Articles tagged "Intubation"

Emergency Department Intubations Are Increasingly Successful

by Joseph Esherick, M.D., FAAFP, FHM

First-pass ED intubation success increased from 80% in 2002 to 86% in 2012, with concomitant increases in the use of video laryngoscopy and rocuronium.

Predictors of and Pearls for Difficult Airway Management

by Joseph Esherick, M.D., FAAFP, FHM

Patients may have anatomically difficult airways or physiologically difficult airways. Both anatomical and physiological factors can lead to peri-intubation complications.

Troubleshooting Difficult Intubations

by Joseph Esherick, M.D., FAAFP, FHM

Have you ever been able to see the vocal cords during direct laryngoscopy but you weren’t able to pass the endotracheal tube cuff beyond the cords? This occurs not too infrequently during endotracheal intubation and I am going to share a trick for this.

Open-Lung Recruitment Maneuvers Increased Mortality Compared with Standard PEEP titration for Moderate-Severe Acute Respiratory Distress Syndrome (ARDS)

by Joseph Esherick, M.D., FAAFP, FHM

Open Lung recruitment maneuvers using PEEP titration based on respiratory system compliance increased mortality compared with ARDSNet PEEP titration in moderate-severe ARDS.

Video laryngoscopy has a superior first pass success rate compared with direct laryngoscopy in the ICU

by Joseph Esherick, M.D., FAAFP, FHM

Video laryngoscopy has a superior first pass success rate and lower rate of difficult intubations and esophageal intubations compared with direct laryngoscopy for ICU intubations.

To Intubate or Not Intubate During In-Hospital Codes?

by Joseph Esherick, M.D., FAAFP, FHM

This observational study suggests that intubation during inpatient cardiac arrest was associated with worse outcomes.

Predictors of Difficult Intubation with Hypercurved Glidescope or C-MAC devices

by Joseph Esherick, M.D., FAAFP, FHM

In a study of controlled intubations in the OR using acute-angled videolaryngoscopes, “sniffing” head position, reduced mouth opening, and attending intubators were associated with prolonged intubation times.

Fentanyl-Based Ventilator Sedation Decreased Ventilator Days in ICU Patients

by Joseph Esherick, M.D., FAAFP, FHM

The use of a fentanyl-based ventilator sedation strategy was associated with a reduction in ventilator time.

Steroids are beneficial for hospitalized patients with community-acquired pneumonia

by Joseph Esherick, M.D., FAAFP, FHM

Steroids appear to decrease mortality, need for mechanical ventilation, ARDS, and hospital length of stay for patients admitted for community-acquired pneumonia (CAP).

Predictors of failed intubations using video laryngoscopy such as failed Glidescope intubations

by Joseph Esherick, M.D., FAAFP, FHM

The overall success rate for Glidescope intubations was 97%. Success for Glidescope intubation following direct laryngoscopy and success in patients with predictors of difficult direct laryngoscopy were 94% and 96%, respectively.

Noninvasive Ventilation is Extremely Effective for Severe COPD Exacerbations

by Joseph Esherick, M.D., FAAFP, FHM

Compared with invasive ventilation for severe chronic obstructive pulmonary disease exacerbations, noninvasive positive pressure ventilation was associated with lower in-hospital mortality, length of stay, and cost.

Pre-hospital cardiac arrest patients do best with supraglottic airway or BVM ventilation

by Joseph Esherick, M.D., FAAFP, FHM

Cardiac arrest patients who were intubated had similar outcomes to those who had a supraglottic airway device (e.g., King tube) inserted in the pre-hospital setting.