Articles: intubation.
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The esophageal obturator airway (EOA) has been used in the Jerusalem area by the ambulance services approximately 1,000 times in the past six years. We report an unusual complication of the EOA in the case of a 50-year-old man rescued from drowning who received both basic and advanced cardiopulmonary resuscitation. He was ventilated by an EOA attached to an Ambu bag; however, resuscitation attempts were unsuccessful. Autopsy revealed gastric rupture.
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A simple technique is described for confirming oral tracheal intubation carried out under direct laryngoscopy. With the laryngoscope blade still in the mouth following intubation, posterior displacement of the tracheal tube towards the palate will usually bring the tube and vocal cords into direct view, providing confirmation of correct tube placement. ⋯ In the remaining 21 cases, the larynx was obscured during intubation. Posterior displacement of the tube confirmed correct placement in all 21 cases.
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A retrospective study of 140 babies who survived the first week of life and who had endotracheal intubation showed that 65 of them had either or both of the following complications of endotracheal tube therapy: (a) Collapse of one or more lobes with the tube in place or within the first two days following extubation and lasting less than 24 hours. When collapse lasted more than 48 hours, it often required repeated intubation for tracheal cleansing. ⋯ A statistical comparison with intubated babies of similar age without complications showed the following factors to predispose to lobar collapse: younger gestational age, maximal high oxygen concentration administered, and prolonged duration of intubation. The results of endotracheal tube cultures bore no relation to the complication rate.