Articles: intubation.
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Secure positioning of orally or nasally placed endotracheal and gastric tubes is a necessity for the patient with burns. This article describes a technique for securing these tubes with a simple modification to avoid compression on the ear that may lead to subsequent necrosis and infection.
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Clinical Trial Controlled Clinical Trial
Intravenous lidocaine does not attenuate the haemodynamic response of children to laryngoscopy and tracheal intubation.
The haemodynamic responses to laryngoscopy and intubation after induction of anaesthesia with thiopentone alone or in combination with 1.5 mg.kg-1 IV lidocaine were measured in 125 children age 2 to 12 yr to determine whether lidocaine administered one, two, three or four minutes before tracheal intubation attenuated the pressor response. Lidocaine did not attenuate the increases in heart rate and arterial blood pressure. ⋯ The increases in systolic and mean blood pressure were significantly affected by the age of the patient, P less than 0.05. Lidocaine is not a beneficial adjunct to induction of anaesthesia with thiopentone in healthy children for the purpose of attenuating the pressor response to intubation.
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Randomized Controlled Trial Comparative Study Clinical Trial
Nasotracheal intubation using a flexible lighted stylet.
Nasotracheal intubation is an essential skill for clinicians involved in the care of acutely ill or injured patients. Unfortunately, it has the dangers and difficulties of any blind technique. Although usually performed in the awake patient, nasotracheal intubation has also been used in the apneic patient. ⋯ There were no significant differences in the time needed to intubate or the number of attempts. There were notable differences in the success rates of individual intubators with each technique. Although not statistically significant, our results suggest a useful role for the lighted stylet in nasotracheal intubation in the apneic patient.