Articles: intubation.
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Emerg Med Australas · Feb 2025
Utility of computed tomography brain scans in intubated patients with overdose.
Describe the yield of computed tomography brain (CTB) scans in patients intubated for drug overdose. ⋯ Routine imaging of patients intubated for overdose without clinical indication is unjustified.
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Journal of anesthesia · Feb 2025
Effect of use of cuffed endotracheal tubes on the occurrence of postoperative extubation-related respiratory adverse events in pediatric patients with airway hypersensitivity: a retrospective cohort study.
Whether endotracheal tube (ETT) configuration (cuffed or uncuffed) influences the occurrence of respiratory adverse events (RAEs) in patients at risk remains largely unknown. We investigated the effects of cuffed ETTs on RAE occurrence after extubation in pediatric patients with airway hypersensitivity. ⋯ In pediatric patients with airway hypersensitivity, the use of cuffed ETTs did not increase the occurrence of RAEs or respiratory interventions after extubation.
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Pediatric emergency care · Feb 2025
Minor Head Trauma in Children Younger Than 3 Months and Clinical Predictors of Clinically Important Traumatic Brain Injuries.
Major studies have defined clinical rules to regulate the use of computed tomography in children after head trauma. Infants younger than 3 months are considered at higher risk of brain injuries than older children and at the same time at higher risk of radiation-induced damage. Hence, it would be desirable to have clinical decision rules more adapted to this subset of patients. The objectives of this study are to compare the rate of brain injuries in children younger than 3 months or 3 to 24 months and to assess predictors of clinically important traumatic brain injuries (ciTBIs) (the ones causing death, neurosurgical intervention, long intubation, or hospitalization for 2 days or more) in the former group. ⋯ Children younger than 3 months presenting after minor head trauma constitute a relevant population. Available clinical predictors well correlate with ciTBIs in this age group.
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Emerg Med Australas · Feb 2025
Effect of case identification changes on pre-hospital intubation performance indicators in an Australian helicopter emergency medical service.
A 45-min interval from injury to intubation has been proposed as a performance indicator for severe trauma patient management. In the Sydney pre-hospital system a previous change in case identification systems was associated with activation delay. We aimed to determine if this also decreased the proportion of patients intubated within this benchmark. ⋯ Time from emergency call to intubation was significantly shorter in the HEMS screening period where all non-trapped cases less than 50 km distant were intubated within the 45-min benchmark. There was no distance where intubation within 45 min could be assured for non-trapped patients in the central control period due to dispatch delays.
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Journal of anesthesia · Feb 2025
Investigation of the effectiveness of preoperative intubation simulation using a custom-made simulator for pediatric patients with difficult airway: a pilot study.
The purpose of this study is to investigate whether preoperative intubation simulation using custom-made simulator is useful during anesthesia induction for the children who have difficult airway. We included the children under 15 years of age who have difficult airway which had been already known. Prior to the scheduled surgery, CT imaging was performed and a 3D reconstruction of the face from the chest was performed. ⋯ Simulation findings correlated well with findings during anesthesia induction. There were no cases of severe hypotension or hypoxia during induction of anesthesia with the planned intubation method. In conclusion, preoperative intubation simulation using custom-made simulator may be useful for the patients who have difficult airway.