Articles: intubation.
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Case Reports
Prehospital SALAD Airway Technique in an Adolescent with Penetrating Trauma Case Report.
We present a case of an adolescent patient with a penetrating gunshot wound to the mouth requiring endotracheal intubation via rapid sequence intubation in the prehospital setting. The team used video laryngoscopy (VL) to secure the airway; however, continuous bloody secretions increased the complexity of the procedure and required the application of the Suction-Assisted Laryngoscopy and Airway Decontamination (SALAD) method to facilitate intubation. By utilizing the SALAD procedure, the field of view on the VL camera remained unobscured, and the patient's airway remained clear, allowing for an uneventful intubation procedure. ⋯ This is followed by permanently placing the large bore suction catheter under constant suction in the posterior pharynx or esophagus to keep the VL camera unobscured by vomit or blood to facilitate intubation. After the intubation, the suction catheter may be removed unless ongoing suction is required. Keeping the VL camera unobscured during the procedure may improve first-pass intubation success rate.
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Rev Assoc Med Bras (1992) · Jan 2024
Hospital cohort study on survival predictors for intubated coronavirus disease 2019 patients.
The objective of this study was to assess the predictors of survival among patients with coronavirus disease 2019 who underwent tracheal intubation, as part of a hospital cohort study. ⋯ Our analysis unveiled that the risk of death in intubated coronavirus disease 2019 patients is four times higher when an emergency physician, as opposed to an anesthesiologist, leads the tracheal intubation team.
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Rev Assoc Med Bras (1992) · Jan 2024
Observational StudyPrevalence of obstructive sleep apnea syndrome and predictors of difficult orotracheal intubation.
Obstructive sleep apnea syndrome (OSAS) is an underdiagnosed condition that causes recurrent episodes of partial or total collapse of the upper airways during sleep. It is associated with perioperative pulmonary complications. The STOP-BANG is a screening tool for assessing patients at risk of OSAS. The aim of this study was to assess the prevalence of patients with OSAS during pre-anesthetic evaluation at a hospital and its correlation with predictors of ventilation and difficult airway. ⋯ The study had the participation of 221 patients, of whom 121 presented with a STOP-BANG ≥3, with a prevalence of 54.2%. All patients undergoing bariatric surgeries presented STOP-BANG ≥3. No significant statistical relationships were found between predictors of difficult orotracheal intubation and STOP-BANG ≥3. However, significant statistical relationships were found in relation to predictors of difficult ventilation through the facial mask.
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The cause of oropharyngeal dysphagia in patients with coronavirus disease (COVID-19) can be multifactorial and may underly limitations in swallowing rehabilitation. ⋯ Prolonged orotracheal intubation and post-COVID-19 neurological alterations increase the probability of dysphagia immediately after extubation. Increased age and tracheostomy limited rehabilitation.
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Tracheal intubation is recommended for coma patients and those with severe brain injury, but its use in patients with decreased levels of consciousness from acute poisoning is uncertain. ⋯ Among comatose patients with suspected acute poisoning, a conservative strategy of withholding intubation was associated with a greater clinical benefit for the composite end point of in-hospital death, length of ICU stay, and length of hospital stay.