Articles: intubation.
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Randomized Controlled Trial Comparative Study Clinical Trial
Rapid oral anesthesia for awake intubation.
To determine whether sodium benzonatate (Tessalon Perles) can provide rapid, effective topical oral anesthesia in preparation for awake intubations. ⋯ The results of this study indicate that benzonatate capsules provide rapid and reliable oropharyngeal anesthesia in preparation for awake intubation. In addition, if excellent airway anesthesia is provided, awake intubations can be accomplished with minimal patient response and discomfort.
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Review Case Reports
Management of a severed endotracheal tube during LeFort osteotomy.
An unusual but serious case in which the endotracheal tube was severed during LeFort osteotomy is presented. The aspects of the surgery that can create this problem are reviewed. Past literature is reviewed, and various procedures for the management of this problem, including the plan followed in this case, are discussed.
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Comparative Study
Cervical spine injuries in blunt trauma patients requiring emergent endotracheal intubation.
Airway management in the blunt trauma patient is complicated by the potential for causing or exacerbating an injury to the cervical cord if an unstable cervical fracture is present. The records of 987 blunt trauma patients who required emergent endotracheal intubation over a 5-year period were retrospectively reviewed to determine the incidence and type of cervical spine injury and the incidence of injury based on airway management. Sixty of the patients (6.1%) had a cervical fracture; 53 were potentially unstable injuries by radiographic criteria. ⋯ One patient developed a neurologic deficit after nasotracheal intubation. Because of a possible selection bias in which severely injured patients were preferentially referred to this trauma center, the true incidence of cervical spine injuries may be lower than the 6.1% we found. The authors conclude that the incidence of serious cervical spine injury in a very severely injured population of blunt trauma patients is relatively low, and that commonly used methods of precautionary airway management rarely lead to neurologic deterioration.
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Multicenter Study Comparative Study Clinical Trial Controlled Clinical Trial
A field comparison of the pharyngeotracheal lumen airway and the endotracheal tube.
A prospective, sequential study compared ease of use and bag-valve ventilation delivered by an endotracheal tube (ET) with that of the pharyngeotracheal lumen airway (PtL) for 111 victims of cardiac arrest in the pre-hospital setting. The PtL airway was found to be significantly easier to use as measured by the time required to intubate the patient and the number of attempts to place the device. Arterial blood gas determinations were made on arrival at the hospital and repeated 15 minutes later. ⋯ No adverse effects were reported. We conclude that the ability of the PtL to deliver effective ventilation is comparable with that of the ET as measured by arterial PCO2. When the ET method of airway control cannot be achieved, the PtL airway offers an effective alternative.