Articles: intubation.
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Despite the fact that endotracheal intubation is a skill essential for clinicians of varied specialties, the procedure is not without risk, especially when practiced in an emergency setting, particularly the field environment. Of all complications, none is more serious than unrecognized esophageal intubation. Clinical experience with a method of guided orotracheal intubation using a rigid-wire lighted stylet prompted us to develop a technique to confirm correct intratracheal placement of an endotracheal tube using a new flexible lighted stylet designed for nasotracheal intubation. ⋯ The level of experience or training bore no relationship to the ability of the intubator to identify correct placement. We conclude from the study that this technique is a rapid and reliable method of confirming correct placement of endotracheal tubes. The use of this method could reduce, if not eliminate, unrecognized esophageal intubation in the field, emergency department, the critical care unit, and the operating room.
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The frequency histograms of six patients' laryngographs were studied pre- and post-endotracheal intubation. The changes were correlated with the length of intubation. ⋯ The latter change was thought to be a subconscious compensation for the hoarseness. The increased lower frequency spread as measured by standard deviation was directly proportional to the length of intubation.