sore throat following orotracheal intubation.. Consequently, the study hypothesis is an increase of both sore throat intensity and frequency with the plastic blades compared with the metal blades.. The primary purpose of the present study is to compare the impact of these two types of blades, metal versus plastic, on sore throat intensity and frequency following scheduled orotracheal intubation for general anesthesia ...
TY - JOUR. T1 - Emergency Department use of Apneic Oxygenation Versus Usual Care During Rapid Sequence Intubation. T2 - A Randomized Controlled Trial (The ENDAO Trial). AU - Caputo, Nicholas. AU - Azan, Ben. AU - Domingues, Rui. AU - Donner, Lee. AU - Fenig, Mark. AU - Fields, Douglas. AU - Fraser, Robert. AU - Hosford, Karlene. AU - Iuorio, Richard. AU - Kanter, Marc. AU - Mccarty, Moira. AU - Parry, Thomas. AU - Raja, Andaleeb. AU - Ryan, Mary. AU - Williams, Blaine. AU - Sharma, Hemlata. AU - Singer, Daniel. AU - Shields, Chris. AU - Scott, Sandra. AU - West, Jason R.. PY - 2017. Y1 - 2017. N2 - 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. Methods: A ...
Airway management is one of the most important skills for an emergency department practitioner to master because failure to secure an adequate airway can quickly lead to death or disability. Endotracheal intubation using rapid sequence intubation (RSI) is the cornerstone of emergency airway management.
OBJECTIVE. Endotracheal intubation of newborn infants is a mandatory competence for many pediatric trainees. The Neonatal Resuscitation Program recommends a 20-second limit for intubation attempts. Intubation attempts by junior doctors are frequently unsuccessful, and many infants are intubated between 20 and 30 seconds without apparent adverse effect. Little is known about the proficiency of more senior medical staff, the time taken to determine endotracheal tube (ETT) position, or the effects of attempted intubation on infants heart rate (HR) and oxygen saturation (Spo2) in the delivery room (DR). The objectives of this study were to determine (1) the success rates and duration of intubation attempts during DR resuscitation, (2) whether experience is associated with greater success rates and shorter time taken to intubate, (3) the time taken to identify ETT position after intubation, and (4) the frequency with which infants deteriorated during intubation attempts and the time at which this ...
Background: Etomidate is the standard induction agent used during rapid sequence intubation (RSI) in the emergency department (ED). Etomidate shortages require providers to utilize alternative agents. The purpose of this study is to compare the safety and procedural outcomes of propofol and etomidate for RSI in the ED. Methods: This was a retrospective chart review of adult patients in the ED who received propofol or etomidate for induction during RSI. The main endpoint was hypotension, defined as a systolic blood pressure | 90 mmHg or diastolic blood pressure | 60 mmHg, within the first hour of intubation. Time to intubation, intensive care unit length of stay, hospital length of stay, and in-hospital mortality were also evaluated. Results: Two hundred and seventy five patient charts were reviewed. Of the 98 patients included, 43 patients received propofol and 55 patients received etomidate. Propofol was associated with an increased incidence of hypotension within the first hour of intubation (65.1% vs
Sean P. Kane, PharmD, BCPS, speaks with Joseph Muench, PharmD, BCPS about airway pharmacology. In the episode, the most common sedatives and paralytics for rapid sequence intubation are discussed, including concepts regarding dosing, adverse effects, onset and duration of effect, and clinical pearls.
... The Paediatric Emergencies Intubation Course is truly multidisciplinary, attracting healthcare professionals ...
In advanced airway management, rapid sequence induction (RSI) - also described as rapid sequence intubation or as rapid sequence induction and intubation (RSII) - is a special process for endotracheal intubation that is used where the patient is at a high risk of pulmonary aspiration or impending airway compromise. It differs from other forms of general anesthesia induction in that artificial ventilation is generally not provided from the time the patient stops breathing (when drugs are given) until after intubation has been achieved. This minimizes insufflation of air into the patients stomach, which might otherwise provoke regurgitation. "Classic" RSI involves pre-filling the patients lungs with a high concentration of oxygen gas, followed by applying cricoid pressure, administering rapid-onset sedative or hypnotic and neuromuscular-blocking drugs that induce prompt unconsciousness and paralysis, inserting an endotracheal tube with minimal delay, and then releasing the cricoid pressure. ...
