Articles: intubation.
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This study determines the flammability of polyvinylchloride (PVC), red rubber (RR), and silicone (Si) endotracheal tubes in oxygen- and nitrous-oxide-enriched atmospheres. Flammability is measured by using the oxygen and nitrous oxide indices of flammability with laser ignition. ⋯ These results are similar to the previously reported O2 and N2O indices of flammability with propane-torch ignition. This study validates the concept that the indices of flammability are useful measures of endotracheal tube flammability and are independent of the ignition source.
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There is controversy regarding the optimal mode of elective tracheal intubation in the patient with an unstable cervical spine following trauma. A ten-year review of 150 patients with traumatic cervical spine injuries with well-preserved neurological function, presenting for operative stabilization, was conducted to compare neurological outcome with the mode of tracheal intubation. Preoperative neurological deficits were identified in 49 patients (33%); most were single-level radiculopathies. ⋯ There were no differences in neurological outcome whether intubation was performed while the patient was awake or under general anaesthesia, or comparing oral tracheal intubation with all other techniques (P = 0.5, Fisher exact test). Also, in-line traction did not affect neurological outcome. Oral tracheal intubation with in-line stabilization, either performed after induction of general anaesthesia or with the patient awake, remains an excellent option for elective airway management in patients with cervical spine injuries.