Journal of the Royal Army Medical Corps
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Comparative Study
Airway management at floor level: a comparison of tracheal intubation using the Macintosh and Airtraq laryngoscopes.
Practitioners providing pre-hospital care during civilian practice and on military operations may be required to perform airway management and tracheal intubation at floor level. It has been shown that intubation using the Airtraq laryngoscope is easier to learn than standard Macintosh laryngoscopy. We hypothesised that the Airtraq would be easier to use and have shorter intubation times than Macintosh intubation. ⋯ The Airtraq was found to be superior in ease of use (VAS 30 mm, P < 0.001), had a shorter total intubation time (19.4seconds) and a higher intubation success rate (P = 0.012) than the Macintosh laryngoscope (VAS 50 mm, 20.4 seconds). Rotating the tracheal tube 90 degrees anticlockwise during loading into the guiding channel, made the Airtraq intubation easier (VAS 30 mm, P = 0.001) and faster (19.4 seconds, P < 0.001) than with standard orientation of the tube (VAS 40 mm, 25.3 seconds). Airtraq intubation may prove to be easier than Macintosh intubation, when utilised in the clinical pre-hospital setting, though randomised controlled clinical trials are required to confirm this.
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Comment Letter Case Reports
The Airtraq laryngoscope in severe ankylosing spondylitis.
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Historical Article
D-day on board a tank landing ship: meat, cheese and blood transfusion.
Tank Landing Ships were used as evacuation station hospitals during D-Day of World War Two. This historical vignette describes how difficulties were overcome in blood transfusion and trauma surgery aboard these ships. Their place in the evacuation chain is discussed in relation to previous experiences in military medicine.
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This study was designed to identify the most effective underbody position when using the patient's own body weight as an infusion device. Twenty volunteers had an air-less 500 ml bag of saline located at various under-body positions. ⋯ Locating the fluid bag at the buttock cleft delivered the highest mean flow rate at 135 ml/min. This underbody position may provide flow rates sufficient to achieve the clinical aim of fluid resuscitation in the military pre-hospital environment.