Articles: intubation.
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Multicenter Study
Attitudes of patients and anaesthetists to informed consent for specialist airway techniques.
We investigated the attitudes of 96 patients and 163 anaesthetists to the need for obtaining informed consent before specialist airway techniques. Participants were asked to score six questions using a numerical scale, as to whether they thought consent was necessary before specific procedures, particularly in relation to fibreoptic intubation used for teaching or maintaining skills. ⋯ Overall, patients felt that specific consent was required for non-routine techniques, whilst anaesthetic respondents felt this was unnecessary, even if teaching. We conclude that guidance in obtaining consent is needed to support anaesthetists wishing to practice or teach fibreoptic intubation.
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Multicenter Study
The failed intubation attempt in the emergency department: analysis of prevalence, rescue techniques, and personnel.
The aims of this study were: To describe the prevalence of Emergency Department (ED) airway management failures requiring rescue maneuvers, to describe successful rescue methods used when the primary method chosen is unsuccessful, and to characterize the roles of emergency physicians and other specialists in rescue airway management. A prospective observational study was conducted of ED airway management in 30 hospitals in the USA, Canada, and Singapore participating in the National Emergency Airway Registry (NEAR) database project. Patients were entered in the study if they underwent ED airway management, the first method chosen was not successful in achieving intubation, and a rescue technique was required. ⋯ In conclusion, a total of 2.7% of emergency intubations required rescue. RSI is the most commonly used first line technique for ED airway management and is also the principal back-up technique when other oral or nasal intubation methods fail. Emergency physicians manage the majority of ED intubations, including those requiring rescue techniques.
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On the basis of the data of a multicenter study, the impact of prehospital intubation and ventilation in the therapy of severe thoracic trauma without manifest respiratory insufficiency was analyzed. ⋯ Prognosis with respect to organ failure, treatment time, and mortality is not adversely affected in the German trauma system, if patients with severe thoracic trauma without manifest respiratory insufficiency and without other indications for intubation are not treated with prehospital intubation.
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Paediatric anaesthesia · Jan 2002
Multicenter StudyA survey of practice of tracheal intubation without muscle relaxant in paediatric patients.
Because of the renewed interest in intubation in children without relaxants, over a period of 1 month, the anaesthesiologists of five paediatric universitary teaching hospitals were asked to complete a questionnaire each time they performed a tracheal intubation without muscle relaxant. ⋯ Sevoflurane is the most commonly used agent for tracheal intubation without relaxants with higher doses being required in infants aged less than 6 months. Propofol, even with opioids, was not so successful.
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Multicenter Study Comparative Study Clinical Trial Controlled Clinical Trial
A prospective comparison of the use of nasogastric and percutaneous endoscopic gastrostomy tubes for long-term enteral feeding in older people.
To compare the indications for and the outcome of long-term enteral feeding by nasogastric tube (NGT) with that of percutaneous endoscopic gastrostomy (PEG) tube. ⋯ In long-term enteral feeding, in a selected group of non-acute patients, the use of PEG was associated with improved survival, was better tolerated by the patient and was associated with a lower incidence of aspiration. A randomized controlled study is needed to determine whether PEG is truly superior to NGT.