Rapid Sequence Intubation (RSI) adalah suatu prosedur tehnik intubasi yang dilakukan setelah preoksigenisasi, kemudian induksi dengan menggunakan obat induksi yang poten lalu diikuti pemberian obat pelumpuh otot dengan kerja cepat untuk dapat menyebabkan penurunan kesadaran dan paralisis motorik untuk tujuan intubasi secara cepat. Teknik ini didasari pada pasien dalam keadaan tidak puasa atau lambung penuh yang akan dilakukan intubasi, yang memiliki resiko aspirasi cairan atau isi lambung ...
An apparatus for endotracheal intubation comprises a suction stylet (10) telescopically disposed within an endotracheal tube (30) such that the suction stylet (10) is operative to aspirate fluids from the vicinity of the distal end (16) of the endotracheal tube. The apparatus further comprises a connector for releasably axially fixing the suction stylet with respect to the endotracheal tube during intubation. The suction stylet (10) and endotracheal tube (30) are advanced down the trachea simultaneously, the suction stylet (10) aspirating unwanted oral secretions from the operators field of view during intubation. Once the trachea is intubated, the connector is disconnected and the suction stylet is withdrawn, leaving the endotracheal tube in place. A method for endotracheal intubation is also disclosed in which a suction stylet (10) is telescopically disposed within an endotracheal tube (30). The suction stylet and endotracheal tube are advanced simultaneously through the trachea, aspirating unwanted
TY - JOUR. T1 - Comparison of haemodynamic responses to orotracheal intubation in anaesthetised and paralysed patients with simulated cervical spine injury. T2 - Airtraq® video laryngoscope versus fibreoptic bronchoscope. AU - Pillai, Ajith Kumar. AU - Muhamed, Shiyad. AU - Giri, Manu. AU - Shenoy, Kailasnath. AU - Mathew, Shaji. AU - Dugappa, Arunkumar Handittu. AU - Rahiman, Ramzi Aboo Abdul. PY - 2019/1/1. Y1 - 2019/1/1. N2 - Background: Endotracheal intubation may produce haemodynamic fluctuations which may be deleterious in patients with cardiovascular and neurological disorders. This is further worsened in patients with difficult airway. This study was conducted to compare haemodynamic fluctuations produced when intubation was done using Airtraq and fibreoptic bronchoscopy which are used in patients with anticipated difficult airway. Methodology: Prospective randomized study. Eighty patients, ASA PS 1 and 2 undergoing elective surgery were randomized into two groups - Group A and Group F. ...
Introduction: Filling tracheal tube cuff (TTC) after intubation is necessary to provide a safe airway in intubated patients. On the other hand, excessive increase or decrease in the pressure of TTCs balloon leads into the dangerous complications such as necrosis and/or aspiration. Accordingly, in the present study, we tried to evaluate the most two common fixed volume and pilot balloon palpitation methods to control TTC pressure. Methods: In a prospective cross-sectional study that was carried out in the emergency department of Tabriz Imam Reza hospital upon 194 patients who needed intubation and from April 2015 to June 2016. The patients were randomly allocated into two equal groups. For the first the Pilot Balloon Palpation technique and for the second group 10 cc fixed volume cuff filling technique was assigned. After that, the pressure was checked with manometer and data were analyzed using SPSS software. Results: TTC pressure average in fixed volume group was 44.96±21.77 cmH2O and for
PURPOSE: Intubation in ICU strongly differs from intubation in operative rooms. The results of studies about risk factors of difficult intubation performed in operative rooms cannot therefore be extrapolated directly to ICU.. The primary purpose of this trial (cf Part Design of this registration) is other and more particularly Prognosis because it is is an assessment of risk factors of difficult airway in intensive care units.. DESIGN AND METHODOLOGY: This is an open prospective multicentric study of intubation in ICU in more than 50 centres. Consecutive intubations will be included in each centre, in order to reach the sample size required (at least 1000 procedures intubations). The usual risk factors of difficult intubation in operative rooms, the demographic parameters and the complications of intubation will be assessed, as well as survival status at 28 days. ...
