Articles: intubation.
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Oral endotracheal intubation is a procedure performed by emergency medical services (EMS) providers-who are stationed on ground ambulances, rotor-wing air ambulances (helicopter), and fixed-wing air ambulances (airplane)-for the purpose of securing a patient's airway. ⋯ Our data show that flight crew members-either on fixed-wing or rotor-wing air ambulances-are associated with significantly higher rates of intubation success than ground ambulance providers. There are a number of possible explanations for this trend, including more opportunities to intubate in the air medical setting, increased clinical education focused on airway management in the air medical setting, or assistive technologies being more commonly used in the air medical setting.
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Randomized Controlled Trial Comparative Study
Cuffed versus uncuffed tracheal tubes in a rabbit training model for establishing an emergency front-of-neck airway in infants: a prospective trial.
In a rabbit-model of infant front-of-neck airway rescue, a cuffed 3.0 mm ETT was non-inferior to uncuffed 3.5 mm ETT for success & time-to-perform, but required greater force.
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Current guidelines advocate prehospital endotracheal intubation (ETI) in patients with suspected severe head injury and impaired level of consciousness. However, the ability to identify patients with traumatic brain injury (TBI) in the prehospital setting is limited and prehospital ETI carries a high complication rate. We investigated the prevalence of significant TBI among patients intubated in the field for that reason. ⋯ Altered mental status in the setting of trauma is a major reason for prehospital ETI. Although most of these patients had TBI, one in four of them did not suffer a significant TBI. Patients with a higher field GCS and those suffering from intoxication have a higher risk of misdiagnosis. Future studies should explore better tools for prehospital assessment of TBI and ways to better define and characterize patients who may benefit from early ETI.
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Comparative Study Observational Study
Association of Advanced Airway Insertion Timing and Outcomes After Out-of-Hospital Cardiac Arrest.
While often prioritized in the resuscitation of patients with out-of-hospital cardiac arrest, the optimal timing of advanced airway insertion is unknown. We evaluated the association between the timing of advanced airway (laryngeal tube and endotracheal intubation) insertion attempt and survival to hospital discharge in adult out-of-hospital cardiac arrest. ⋯ In the PART, timing of advanced airway insertion attempt was not associated with survival to hospital discharge.