Articles: intubation.
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Observational Study
Prospective development and validation of a universal classification for paediatric videolaryngoscopic tracheal intubation: the PeDiAC score.
The VIDIAC score, a prospectively developed universal classification for videolaryngoscopy, has shown excellent diagnostic performance in adults. However, there is no reliable classification system for videolaryngoscopic tracheal intubation in children. We aimed to develop and validate a multivariable logistic regression model and easy-to-use score to classify difficult videolaryngoscopic tracheal intubation in children and to compare it with the Cormack and Lehane classification. A secondary aim was to externally validate the VIDIAC score in children. ⋯ We developed and validated a specifically tailored classification for paediatric videolaryngoscopic tracheal intubation with excellent diagnostic performance and calibration that outperformed the Cormack and Lehane classification.
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Int J Obstet Anesth · Nov 2024
Rate of difficult intubation during caesarean delivery: A single centre before/after standardised airway management implementation study.
The use of general anaesthesia (GA) for caesarean delivery (CD) introduces the risk of both difficult and failed intubation. Various strategies may be utilised to reduce this risk; however, not all are supported by evidence. We analysed the rate of difficult intubation following implementation of three recommendations specific to airway management in CD. ⋯ Implementation of standardised airway management recommendations had no significant impact on difficult intubation rate, though adoption of all three recommendations was not universal.
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Pediatric emergency care · Nov 2024
Video-Based Study of the Progression of Pediatric Emergency Medicine Fellows' Tracheal Intubation Performance During Training.
The lower clinical exposure of Pediatric Emergency Medicine (PEM) fellows to critical procedures may impede skill acquisition. We sought to determine the tracheal intubation learning curve of PEM fellows during training and compared PEM fellow success against standards for tracheal intubation success. ⋯ Despite performing the majority of attempts, PEM fellows often failed to reach the standard thresholds for performance of tracheal intubation. Clinical exposure alone is too low to ensure acquisition of airway skills.
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Transporting spontaneously ventilating adults with tracheostomies from the operating room (OR) or other anesthetizing locations to the intensive care unit (ICU) or other recovery locations presents significant challenges, as traditional T-pieces may not be readily available. This article describes a novel modification to the Ayre's T-piece, designed to address this gap by using readily available equipment. The modification integrates a 3-mL syringe, a size 7.0 endotracheal tube (ETT) connector, and oxygen tubing from an adult under-the-chin style facemask while adapting the expiratory and inspiratory limbs of the anesthesia circuit.