... Laryngoscopy and tracheal intubation produce marked increases in heart rate and blood pressure, which is potentially dangerous in certain patients. Various pharmacological agents have been used before laryngoscopy and tracheal intubation in an attempt to attenuate the adrenergic response, but with varying degree of success. OBJECTIVE To compare the efficacy of lignocaine to alfentanil in blunting the pressor response to endotracheal intubation. DESIGN An open label comparative study. POPULATION Seventy eight ASA I and II adult patients between the ages of 18 and 65 years booked for elective surgery which requires endotracheal intubation. SETTING Dr George Mukhari Hospital, a tertiary level training hospital in Gauteng, South Africa. 2 METHOD After obtaining ethical clearance the study was conducted on 78 ASA class I & II patients. The patients were randomly allocated to three groups according ...
INTRODUCTION: Postoperative sore throat is listed from the top as patients most undesirable outcome in the postoperative period. It is believed to originate from mucosal dehydration or edema, tracheal ischemia secondary to the pressure of endotracheal tube cuffs, aggressive oropharyngeal suctioning, and mucosal erosion from friction between delicate tissues and the endotracheal tube. Even if the problem was indicated in many literatures, it has never been studied in our country. The study aimed to assess prevalence and factors associated with postoperative sore throat among patients who were operated under general anesthesia with endotracheal intubation. METHODS: hospital based cross sectional study was conducted from February 25 - April 10, 2014 in Gondar University hospital. Patient interview and chart review were employed for data collection. Bivariate and multivariate logistic regressions were used to determine the association.
Background: Awake intubation is the standard of care for management of the anticipated difficult airway. The performance of awake intubation may be perceived as complex and time-consuming, potentially leading clinicians to avoid this technique of airway management. This retrospective review of awake intubations at a large academic medical center was performed to determine the average time taken to perform awake intubation, its effects on hemodynamics, and the incidence and characteristics of complications and failure. Methods: Anesthetic records from 2007 to 2014 were queried for the performance of an awake intubation. Of the 1,085 awake intubations included for analysis, 1,055 involved the use of a flexible bronchoscope. Each awake intubation case was propensity matched with two controls (1:2 ratio), with similar comorbidities and intubations performed after the induction of anesthesia (n = 2,170). The time from entry into the operating room until intubation was compared between groups. The ...
Tracheal intubation (usually simply referred to as intubation), an invasive medical procedure, is the placement of a flexible plastic catheter into the trachea. For millennia, tracheotomy was considered the most reliable (and most risky) method of tracheal intubation. By the late 19th century, advances in the sciences of anatomy and physiology, as well as the beginnings of an appreciation of the germ theory of disease, had reduced the morbidity and mortality of this operation to a more acceptable rate. Also in the late 19th century, advances in endoscopic instrumentation had improved to such a degree that direct laryngoscopy had finally become a viable means to secure the airway by the non-surgical orotracheal route. Nasotracheal intubation was not widely practiced until the early 20th century. The 20th century saw the transformation of the practices of tracheotomy, endoscopy and non-surgical tracheal intubation from rarely employed procedures to essential components of the practices of ...
Methods: HFNO of 60 L.min−1 at an inspiratory oxygen fraction of 1 was delivered 4 min before laryngoscopy and maintained until the patient was intubated, and correct intubation was verified by the appearance of the end-tidal CO2 (EtCO2) waveform. Transcutaneous oxygenation (SpO2), heart rate and non-invasive mean arterial pressure were monitored at baseline (T0), after 4 min on HFNO (T1) and at the time of laryngoscopy (T2) and endotracheal intubation (ETI) (T3). An SpO2 of ...
