Articles: intubation.
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Multicenter Study Observational Study
Prehospital and en route cricothyrotomy performed in the combat setting: a prospective, multicenter, observational study.
Airway compromise is the third most common cause of potentially preventable combat death. Surgical cricothyrotomy is an infrequently performed but lifesaving airway intervention. There are limited published data on prehospital cricothyrotomy in civilian or military settings. Our aim was to prospectively describe the survival rate and complications associated with cricothyrotomy performed in the military prehospital and en route setting. ⋯ In our prospective, multicenter study evaluating cricothyrotomy in combat, procedural success was higher than previously reported. In addition, the majority of cricothyrotomies were performed by the evacuation helicopter medic rather than the prehospital combat medic. Prehospital military medics should receive training in decision making and be provided with adjuncts to facilitate this lifesaving procedure.
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Multicenter Study Observational Study
Neonatal intubation performance: Room for improvement in tertiary neonatal intensive care units.
To describe neonatal tracheal intubation (TI) performance across five neonatal intensive care units. ⋯ Overall TI procedure success rates were poor. Providers with advanced training were more likely to be successful. Patient factors were not associated with TI success.
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Multicenter Study
Factors associated with successful second and third intubation attempts in the ED.
The aim of this study was to identify the factors associated with successful second and third attempts in adults following a failed first intubation attempt in the emergency department (ED). ⋯ Nondifficult airway and the use of RSI were associated with successful second and third intubation attempts. The use of RSI, backup by experienced senior physicians, and preparation for management of a difficult airway could be strategies for successful rescue intubation attempts in the ED.
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Randomized Controlled Trial Multicenter Study Comparative Study
Mask versus nasal tube for stabilization of preterm infants at birth: a randomized controlled trial.
Positive-pressure ventilation (PPV) using a manual ventilation device and a face mask is recommended for compromised newborn infants in the delivery room (DR). Mask ventilation is associated with airway obstruction and leak. A nasal tube is an alternative interface, but its safety and efficacy have not been tested in extremely preterm infants. ⋯ In infants at <30 weeks' gestation receiving PPV in the DR, there were no differences in short-term outcomes using the nasal tube compared with the face mask.
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Journal of critical care · Aug 2013
Multicenter StudyPediatric upper airway obstruction: interobserver variability is the road to perdition.
The purposes of the study are to determine the interobserver variability in the clinical assessment of pediatric upper airway obstruction (UAO) and to explore how variability in assessment of UAO may contribute to risk factors and incidence of postextubation UAO. ⋯ Physical findings routinely used for UAO have poor interobserver reliability among bedside providers. This variability may contribute to inconsistent findings regarding incidence, risk factors, and therapies for postextubation UAO.