Articles: intubation.
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Paediatric anaesthesia · Jan 2024
An analysis of a new rapid difficult airway response team in a vertically built children's hospital.
Intrahospital transport is associated with adverse events. This challenge is amplified during airway management. Although difficult airway response teams have been described, little attention has been paid to patient transport during difficult airway management versus the alternative of managing patient airways without moving the patient. This is especially needed in a 22-floor vertical hospital. ⋯ A rapid difficult airway response team allows a large majority of patients' airways to be managed and secured in the patient's primary hospital location. Future directions include reducing time to airway securement and identifying factors associated with cardiac arrest.
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Practice Guideline
Evidence-Based Guideline for Prehospital Airway Management.
Airway management is a cornerstone of emergency medical care. This project aimed to create evidence-based guidelines based on the systematic review recently conducted by the Agency for Healthcare Research and Quality (AHRQ). A technical expert panel was assembled to review the evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. ⋯ The recommendations address the use of ventilation with bag-valve mask ventilation alone vs. supraglottic airways vs. endotracheal intubation for adults and children with cardiac arrest, medical emergencies, and trauma. Additional recommendations address the use of video laryngoscopy and drug-assisted airway management. These recommendations, and the associated good practice statements, offer EMS agencies and clinicians an opportunity to review the available evidence and incorporate it into their airway management strategies.
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J Neurosurg Anesthesiol · Jan 2024
Factors Associated With Unplanned Post-Craniotomy Re-intubation in Children: A NSQIP-Pediatric® Analysis.
Most children undergoing craniotomy with general endotracheal anesthesia are extubated postoperatively, but some require unplanned postoperative intubation (UPI). We sought to determine the incidence of UPI and identify associated factors and related postoperative mortality. ⋯ Although uncommon, UPI in children who underwent craniotomy was associated with an elevated risk of postoperative mortality. The presence of identifiable risk factors may be used for preoperative counseling and risk profiling in these patients.