The results of using a prewarmed tube for nasotracheal intubation are variable.1-3 Although studies in adults suggest reduced bleeding, its efficacy in pediatric patients seems to be poor.1-4 In the control group in the study by Watt et al .,1 where tracheal intubation was achieved by using a tube at room temperature, the incidence of bleeding was 56%, significantly higher than in the control group of Elwood et al .,4 wherein a thermosoftened tube was used and the incidence of bleeding was only 29%. Further, although Watt et al .1 report that a 39% incidence of epistaxis in patients in whom the nasotracheal tube was carried with a thermosoftened uncuffed tube is consistent with that reported by Elwood et al .4 in their thermosoftening group (29%), it is still higher in the study of Watt et al . Considering these facts, in the study by Watt et al ., the higher incidence of bleeding in patients in whom a prewarmed tube was used can be attributed to the use of a larger tube (selected by Coles ...
Yoshihiro Hirabayashi, Norimasa Seo, Jichi Medical University, Japan 20 anesthetists performed tracheal intubations on a manikin with either an in-line head and neck position or the sniffing position. There were no differences in the success rate and the time to intubation between the two positions. The overall number of teeth clicks was lower in the in-line head and neck position than in the sniffing position (P , 0.05). The score for preference of position, on a visual analogue scale, was better for the in-line head and neck position than for the sniffing position (P , 0.01). We concluded that the in-line head and neck position was preferable for tracheal intubation with the Airtraq laryngoscope compared to the sniffing position. ...
Objective To describe a simple protocol for ventilator-assisted preoxygenation (VAPOX) prior to rapid sequence intubation in the ED using a Hamilton T1 ventilator in an effort to further reduce the incidence of transient and critical hypoxaemia. Methods Ventilator-assisted preoxygenation includes the following steps; preparation for rapid sequence intubation as per institutional protocols, including departmental checklists. Hamilton T1 ventilator is setup in non-invasive spontaneous/timed mode with settings as described. The patient is optimally positioned and nasal cannula applied with an oxygen flow rate of 15 L/min. A face mask is applied with the jaw pulled forward using a two-handed thenar eminence grip and the ventilator is started. Preoxygenation occurs for 3 min. Drugs including neuromuscular blockers are administered, while the operator ensures the airway remains patent. The ventilator transitions into Pressure Controlled Ventilation once apnoea ensues. Nasal oxygen continues until endotracheal
A malleable stylet... was placed within a 4.0 cuffed tracheal tube... and shaped like a hockey stick. A 15-6 MHZ HFL50x linear array ultrasound probe attached to a Sonosite S-nerve machine (SonoSite Inc., Bothell, WA) was lightly placed transversely on the patients neck at the level of the thyrohyoid membrane. The probe was moved caudally until a view of the vocal cords and surrounding hypopharyngeal tissue was obtained. A second provider opened the mouth and performed a jaw thrust while inserting the hockey-stick-shaped styletted tube in the midline of the patients pharynx. The tube was inserted in the midline of the pharynx under the operators direct vision, it was then advanced slowly along the tongue base at which point it was visualized to the left of the glottis on the ultrasound image. The tube was withdrawn slightly and its trajectory modified to direct it into the glottis; hypoechoic shadowing and widening of the vocal cords was noted as the tube entered the trachea, a characteristic ...
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Mallinckrodt, the M brand mark, the Mallinckrodt Pharmaceuticals logo and other brands are trademarks of a Mallinckrodt company.© 2018 Mallinckrodt. Mallinckrodt Pharmaceuticals is a registered business name of Mallinckrodt plc, which is registered in Ireland as a public limited company with registration number 522227 and has its registered office at College Business & Technology Park, Cruiserath, Blanchardstown, Dublin 15, Ireland.. ...
