Articles: intubation.
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Pediatric emergency care · Dec 2021
Randomized Controlled TrialImpact of Environmental Noise Levels on Endotracheal Intubation Performance Among Pediatric Emergency Providers: A Simulation Study.
The emergency department is a stressful workplace environment with environmental stimuli and distractions, including noise. This has potential effects on perceived stress for providers and critical procedure performance. ⋯ Intubation performance improved with attempt number, but no differences in performance were seen between noise levels. This suggests that rehearsing and practice impacts performance more than environmental noise levels.
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When using a standard geometry laryngoscope, experts recommend engaging the hyoepiglottic ligament-a ligament deep to the vallecula not visible to the intubator. The median glossoepiglottic fold (hereafter termed midline vallecular fold) is a superficial mucosal structure, visible to the intubator, that lies in the midline of the vallecula. We aimed to determine whether engaging the midline vallecular fold with a standard geometry blade tip during orotracheal intubation improved laryngeal visualization. ⋯ Engaging the midline vallecular fold with the laryngoscope blade tip during orotracheal intubation when using a standard geometry blade was associated with improved laryngeal visualization.
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This study evaluates the utility of arterial blood gas (ABG) parameters and chest radiography in predicting intubation need in patients with burn injuries with suspected inhalation injury. ⋯ In patients suspected inhalation injury, pH and P/F ratio were good predictors for appropriate intubations. Incorporating the parameters into the ABA criteria improved their clinical utility.
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There is no evidence supporting intubation for a Glasgow Coma Scale (GCS) of 8. We investigated the effect of intubation in trauma patients with a GCS 6-8, with the hypothesis that intubation would increase mortality and length of stay. ⋯ Among patients with GCS of 6 to 8, intubation on arrival was associated with an increase in mortality and with longer ICU and overall length of stay. The use of a strict threshold GCS to mandate intubation should be revisited.