The authors' goal was to determine the rate at which emergency physicians document confirmation of endotracheal tube (ET) placement. The study was conducted in a 60 000-visit emergency department (ED) of an urban tertiary referral hospital. The authors' airway registry database was used to identify patients requiring airway management; 433 patients met study criteria, 281 (65%) were intubated in the ED, and 152 (35%) were intubated prior to arrival. ET confirmation was documented for 270 (96%) patients intubated in the ED and 52 (34%) patients intubated before arrival (P < .0001).The rate was higher for patients intubated by emergency medical services (40/64 [63%]) than for interhospital transfers (12/88 [14%]) (P < .0001). Documentation of ET placement has implications for patient care and safety. This study indicates that educational interventions are warranted to improve physicians' awareness of the importance of documenting correct tube placement.
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http://dx.doi.org/10.1177/1062860610395008 | DOI Listing |
PLoS One
January 2025
Department of Anesthesiology, The Second Affiliated Hospital, The Army Military Medical University, Chongqing, China.
Background: Rapid sequence induction intubation (RSII) is commonly used in emergency surgeries for patients at high risk of aspiration. However, these patients are more susceptible to hypoxemia during the RSII process. High-flow nasal cannula (HFNC) oxygen therapy has emerged as a potential alternative to traditional face mask (FM) ventilation pre- and apneic oxygenation.
View Article and Find Full Text PDFPLoS One
January 2025
Department of Computer Science, University College London, London, United Kingdom.
Complex biological systems undergo sudden transitions in their state, which are often preceded by a critical slowing down of dynamics. This results in longer recovery times as systems approach transitions, quantified as an increase in measures such as the autocorrelation and variance. In this study, we analysed paediatric patients in intensive care for whom mechanical ventilation was discontinued through removal of the endotracheal tube (extubation).
View Article and Find Full Text PDFPediatr Surg Int
January 2025
Department of Paediatric Surgery and Urology, Southampton Children's Hospital, Southampton, UK.
Purpose: Recent efforts have sought to streamline gastrostomy insertion care, particularly length of stay (LOS). We report our initial experience with day-case gastrostomy (DCG) insertion.
Method: Retrospective review (April 2018-2024) of all primary gastrostomy insertions.
Pediatr Infect Dis J
December 2024
Section of Infectious Diseases, Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado.
Background: Bacterial lower respiratory tract infection, particularly ventilator-associated pneumonia (VAP), is a significant cause of morbidity and mortality in children who require mechanical ventilation (MV). Microbiologic diagnosis has relied on bacterial culture, but reverse transcriptase polymerase chain reaction (RT-PCR) with bacterial targets is now available for clinical use. We compared the diagnostic performance of tracheal aspirate (TA) multiplex RT-PCR to culture in children requiring MV with suspected lower respiratory tract infection.
View Article and Find Full Text PDFClin Pract
January 2025
Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, QC H4A 3J1, Canada.
Emergency airway management is a critical skill for healthcare professionals, particularly in life-threatening situations like "cannot intubate, cannot oxygenate" (CICO) scenarios. Errors and delays in airway management can lead to adverse outcomes, including hypoxia and death. Cognitive aids, such as checklists and algorithms, have been proposed as tools to improve decision-making, procedural competency, and non-technical skills in these high-stakes environments.
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