Objective: To determine if endotracheal tubes (ETTs) that are opened, prepared, and stored in an ED airway cart are prone to bacterial contamination.
Methods: A prospective study conducted in the ED of a level 1 trauma center. A study group of 50 endotracheal tubes were opened, preloaded with a stylet, the cuff checked for integrity by air inflation, and then stored in an ED airway cart. The study group was subdivided into 5 groups of 10 ETTs each, cultured at different time intervals. The ETTs were cultured at 6, 12, 24, 36, and 48 hours for the presence of bacterial contamination. The control group consisted of 10 ETTs that were left in their sterile packing in the ED airway cart and then removed at 48 hours and cultured.
Results: In the study group, 7 (14%) ETTs resulted in a positive culture; 43 ETTs cultured negative for bacteria. In the control group, 2 (20%) ETTs cultured positive, the remainder was all negative. There was no statistically significant difference between the 2 groups (P = .63). If only clinically significant bacteria are considered, defined as a culture with 5 or more colony-forming units, 3 ETTs in the study group cultured positive; there were no clinically significant bacteria cultured in the control group. Once again, there was no statistically significant difference between the 2 groups, with a P value of .57.
Conclusion: It appears that opening, preparing, and storing ETTs in an ED airway cart for up to 48 hours does not increase the risk of bacterial contamination of the ETTs.
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http://dx.doi.org/10.1016/j.ajem.2004.10.012 | DOI Listing |
Oxf Med Case Reports
January 2025
Department of Hematology, Kyoto University, Kyoto, Japan.
Craniocervical edema appears soon after chimeric antigen receptor T-cell (CAR-T) therapy in some cases. This phenomenon is often observed right after systemic cytokine release syndrome (CRS), and it is called local CRS (L-CRS). In severe cases, L-CRS causes airway obstruction and asphyxia, but it is not yet well known among hematologists.
View Article and Find Full Text PDFCJEM
January 2025
School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada.
Background: Management of the adult airway is one of the most stressful and time-critical procedures in emergency medicine. In the Cowichan District Hospital, a rural hospital in British Columbia, Emergency Department (ED) staff were uncomfortable with acquiring the equipment needed for adult advanced airway management and the mean length of time to acquire the equipment was 319 s. The aim of this quality improvement (QI) project was to decrease the time to obtain the equipment needed for adult advanced airway management by nurses and physicians in the Cowichan District Hospital ED to less than 90 s by May 2023.
View Article and Find Full Text PDFSleep Breath
November 2024
Department of Otorhinolaryngology- Head and Neck Surgery, OLVG, Jan Tooropstraat 164, Amsterdam, 1061AE, The Netherlands.
Purpose: Drug-induced sleep endoscopy (DISE) helps select patients with obstructive sleep apnea (OSA) for surgery by identifying upper airway collapse patterns. This study aimed to predict the probability of complete concentric collapse at the palatal level (CCCp) during DISE based on patient characteristics, specifically body mass index (BMI).
Methods: We retrospectively reviewed records of OSA patients who underwent DISE from January 2018 to July 2023.
Cureus
October 2024
Department of Hematology, Japanese Red Cross Medical Center, Tokyo, JPN.
Chimeric antigen receptor T-cell (CAR-T) therapy targeting the B-cell maturation antigen (BCMA) is an effective treatment for patients with relapsed/refractory multiple myeloma (RRMM). However, cytokine release syndrome (CRS) represents a significant complication associated with CAR-T therapy. While most CRS cases involve systemic symptoms such as fever, hypotension, and respiratory distress, localized symptoms (referred to as local CRS) can also occur.
View Article and Find Full Text PDFPLoS One
October 2024
Department of Physiology, School of Medicine and Dentistry, KNUST, Kumasi, Ghana.
Background: Human immunodeficiency virus (HIV) infection is associated with chronic airway obstruction, even in patients who have achieved viral suppression from combination antiretroviral treatment (cART). Spirometry is a supplementary test that aids in diagnosing pulmonary dysfunction in people living with HIV.
Aim: To compare the prevalence of spirometric abnormalities among cART-treated HIV patients and cART-naïve HIV patients with non-HIV controls with no recent history of pulmonary infection in a peri-urban hospital in Ghana.
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