PubMed journal article: New method of preoxygenation for orotracheal intubation in patients with hypoxaemic acute respiratory failure in the intensive care unit, non-invasive ventilation combined with apnoeic oxygenation by high flow nasal oxygen: the randomised OPTINIV study protocol. Download Prime PubMed App to iPhone, iPad, or Android
Objectives: To examine whether urgent orotracheal intubation (OI) can induce bacteremia. To find predictive factors for post-intubation b
ENT Procedures Tracheostomy Dressing Nasopharyngeal Airway LBH Clinical Practice Manual Intubations Intubation: Stomal Head Tilt-Chin Lift Jaw Thrust Cricothyroidotomy Cricothyrotomy Emergency Intubation Oropharyngeal Airway Orotracheal Intubation Suctioning A Patient With A Tracheostomy Tube Suctioning A Patient With An Endotracheal Tube (ETT) Needle Thoracentesis Episiotomy Esophageal Tracheal Intubation Positive Pressure Ventilation General surgery procedures Sewing… Read More » ...
Midazolam, Diazepam, Lorazepam. Provide excellent amnesia and sedation ... Diazepam and Lorazepam. Moderate/long acting agents. Longer onset time than midazolam ... - A free PowerPoint PPT presentation (displayed as a Flash slide show) on PowerShow.com - id: 567d5-MGRmM
Prolonged time during endotracheal tube placement has been associated with poor outcomes, including cardiac arrest and death. For this reason, the accurate measurement of the duration of intubation time is an important metric in studies that evaluate interventions to improve airway outcomes. In the current study we correlated the gaps in routinely measured ventilatory parameters with duration of the intubation procedure to determine if these intervals could be used to accurately calculate the intubation time. Fifty-six random airway management encounters were video recorded along with a continuous video feed of the patient monitor. Intubation event times were measured and correlated with gap times of end-tidal carbon dioxide, airway pressure, airway flow, tidal volume, and respiratory rate defined as the disappearance of the parameter at the end of mask ventilation to the reappearance after intubation. Scatter plots were generated for intubation times versus each parameter time gap and ...
Delayed Sequence Intubation (DSI) is a procedural sedation, the procedure in this case being effective preoxygenation. Give ketamine, put them on the mask, and in 3 minutes paralyze and intubate.
For professionals, however, the bag valve mask is still the preferred ventilation method early on in cardiac arrest, Harper said. Looking at intubation success rates, Harper reported a 31 percent failure rate for prehospital intubation with about 12 percent unrecognized esophageal intubation on arrival a the hospital. Interestingly, this study showed no difference in mortality between those with failed intubation and those who were successfully intubated on arrival. Does that mean a bad tube is just as good as a good tube? In some respect this supports the idea of just working the patient longer with a BVM, Harper said ...
Stenoses of the respiratory tract are life threatening conditions of various origins. The authors give referrence on 21 patients operated for postintubation stenoses of their trachea at the IInd Surgical Clinic of the UPJŠ Medical Faculty, the Faculty Hospital of L. Pasteur in Košice, from 01. 01. 1999 to 30. 06. 2005. All patients had a tracheobronchoscopic examination and a CT examination completed prior to the procedure. Within 24 hours of their admission, 9 patients were operated, 7 underwent resection procedures and 2 patients had Montgomerys T-cannula introduced. 12 patients had their procedures planned, and were operated later than 24 hours after their admission. 10 patients underwent resections of the trachea, 2 had Montgomerys Tcannula implanted. The postoperative course following the resection of the trachea was without complications in 14 patients, 1 patient experienced transitional oedema in the anastomosis and 2 patients suffered restenoses. In this patient group, no fatal case ...
Some 40-60% of patients with coma producing brain injuries will have intracranial hypertension. The National Emergency Airway Course recommends a pre-treatment dose of Lignocaine (1.5mg/kg) given 3 minutes before induction when intubating head injured patients. Analysing the results of the above search there appears to be little high quality evidence available to show that intravenous lignocaine suppresses the rises in intracranial pressure associated with rapid sequence intubation in head injured patients ...
