Articles: intubation.
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Varying rates of complications have been reported for prehospital sedation with ketamine, and the relationship to dosing has not been studied on a large scale. We evaluated the association between prehospital ketamine dosing and rates of intubations and other adverse events in patients with behavioral emergencies. ⋯ Patients given ketamine doses above consensus recommendations for sedation appeared more likely to receive prehospital intubation but not more likely to experience other adverse events.
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Routine continuous monitoring of endotracheal tube placement with waveform capnography is considered standard of care in the prehospital setting. However, maintaining this standard in neonatal patients remains a challenge due to low tidal volumes that do not tolerate the additional dead space ETCO2 attachments add. Additionally, continuous ETCO2 can increase the risk of ETT dislodgement or kinking because of the weight and size of the capnography attachments relative to the patient and tube size. We hypothesize that there is a gap in care of intubated neonates when compared to adults in the prehospital setting in terms of continuous monitoring of ETT placement. ⋯ Continuous ETCO2 monitoring is underutilized in intubated neonates compared to children, adolescents, and adults in the prehospital setting in this study population. This suggests a gap in the standard of care provided to neonates. Additional studies are needed to determine if these results are consistent around the industry and if there is a higher rate of undetected tube displacement in neonates who are transported without waveform capnography.
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Rev Assoc Med Bras (1992) · Jan 2024
Hospital cohort study on survival predictors for intubated coronavirus disease 2019 patients.
The objective of this study was to assess the predictors of survival among patients with coronavirus disease 2019 who underwent tracheal intubation, as part of a hospital cohort study. ⋯ Our analysis unveiled that the risk of death in intubated coronavirus disease 2019 patients is four times higher when an emergency physician, as opposed to an anesthesiologist, leads the tracheal intubation team.
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Rev Assoc Med Bras (1992) · Jan 2024
Observational StudyPrevalence of obstructive sleep apnea syndrome and predictors of difficult orotracheal intubation.
Obstructive sleep apnea syndrome (OSAS) is an underdiagnosed condition that causes recurrent episodes of partial or total collapse of the upper airways during sleep. It is associated with perioperative pulmonary complications. The STOP-BANG is a screening tool for assessing patients at risk of OSAS. The aim of this study was to assess the prevalence of patients with OSAS during pre-anesthetic evaluation at a hospital and its correlation with predictors of ventilation and difficult airway. ⋯ The study had the participation of 221 patients, of whom 121 presented with a STOP-BANG ≥3, with a prevalence of 54.2%. All patients undergoing bariatric surgeries presented STOP-BANG ≥3. No significant statistical relationships were found between predictors of difficult orotracheal intubation and STOP-BANG ≥3. However, significant statistical relationships were found in relation to predictors of difficult ventilation through the facial mask.