Articles: intubation.
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Randomized Controlled Trial Clinical Trial Controlled Clinical Trial
The oesophageal detector device. A prospective trial on 100 patients.
Misplacement of a tracheal tube in the oesophagus remains a significant cause of mortality and morbidity in anaesthesia, despite decades of effort aimed at prevention, or perhaps more importantly, detection, of such an event. We have evaluated a cheap, simple and quick device which relies mainly on the reflation or otherwise of an Ellick's evacuator applied to the supposed 'tracheal' tube. ⋯ There were no false positive results and the correct deduction of which was the tracheal tube was reached in 100 tests using this device. Its use is recommended for widespread evaluation as a valuable adjunct to existing methods of detecting misplacement.
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Although a number of studies have described endotracheal intubation of adult patients in the prehospital setting, there are few studies on prehospital endotracheal intubation of pediatric patients. The purposes of our study were to determine how frequently prehospital endotracheal intubation was used in pediatric cardiopulmonary arrests when a paramedic trained in endotracheal intubation was present, to determine the success rate and complications associated with the procedure in the field, and to compare resuscitation rates and outcome in patients with and without prehospital endotracheal intubation. Our retrospective study covered a 38-month period and included all prehospital victims of medical cardiopulmonary arrest under the age of 19 years. ⋯ In patients less than 1 year old, only six of 16 (38%) had endotracheal intubation attempted and only three of six (50%) attempts were successful. Of the 18 patients who were intubated successfully before arrival at the hospital, nine (50%) survived to hospital admission and one (6%) survived to discharge. The remainder died in the emergency department.(ABSTRACT TRUNCATED AT 250 WORDS)
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We evaluated the use of an inexpensive trans-illuminating light wand for tracheal intubation. Expertise in its use was acquired quickly, thereby providing successful per-oral intubation in all patients who were able to open the mouth, irrespective of the view obtained of the epiglottis and larynx.
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Randomized Controlled Trial Clinical Trial
Effect of buprenorphine on the cardiovascular response to tracheal intubation.
The effects of buprenorphine on the haemodynamic responses to tracheal intubation were studied in a placebo-controlled double-blind trial in 40 patients who had elective surgery. In one group saline was administered intravenously 8 minutes before induction, whereas the others received buprenorphine 2.5 micrograms/kg intravenously. ⋯ In the buprenorphine group, the maximum increase in systolic and diastolic arterial blood pressures, heart rate and rate pressure product were significantly lower compared to the control group. It is concluded that buprenorphine is partially effective in attenuating the cardiovascular response to laryngoscopy and intubation, but does not obliterate it.