Articles: intubation.
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J Clin Monit Comput · Dec 2022
Improvement in vocal-cord visualization with Trachway video intubating stylet using direct oxygen flow and effective analysis of the fraction of inspired oxygen: a bench study.
The Trachway video intubating stylet device facilitates the visualization of the airways of patients from the tip of an endotracheal tube (ETT) during intubation. The major limitations of Trachway are the restricted view due to secretions and the risk of a prolonged apnea during intubation. We conducted a bench study to verify the performance of an alternative, easily applicable airway device that allows better visualization of trackways during Trachway-assisted intubation and prevents the detrimental effects of apnea-related hypoxia. ⋯ The ODD, which can be easily coupled with Trachway stylets, enabled high-quality visualization during oxygen flows of 6-8 L/min, and higher FiO2 fractions were achieved at higher oxygen flow rates. The use of the ODD improved the visualization of the airways during video stylet-assisted intubations using the additional FiO2 supply. The ODD developed in this study improves the visualization of airways with Trachway stylets and enhances the safety of intubation.
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Across multiple disciplines undertaking airway management globally, preventable episodes of unrecognised oesophageal intubation result in profound hypoxaemia, brain injury and death. These events occur in the hands of both inexperienced and experienced practitioners. Current evidence shows that unrecognised oesophageal intubation occurs sufficiently frequently to be a major concern and to merit a co-ordinated approach to address it. ⋯ The tube should be removed if timely restoration of sustained exhaled carbon dioxide cannot be achieved. In addition to technical interventions, strategies are required to address cognitive biases and the deterioration of individual and team performance in stressful situations, to which all practitioners are vulnerable. These guidelines provide recommendations for preventing unrecognised oesophageal intubation that are relevant to all airway practitioners independent of geography, clinical location, discipline or patient type.
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Randomized Controlled Trial
Impact of choice of nostril on nasotracheal intubation when using video rigid stylet: a randomized clinical trial.
Patients undergoing oral and maxillofacial surgeries under general anesthesia usually require nasotracheal intubation. When presented with patients with equally patent nostrils, selection of the nostril to use for intubation is an important decision for facilitating intubation. The objective of this trial is to determine whether choice of nostril impacts nasotracheal intubation when using a video rigid stylet in patients undergoing oral and maxillofacial surgery. ⋯ When considering which nostril to use for intubation with video rigid stylet, either nostril can be used similarly.