Articles: intubation.
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Paramedics intubated 358 of 383 (93.5%) patients over a nine-month period. There were 85 survivors. The intubators used the curved-blade laryngoscope in 304 patients (79.5%). ⋯ This retrospective study further documents the ability of paramedics to successfully perform endotracheal intubation. The high success rate supports training with live subjects. Further studies of cause and impact of complications, correlation of success with increased survival, and alternative techniques are essential for effective EMS system medical control.
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Maintaining endotracheal intubation is critical to treating respiratory failure in newborns. To reduce accidental extubations in our neonatal intensive care unit, a prospective comparison of rates of extubation was made between two taping methods and whether or not a head restraint was used. ⋯ Factors that preceded or were associated with accidental extubation included the time intubated, infant agitation, endotracheal tube suctioning, the infant turning its head, chest physiotherapy, loose tape, too short a tube between lip and adapter, weighing, and endotracheal tube taping. This information and the study design are valuable in developing strategies to minimize accidental endotracheal extubation and the subsequent risks of airway injury and subglottic stenosis in sick newborns.
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Limited data are available on the efficacy of a common endotracheal suctioning intervention to prevent postsuctioning decreases in arterial oxygenation (PaO2). This study evaluated the effect on Pao2 of five hyperinflation (tidal volume 1.5 times normal) and hyperoxygenation breaths, administered before and after each of two consecutive endotracheal suctioning passes, with use of a manual resuscitation bag (PMR-2 model). The convenience sample consisted of 32 patients with endotracheal tubes who were observed within 24 hours of coronary artery bypass surgery. ⋯ In addition, a clinical measure of alveolar-capillary gas exchange (PaO2/PAO2 ratio) was found to be a significant predictor of PaO2 after suctioning, accounting for 38% of the variance. The data from this study support the efficacy of administering five hyperinflation and hyperoxygenation breaths, with use of a manual resuscitation bag, before and after endotracheal suctioning in stable patients after coronary artery bypass surgery. Further study is necessary to determine the efficacy of this suctioning intervention in patients with other respiratory problems.
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Middle East J Anaesthesiol · Oct 1988
A simple method for preventing obstruction of the endotracheal tube during palatal surgery.
In this paper we describe a simple method for avoiding the obstruction of the Mallinckrodt R. A. E. (Ring, Adair and Elwin) preformed endotracheal tube which we use during cleft palate surgery, palatal lengthening and pharyngoplasty in patients who have well developed lower incisor teeth.