In reply:. We appreciate the response to our manuscript "Alternatives to Rapid Sequence Intubation: Contemporary Airway Management with Ketamine" and value the authors perspectives, both competing and complementary.. We agree that flexible endoscopy is a powerful, safety-preserving airway management modality that should be a foundational component of the emergency physicians arsenal and that, ideally, all emergency physicians would be competent in this skill and use it regularly for fully awake intubation technique, facilitated by "meticulous topical anesthesia," as well as dissociated ketamine-only breathing intubation (KOBI). At the moment, however, the majority of practicing emergency physicians are not able to efficiently apply topical anesthesia dense enough to facilitate a fully awake technique in most patients, and are not able to able to efficiently intubate using a flexible endoscope, either because they lack the equipment or the skill set, or both.. Furthermore, even providers ...
Im a dinosaur. I look at new technology with a suspicious eye. I see no reason to change for the sake of change. For instance, I finally purchased a PDA cell phone recently, and I realized what everyone seems to have known for years-theyre amazing.. The first time I saw a video laryngoscope, I felt much the same way I initially did about the PDA: Thats a lot of money for a camera and some lights. I also thought, Ive done just fine with my bent metal stick for the past two decades, why should I change now? However, having used the device, I know why. Because its a better way to deliver patient care, with less opportunity for physical trauma to the patient, quicker visualization of the glottis and enhanced verification of endotracheal tube placement.. Straight or curved direct laryngoscopy blades are de-signed to move the anatomy to obtain a line-of-sight glottic view. Head-neck manipulation, tongue displacement, direct contact with laryngeal structures, and impacting teeth are all ...
The overall aim of the present thesis was to study aspects of patient safety in critically ill patients with special focus on airway management, respiratory complications and nursing procedures. Study I describes a method called pharyngeal oxygen administration during intubation in an experimental acute lung injury model. The study showed that pharyngeal oxygenation prevented or considerably increased the time to life-threatening hypoxemia at shunt fractions by at least up to 25% and that this technique could be implemented in airway algorithms for the intubation of hypoxemic patients. In study II, we investigated short-term disconnection of the expiratory circuit from the ventilator during filter exchange in critically ill patients. We demonstrated that when using pressure modes in the ventilator, there was no indication of any significant deterioration in the patients lung function. A bench test suggests that this result is explained by auto-triggering with high inspiratory flows during the ...
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Difficult intubation is one of the major reasons for perioperative mortality and morbidity in relation to anesthesia [ 1 ]. Difficult intubations
The sympathoadrenal response to endotracheal intubation was investigated in nine infants 2-4 months old and in eight adults 23-45 years old at the start of inguinal hernia operations. In both infants and adults, heart rate and diastolic blood pressure increased significantly immediately after intubation. In both groups, moreover, there was a mean (SD) reduction in microvascular blood flow in the abdominal skin (infants -21 (14)%, adults -14 (7)%) and in the adipose tissue (infants -7 (4)%, adults -5 (4)%). However, the plasma glycerol concentration did not increase in the infants whereas it increased in the adults by 50 (12)%. In conclusion, infants and adults showed similar circulatory reactions during endotracheal intubation but the markedly increased lipolysis rate observed in adults was not seen in the infants. This may indicate that catecholamine induced lipolysis in vivo as well as in vitro is poor during infancy.. ...
Background: Lignocaine is a local anaesthetic of moderate potency and duration with good penetrative power and rapid onset of action carbonated lignocaine has remarkable penetrative power, rapid onset of action a high incidence of motor block and a reduced incidence of missed segments (When used for epidural anaesthesia) when compared to hydrochloride of lignocaine. Subjects and Methods: Seventy five (75) patients belonging to ASA grade 1 & 2 scheduled for general surgical, orthopaedic surgical, ENT, gynaecological surgical producers were studied. Results: The age of the patients varied from 10 to 60 years. In our study, the heart rate in controls (Group A) before induction was 86+/-10 rose to 93+/-12 and 107+/-13 after induction and after laryngoscopy + ETI respectively. The changes seen after endotracheal intubation alone was statistically very highly significant (,0.001). In Group B, the pre induction heart rate was 94+/-17, which increased to 99+/-13, after induction.This increase not ...
