Background And Aims: Supraglottic airways (SGAs) are generally used for airway management; but can also be used as a conduit for tracheal intubation. Our primary aim was to evaluate i-Gel and laryngeal mask airway (LMA) classic as conduits for tracheal intubation using ventilating bougie by assessing number of attempts and time for insertion of SGAs, ventilating bougie and endotracheal tube (ETT), and total intubation time.
Material And Methods: A randomized clinical trial was carried out in 58 patients requiring general anesthesia and endotracheal intubation for planned surgery. They were randomly divided into Group I and Group C. After induction of anesthesia, i-Gel was inserted in Group I and LMA Classic in Group C; ventilating bougie was passed through SGA followed by the removal of SGA and railroading of ETT over ventilating bougie. Parameters observed were number of attempts and time taken for device insertion, total intubation time, and hemodynamic variables.
Results: Twenty-nine patients were included in each group. First attempt success rate for SGA insertion (86.2% in Group I and 75.9% in Group C ( = 0.5)), ventilating bougie insertion (79.32% in Group I and 82.8% in Group C ( = 0.99)) and ETT insertion (100% in Group I and 96.5% in Group C) was not different in the two groups. Total intubation time was 93.3 ± 9.0 s in Group I and 108. 96 ± 16.5 s in Group C ( < 0.0001).
Conclusions: i-Gel and LMA Classic both can be used as a conduit for tracheal intubation using ventilating bougie with stable hemodynamic parameters.
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http://dx.doi.org/10.4103/joacp.JOACP_113_16 | DOI Listing |
Crit Care Med
January 2025
Department of Medicine, University of Wisconsin School of Medicine & Public Health, Madison, WI.
Objectives: Diabetes mellitus has been associated with greater difficulty of tracheal intubation in the operating room. This relationship has not been examined for tracheal intubation of critically ill adults. We examined whether diabetes mellitus was independently associated with the time from induction of anesthesia to intubation of the trachea among critically ill adults.
View Article and Find Full Text PDFAir Med J
December 2024
UW Health Med Flight, Madison, WI; Berbee Walsh Department of Emergency Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI.
The transport of intubated patients is a common but high-risk scenario for air medical transport crews. In the case presented, a physician-nurse HEMS crew responded for the interfacility transfer of a patient with severe angioedema who had undergone awake fiberoptic nasotracheal intubation in the referring emergency department. The endotracheal tube had been damaged, however, and could not be adequately secured for transport.
View Article and Find Full Text PDFHealthcare (Basel)
November 2024
Department of Anesthesiology and Intensive Therapy, Medical University of Lodz, 90-153 Lodz, Poland.
Airway management in pre-hospital settings is often challenging and difficult to perform. This is particularly true during tracheal intubation of entrapped patients with difficult airway access. There are various airway adjuncts available in the current practice.
View Article and Find Full Text PDFCureus
October 2024
Community Medicine Education Promotion Office, Faculty of Medicine, Kagawa University, Miki, JPN.
Emergency airway management is a crucial procedure performed to secure the airway and ensure effective ventilation during respiratory distress or airway obstruction. In the context of cardiopulmonary resuscitation (CPR), this process is complicated by factors such as anatomical challenges, environmental conditions, and the urgency of the situation. Recent advancements in airway management devices, including videolaryngoscopes and supraglottic devices (SGDs), have proven beneficial in managing these challenges.
View Article and Find Full Text PDFAm J Emerg Med
November 2024
Department of Emergency Medicine, Rush University Medical Center, Chicago, IL, USA.
Introduction: Airway management including endotracheal intubation (ETI) is a key skill for emergency clinicians. Therefore, it is important for emergency clinicians to be aware of the current evidence regarding the identification and management of patients requiring ETI.
Objective: This paper evaluates key evidence-based updates concerning ETI for the emergency clinician.
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