BACKGROUND： Airway management in the emergency department is a critical intervention that requires both standard techniques and rescue techniques to ensure a high rate of success. Recently, video laryngoscope （VL） ...BACKGROUND： Airway management in the emergency department is a critical intervention that requires both standard techniques and rescue techniques to ensure a high rate of success. Recently, video laryngoscope （VL） systems have become increasingly common in many large urban EDs, but these systems may exceed the budgets of smaller rural EDs and EMS services and the Airtraq optical laryngoscope （OL） may provide an effective, low-cost alternative. We hypothesized that laryngeal view and time to endothracheal tube placement for OL and VL intubations would not be significantly different. METHODS：This was a prospective, crossover trial. Setting： University-based emergency medicine residency program procedure laboratory utilizing lightly embalmed cadavers. Subjects： PGY1-3 emergency medicine residents. The study subjects performed timed endotracheal intubations alternately using the OL and VL. The subjects then rated the Cormack-Lehane laryngeal view for each device. Statistical analysis： Mean time to intubation and the mean laryngeal view score were calculated with 95% confidence intervals and statistical significance was determined by Student＇s t test. RESULTS：Fourteen subjects completed the study. The average laryngeal view achieved with the OL vs. the VL was not significantly different, with Cormack-Lehane grade of 1.14 vs. 1.07, respectively. Time to endotracheal intubation, however, was significantly different （P〈0.001） with the average time to intubation for the OL 25.49 seconds （95% CI： 17.95-33.03） and the VL 13.41 seconds （10.27-16.55）. CONCLUSION：The Airtraq OL and the Storz VL yielded similar laryngeal views in the lightly embalmed cadaver model. Time to endotracheal tube placement, however, was less for the VL.展开更多
McGrath? MAC video laryngoscope (McG) has been used for orotracheal intubation in both normal patients and patients for whom intubation was expected to be difficult, and has been reported to provide improved visibilit...McGrath? MAC video laryngoscope (McG) has been used for orotracheal intubation in both normal patients and patients for whom intubation was expected to be difficult, and has been reported to provide improved visibility of the glottis during tracheal intubation. There are some reports that normal nasotracheal intubation is easier with McG than with macintosh laryngoscope (ML). The usefulness of McG for nasotracheal intubation is beginning to be recognised. We experienced three cases using McG in patients for whom intubation was expected to be difficult due to the limited mouth opening and using McG for those patients enabled smooth nasotracheal intubation. McG provides good visual field during nasotracheal intubation, and is less invasive to the patient.展开更多
The tonsillar polyp is a rare benign tumor of the pharynx.1 We describe a successful management of a case with severe airway obstruction by the tonsillar polyp after anesthesia induction in an adult patient with a kno...The tonsillar polyp is a rare benign tumor of the pharynx.1 We describe a successful management of a case with severe airway obstruction by the tonsillar polyp after anesthesia induction in an adult patient with a known difficult airway.In this case,airway was successfully rescued with a difficult airway management scheme incorporating a videolaryngoscope.展开更多
文摘BACKGROUND： Airway management in the emergency department is a critical intervention that requires both standard techniques and rescue techniques to ensure a high rate of success. Recently, video laryngoscope （VL） systems have become increasingly common in many large urban EDs, but these systems may exceed the budgets of smaller rural EDs and EMS services and the Airtraq optical laryngoscope （OL） may provide an effective, low-cost alternative. We hypothesized that laryngeal view and time to endothracheal tube placement for OL and VL intubations would not be significantly different. METHODS：This was a prospective, crossover trial. Setting： University-based emergency medicine residency program procedure laboratory utilizing lightly embalmed cadavers. Subjects： PGY1-3 emergency medicine residents. The study subjects performed timed endotracheal intubations alternately using the OL and VL. The subjects then rated the Cormack-Lehane laryngeal view for each device. Statistical analysis： Mean time to intubation and the mean laryngeal view score were calculated with 95% confidence intervals and statistical significance was determined by Student＇s t test. RESULTS：Fourteen subjects completed the study. The average laryngeal view achieved with the OL vs. the VL was not significantly different, with Cormack-Lehane grade of 1.14 vs. 1.07, respectively. Time to endotracheal intubation, however, was significantly different （P〈0.001） with the average time to intubation for the OL 25.49 seconds （95% CI： 17.95-33.03） and the VL 13.41 seconds （10.27-16.55）. CONCLUSION：The Airtraq OL and the Storz VL yielded similar laryngeal views in the lightly embalmed cadaver model. Time to endotracheal tube placement, however, was less for the VL.
文摘McGrath? MAC video laryngoscope (McG) has been used for orotracheal intubation in both normal patients and patients for whom intubation was expected to be difficult, and has been reported to provide improved visibility of the glottis during tracheal intubation. There are some reports that normal nasotracheal intubation is easier with McG than with macintosh laryngoscope (ML). The usefulness of McG for nasotracheal intubation is beginning to be recognised. We experienced three cases using McG in patients for whom intubation was expected to be difficult due to the limited mouth opening and using McG for those patients enabled smooth nasotracheal intubation. McG provides good visual field during nasotracheal intubation, and is less invasive to the patient.
文摘The tonsillar polyp is a rare benign tumor of the pharynx.1 We describe a successful management of a case with severe airway obstruction by the tonsillar polyp after anesthesia induction in an adult patient with a known difficult airway.In this case,airway was successfully rescued with a difficult airway management scheme incorporating a videolaryngoscope.