Due to a higher metabolic rate, oxygen consumption is increased in children, especially in infants. Infants and children have an increased relative cardiac output and minute ventilation to match the increased metabolic demand. However, children are vulnerable to rapid desaturation when oxygenation or ventilation is reduced. Children have relatively small-volume lungs with small functional residual capacities. This translates into a reduced oxygen reservoir, which decreases the effectiveness of preoxygenation and makes optimal preoxygenation more difficult. Therefore, be prepared to support oxygenation with bag-mask ventilation, often before an intubation attempt, while awaiting the onset of induction and paralysis. Attempts at intubation may need to stop once oxygen saturation drops below 90% to allow for bag-mask ventilation before the next attempt. Below an oxygen saturation of 90%, desaturation is particularly rapid.5 The vast majority of children are easily bag ventilated when the proper ...
A 36-year-old woman presented as an emergency with decompensated alcoholic liver disease and sepsis from spontaneous bacterial peritonitis. Emergency intubation was carried out without difficulty (size 8 endotracheal tube without stylet). Chest x ray revealed suboptimal tube placement, so 8 ml of air was aspirated from the … ...
A 68-year-old patient was scheduled for a thoracotomy. A double-lumen endobronchial tube was requested by the surgeon to facilitate operating conditions. Initial attempts at intubation by conventional methods were unsuccessful. The proximal ends of a
We found that problematic intubation was associated with thyromental distance, increasing neck circumference, BMI, and a Mallampati score of | or = 3. Neck circumference should be assessed preoperatively to predict difficult intubation.
The process of inserting an ETT is called intubation. Intubation usually requires general anaesthesia and muscle relaxation but can be achieved in the awake patient with local anaesthesia or in an emergency without any anaesthesia, although this is extremely uncomfortable and generally avoided in other circumstances. It is usually performed by visualising the larynx by means of a hand-held laryngoscope that has a variety of curved and straight blades, with a light source. Intubation can also be performed "blind" or with the use of the attendants fingers (this is called digital intubation). Intubation aids: A stylet can be used inside the endotracheal tube. The malleable metal stylet is a bendable piece of metal inserted into the ETT as to make the tube more stiff for easier insertion, or to provide more curvature to the tip in difficult cases. This is then removed after the intubation and a ventilator or self-inflating bag is attached to the ETT. The goal is to position the end of the ETT 2 ...
The evaluation standards for artificial airway management are related to patient outcomes. The incidence of ventilator-associated pneumonia (VAP) is one of the primary outcomes used to determine standards of care for acutely and critically ill patients with artificial airways. The Centers for Disease Control and Prevention (CDC) defines ventilator in the following way: A ventilator is a device to assist or control respiration continuously, inclusive of the weaning period, through a tracheostomy or by endotracheal intubation.1 ...
Attending: ******. A time-out was completed verifying correct patient, procedure, site, positioning, and special equipment if applicable. The patient was placed in a flat position. Sedation was obtained using "Versed **mg and Etomidate **mg". The patient was initially ventilated using an ambu bag. The GLIDESCOPE / MAC 3 BLADE was used and inserted into the oropharynx at which time there was a Grade 1 view of the vocal cords. A 7.5-french endotracheal tube was inserted and visualized going through the vocal cords. The stylette was removed. Colorimetric change was visualized on the CO2 meter. Breath sounds were heard in both lung fields equally. The endotracheal tube was placed at 23 cm, measured at the teeth. Attending ********** was available for the entire procedure.. A chest x-ray was ordered to verify endotracheal tube placement.. Estimated Blood Loss: ...
An enhanced endotracheal tube utilizing a fiber optic bundle positioned in its wall section to transmit light and a reflectively coated bore to transmit images is disclosed. Additional passages formed in the wall of the endotracheal tube are adapted to receive a stylette and to act as an air passage for inflating an inflatable cuff formed on the inner end of the endotracheal tube. The light transmitted through the fiber optic bundle aids in illuminating the patients laryngeal area and the image is reflected along the reflectively coated bore to aid the physician in intubating the patient. Alternative embodiments using a bore with a sleeve having a different refractive index from that of the tube material and an enhanced endotracheal tube for use with children are shown.
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