Is Intubation Success Rate Higher With Two-Medic Crews

The Research Myers LA, Gallet CG, Kolb LJ, et al. Determinants of success and failure in prehospital endotracheal intubation. West J Emerg Med. 2016;17(5):640–647. The Science The documentation of 200 intubation attempts on 150 patients cared for by a multisite EMS agency was reviewed by the authors to determine what factors were associated with success and failure of prehospital intubation. They defined an attempt as the laryngoscope blade entering the mouth. Overall success rate was 75%. The use, on an adult, of an endotracheal (ET) tube size
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Airway & Respiratory Columns Source Type: news

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We report a case of difficult endotracheal intubation in a patient with Treacher Collins syndrome. A sixteen-year-old female patient scheduled for general anesthesia had a displaced palatal tooth that interfered with laryngoscope insertion into the pharyngeal space. To address this problem, we successfully performed endotracheal intubation using a fiberscope while elevating the epiglottic vallecula using a King Vision™ video laryngoscope. A later operation was performed after tooth extraction without difficult laryngoscopy. Our experience stresses the importance of removing obstructions to laryngoscopic inspection pr...
Source: Anesthesia Progress - Category: Anesthesiology Tags: Anesth Prog Source Type: research
Objectives: Severe hypoxemia is the most common serious adverse event during endotracheal intubation. Preoxygenation is performed routinely as a preventive measure. The relative efficacy of the various available preoxygenation devices is unclear. Here, our objective was to assess associations between preoxygenation devices and pulse oximetry values during endotracheal intubation. Design: Post hoc analysis of data from a multicenter randomized controlled superiority trial (McGrath Mac Videolaryngoscope Versus Macintosh Laryngoscope [MACMAN]) comparing videolaryngoscopy to Macintosh laryngoscopy for endotracheal intubat...
Source: Critical Care Medicine - Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research
We report a novel technique for the management of subglottic stenosis in a neonate. The initial endotracheal intubation did not provide adequate mechanical ventilation due to a significant air leak. We then performed suspension laryngoscopy and used a metal suction tube as an intubating stylet. We successfully inserted an endotracheal tube deep enough to maintain adequate mechanical ventilation. This technique is a viable rescue strategy in this clinical scenario.
Source: A&A Case Reports - Category: Anesthesiology Tags: Case Reports Source Type: research
DiscussionThe trial will clarify the efficacy of intubation with a Macintosh laryngoscope and a flexible video endoscope in the lateral position, and whether the two devices could be used in combination to secure the airway in cases where endotracheal intubation in the lateral position has failed with one device.Trial registrationChinese Clinical Trial Register,ChiCTR- IOR-15007175. Registered on 6 October 2015.
Source: Trials - Category: Research Source Type: clinical trials
During an emergency endotracheal intubation, rapid sequence induction intubation (RSII) with cricoid pressure (CP) is frequently implemented to prevent aspiration pneumonia. We evaluated the CVS in endotrachea...
Source: BMC Anesthesiology - Category: Anesthesiology Authors: Tags: Research article Source Type: research
In hospital-based studies, patients intubated by physicians while in an inclined position compared to supine position had a higher rate of first pass success and lower rate of peri-intubation complications. We evaluated the impact of patient positioning on prehospital endotracheal intubation in an EMS system with rapid sequence induction capability. We hypothesized that patients in the inclined position would have a higher first-pass success rate.
Source: The American Journal of Emergency Medicine - Category: Emergency Medicine Authors: Source Type: research
ConclusionsCompared with SMO, preoxygenation with HFNC in the ICU did not improve the lowest SpO2 during intubation in the non-severely hypoxemic patients but led to a reduction in intubation-related adverse events.Trial registrationClinical trial Submission: 7 March 2016. Registry name: Benefits of high-flow nasal cannulae oxygen for preoxygenation during intubation in non-severely hypoxemic patients: the PROTRACH study. Clinicaltrials.gov identifier: NCT02700321. Eudra CT: 2015-A00145-44. CPP: 15/13-975 (Comit é de protection des personnes de Rennes). URL registry:https://clinicaltrials.gov/ct2/show/record/NCT02700321.
Source: Intensive Care Medicine - Category: Intensive Care Source Type: research
Endotracheal intubation has for many years been recognized as the gold standard for airway management [1]. However, as with any procedure, it requires appropriate training [2]. The average learning curve for direct laryngoscopy as shown by studies of Buis et al. is about 50 endotracheal intubations [3]. Studies by Aghamohammadi et al. have shown that the learning curve for videolaryngoscopy is much shorter than for direct laryngoscopy [4]. However, due to the high cost of a videolaryngoscope, standard laryngoscopes with Miller or Macintosh blades are the main type of devices used for endotracheal intubation in the operatin...
Source: The American Journal of Emergency Medicine - Category: Emergency Medicine Authors: Source Type: research
Conclusions: The upper airway of the subglottic area and the cricoid area in cleft palate children are elliptical, with the transverse dimension narrow and the anteroposterior dimension wide. Cleft palate children with airway stenosis underwent surgery smoothly by using a portable visible laryngoscope. PMID: 30630255 [PubMed - in process]
Source: Shanghai Journal of Stomatology - Category: Dentistry Authors: Tags: Zhonghua Kou Qiang Yi Xue Za Zhi Source Type: research
Conclusion: In laterally positioned neonates, GVL is easier than DL with a similar intubation time, comparable time required for tube passage, better views of the glottis, shorter times to obtain the best glottic view, and high success rate as compared with DL. GlideScope seems to be an effective approach for endotracheal intubation of laterally positioned neonates with myelodysplasia.
Source: Saudi Journal of Anaesthesia - Category: Anesthesiology Authors: Source Type: research
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