Articles: intubation.
-
Multicenter Study
How many attempts are required to accomplish out-of-hospital endotracheal intubation?
An important goal of emergency airway management is to complete endotracheal intubation (ETI) correctly, safely, and quickly, and repeated ETI attempts can increase patient morbidity and mortality. Clinical protocols limiting the number of ETI attempts may minimize harm, but this strategy also may reduce the frequency of successful ETI. ⋯ Out-of-hospital rescuers often require multiple attempts to accomplish ETI. A protocol limit of three attempts offers reasonable opportunity for accomplishing ETI within the constraints of the out-of-hospital environment.
-
Paramedics provide life-saving emergency medical care to patients in the out-of-hospital setting, but only selected emergency interventions have proved to be safe or effective. Endotracheal intubation (the insertion of an emergency breathing tube into the trachea) is an important and high-profile procedure performed by paramedics. ⋯ These findings indicate frequent errors associated with this life-saving technique. These events might be emblematic of larger issues in the structure and delivery of out-of-hospital emergency care.
-
Multicenter Study Comparative Study
Unplanned intubation during anesthesia: review of 31 cases from the Thai Anesthesia Incidents Study (THAI study).
To examine the causes, outcomes, and contributing factors associated with patients requiring unplanned emergency intubation for adverse respiratory events. METERIAL AND METHOD: Appropriate unplanned intubation incidents were extracted from the Thai Anesthesia Incidents Study (THAI Study) database conducted between February 1, 2003, and January 31, 2004, and analyzed using descriptive statistics. ⋯ Major incidents of unplanned intubation occurred after bronchoscopy. Common contributing factors related to inadequate ventilation, airway obstruction, sedative agents and unstable hemodynamics. Quality assurance, additional training, and improved supervision tended to minimize the incidents.
-
Multicenter Study
Factors influencing emergency intubation in the pre-hospital setting--a multicentre study in the German Helicopter Emergency Medical Service.
Definitive airway control by endotracheal intubation (ETI) is standard of care in pre-hospital airway management. However, there are specific factors that may influence and complicate ETI. ⋯ Despite various factors increasing the difficulties in managing the airway in the field, definitive airway control by ETI seems to be safe practice.
-
Randomized Controlled Trial Multicenter Study
Noninvasive vs conventional mechanical ventilation in acute respiratory failure: a multicenter, randomized controlled trial.
Noninvasive mechanical ventilation (NIMV) is beneficial for patients with acute respiratory failure (ARF) when added to medical treatment. However, its role as an alternative to conventional mechanical ventilation (CMV) remains controversial. Our aim was to compare the efficacy and resource consumption of NIMV against CMV in patients with ARF. ⋯ NIMV reduces the need for intubation and therapeutic intervention in patients with ARF from different causes. There is a nonsignificant trend of reduction in ICUs and hospital mortality together with fewer complications during ICU stay.