Articles: intubation.
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Otolaryngol Head Neck Surg · Jul 2020
Multicenter Study Observational StudyFactors Associated With Intubation and Prolonged Intubation in Hospitalized Patients With COVID-19.
To identify risk factors associated with intubation and time to extubation in hospitalized patients with coronavirus disease 2019 (COVID-19). ⋯ In addition to clinical signs of respiratory distress, patients with COVID-19 who are older, male, or diabetic are at higher risk of requiring intubation. Among intubated patients, older and more obese patients are at higher risk for prolonged intubation. Otolaryngologists consulted for airway management should consider these factors in their decision making.
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In January 2020, a global pandemic was declared by the World Health Organization authorities for coronavirus disease 2019 (COVID-19). Since then, we have looked for ways to avoid transmission with mitigation measures and social distancing. ⋯ Many innovations have been proposed to assist providers including barriers to use during airway management. We present adaptations to previously described intubation or "aerosol" boxes.
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As the COVID-19 pandemic has created shortages of vital personal protective equipment that threatens healthcare workers' risk of exposure, a need for innovative new ways to protect healthcare workers has emerged. An aerosol containment box that covers the patient's head and neck in bed provides a solution to protect clinicians during aerosol-generating procedures such as intubation. ⋯ The container is outfitted with an ultra-low particulate air-equipped filtration vacuum device to create negative pressure within the chamber and actively remove floating droplet nuclei generated during a procedure. This barrier method will be a valuable and economical option to protect healthcare workers on the front line globally during this pandemic and beyond.
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Critical care airway management (CCAM) is a key skill for critical care physicians. Simulation-based training (SBT) may be an effective modality in training intensivists in CCAM. ⋯ Skill acquired through SBT of critical care fellows for CCAM transfers effectively to the real-life patient care arena. Second- and third-year fellows who had initially received SBT maintained skill at CCAM.