Articles: intubation.
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One hundred seventy-eight endotracheal intubations by paramedics were reviewed prospectively during a nine-month period; 149 patients (83.7%) had medical conditions, and 29 (16.2%) had trauma. The endotracheal tube was successfully placed in 172 (96.6%); in four patients (2.2%), attempts were unsuccessful, and in two patients (1.1%), the attempt was aborted. ⋯ We conclude that endotracheal intubation can be accomplished successfully outside the hospital by paramedical personnel. Comprehensive training and continuous medical control of paramedics' activities seem to be essential requirements for its success.
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Critical care medicine · Oct 1983
Noncardiac pulmonary edema precipitated by tracheal intubation in patients with inhalation injury.
Ten patients with body surface burn and clinical evidence of inhalation injury developed transient, reversible pulmonary edema within 5 min after endotracheal intubation. Hemodynamic studies within 1 hr after intubation revealed normal cardiac output and pulmonary artery wedge pressure (WP). ⋯ It is postulated that glottic generated expiratory retard may increase alveolar pressure, thus preventing pulmonary edema. Bypass of glottis by tracheal intubation may render alveolar pressure atmospheric and facilitate edema formation.