Articles: intubation.
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The general relationships between the pressure inside an endotracheal tube cuff, the pressure exerted by that cuff on the tracheal wall and the airway pressure have been re-examined in a model system. In relatively recent literature, the tracheal wall pressure at a given cuff volume has been calculated as the difference between intracuff pressures at that volume when the cuff is inflated inside the trachea and when it is inflated whilst suspended freely in air. This has been used as a general relationship, as an alternative to direct measurement in real and model tracheas. In this study, the directly measured pressure was not generally equal to the pressure as calculated above.
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Endotracheal intubation in emergency situations is a recognized function of respiratory therapists, as defined by the American Association for Respiratory Therapy in 1973. A training program based in the operating room, using one-on-one instruction, was the basis for a training program designed to meet JCAH standards for endotracheal intubation. To evaluate the success of our training and our system for attempting intubations, we recorded the results of 50 consecutive intubation attempts by our therapists. ⋯ While 39 patients were intubated within one minute, 11 required more than one minute. In five patients, physicians had attempted intubation prior to a therapist's arrival; those intubations took eleven times longer than those that were attempted by therapists only. The average time for intubations attempted solely by therapists was 54 seconds.