European journal of anaesthesiology
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Comparative Study
A comparison of the AMBU ISCOPE and Macintosh laryngoscopes: first experience with a new device for tracheal intubation: a manikin study.
Video laryngoscopes achieve laryngeal visualisation through indirect imaging using video cameras that look around the curve of the tongue. The new AMBU ISCOPE intubation device combines features from the laryngeal mask airway with video laryngoscopy enabling visual control of tracheal intubation without the use of a stylet. ⋯ Tracheal intubation time was significantly longer in trainees using the AMBU ISCOPE intubation device compared to a Macintosh laryngoscope, but with a difference of only 8 s. Laryngeal visualisation was significantly better using the AMBU ISCOPE device, but success rates for intubation were the same.
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The single-use Laryngeal Mask Airway (LMA) Supreme is a new supraglottic airway device. It has been reported to be reliable and easy-to-use in clinical practice; however, the anaesthetic techniques for its insertion are not standardised. ⋯ Sevoflurane alone can provide acceptable conditions for insertion of the LMA Supreme in adults, at an estimated minimum alveolar anaesthetic concentration of 3% with minimal adverse effects.
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Practice Guideline
Pre-interventional haemostatic assessment: Guidelines from the French Society of Anaesthesia and Intensive Care.
Recently the French Society of Anaesthesia and Intensive Care (Société Française d'Anesthésie et de Réanimation [SFAR]) issued recommendations for the prescription of routine preoperative testing before a surgical or non-surgical procedure, requiring any type of anaesthesia. Thirty clinical specialists performed a systematic analysis of the literature, and recommendations were then developed using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system. One part of these guidelines is dedicated to haemostatic assessment. ⋯ Standard tests (prothrombin time, activated partial thromboplastin time, platelet count) have a low positive predictive value for bleeding risk in the general population. Patients with no history of haemorrhagic diathesis and no conditions liable to interfere with haemostasis should not undergo pre-interventional haemostasis testing. Conversely, the existence of a positive history or a disease that could interfere with haemostasis should be an indication for clinically appropriate testing.