Articles: intubation.
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Trauma patients requiring intubation at the scene of the accident were entered into a study from June 1985 to June 1987 to determine: 1) the success rate of intubation by flight crews and 2) factors important in managing the difficult airway at the scene. One hundred thirty-six patients were reviewed. The success rate of trauma patients intubated in the field was 92.6%. ⋯ An aeromedical crew (MD, RN, RT) can successfully intubate trauma patients at the scene of the accident. Severe facial injuries with vomiting and blood in the oropharynx are factors in intubation failure. The use of muscle relaxants and sedatives facilitates difficult intubations.
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Medical students are trained in airway management by endotracheal intubation in most medical schools. Unfortunately, little data exist examining retention, and no data exist that actually break down the steps of intubation to determine where students encounter problems. ⋯ The most frequent errors during intubation were failure to check the light before intubation, use of the teeth as a fulcrum, and failure to check the cuff on the endotracheal tube. Knowledge of the most common errors will allow instructors to place greater emphasis on those areas during the initial instruction period with a focus on decreasing their occurrence in the future.
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In this study, 82 patients who experienced translaryngeal intubation (TLI) for more than four days were prospectively evaluated for laryngeal complications. At the time of extubation or tracheostomy, direct laryngoscopy was performed in these patients and laryngeal damage evaluated. ⋯ Laryngoscopy was repeated at two-week intervals in 54 patients and laryngeal damage was resolved within four weeks in 63 percent. These 54 patients were evaluated for adverse clinical effects arising from TLI-induced laryngeal pathology and no relationship was found between laryngeal pathology seen at initial laryngoscopy and the development of adverse effects.