Annals of emergency medicine
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[Vinson DR: Superstitions in medicine: bad luck or bad logic? Ann Emerg Med May 1998;31:650-652.].
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Distal placement of the endotracheal tube tip in the glottic opening is rarely discussed in most emergency medicine, surgery, and prehospital medicine texts. We report three cases of glottic intubation recognized after the patients were thought to have been successfully intubated. ⋯ Recognition of this complication is aided by the use of radiographic findings, inappropriate endotracheal tube depth, and the presence of inadequate ventilatory volumes. Potential complications of glottic intubation include dislodgement of the endotracheal tube, kinking of the tube, and inadequate protection of the airway.
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The American Board of Emergency Medicine gathers extensive background information on emergency medicine residents and the programs in which they train. Before the compilation of this report, this information has not been widely available.
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To determine whether condensation on the inner surface of the endotracheal tube (vapor trail) is a reliable indicator of intratracheal placement. ⋯ In this model, condensation on the inner surface of the endotracheal tube was common after placement within the esophagus. If these results are confirmed in human studies, the presence of a vapor trial should not be used as a clinical indicator of correct endotracheal tube placement.