Corrigendum to “Inclined position is associated with improved first pass success and laryngoscopic view in prehospital endotracheal intubations” [The American Journal of Emergency Medicine 37 (2019) 937–941]

IntroductionAdvanced airway management is necessary in the prehospital environment and difficult airways occur more commonly in this setting. Failed intubation is closely associated with the most devastating complications of airway management. In an attempt to improve the safety and success of tracheal intubation, we implemented videolaryngoscopy (VL) as our first-line device for tracheal intubation within a UK prehospital emergency medicine (PHEM) setting.MethodsAn East of England physician–paramedic PHEM team adopted VL as first line for undertaking all prehospital advanced airway management. The study period was 2016–2020. Statistical process control charts were used to assess whether use of VL altered first-pass intubation success, frequency of intubation-related hypoxia and laryngeal inlet views. A survey was used to collect the team’s views of VL introduction.Results919 patients underwent advanced airway management during the study period. The introduction of VL did not improve first-pass intubation success, view of laryngeal inlet or intubation-associated hypoxia. VL improved situational awareness and opportunities for training but performed poorly in some environments.ConclusionDespite the lack of objective improvement in care, subjective improvements meant that overall PHEM clinicians wanted to retain VL within their practice.

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25 Inclined Position Does Not Improve First Pass Success or Laryngoscopic View in Patients Undergoing Endotracheal Intubation in the Out-of-Hospital Setting

Annals of Emergency Medicine ◽

10.1016/j.annemergmed.2017.07.049 ◽

2017 ◽

Vol 70 (4) ◽

pp. S11

Author(s):

D. Murphy ◽

A. McCoy ◽

M. Sayre ◽

T. Rea ◽

B. Tonelli ◽

...

Keyword(s):

Endotracheal Intubation ◽

Hospital Setting ◽

Laryngoscopic View ◽

First Pass

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Effect of the introduction of C‐MAC videolaryngoscopy on first‐pass intubation success rates for emergency medicine registrars

Emergency Medicine Australasia ◽

10.1111/1742-6723.13329 ◽

2019 ◽

Vol 32 (1) ◽

pp. 25-32

Author(s):

Stephanie Mackie ◽

Fen Moy ◽

Sinan Kamona ◽

Peter Jones

Keyword(s):

Emergency Medicine ◽

Success Rates ◽

Intubation Success ◽

First Pass

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Impact of Video Laryngoscopy on Advanced Airway Management by Critical Care Transport Paramedics and Nurses Using the CMAC Pocket Monitor

BioMed Research International ◽

10.1155/2015/821302 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6 ◽

Cited By ~ 9

Author(s):

Bradley Boehringer ◽

Michael Choate ◽

Shelley Hurwitz ◽

Peter V. R. Tilney ◽

Thomas Judge

Keyword(s):

Emergency Medicine ◽

Airway Management ◽

Gold Standard ◽

Video Laryngoscope ◽

Success Rates ◽

Complex Process ◽

Advanced Airway ◽

Intubation Success ◽

First Pass ◽

Active Video

Accurate endotracheal intubation for patients in extremis or at risk of physiologic decompensation is the gold standard for emergency medicine. Field intubation is a complex process and time to intubation, number of attempts, and hypoxia have all been shown to correlate with increases in morbidity and mortality. Expanding laryngoscope technology which incorporates active video, in addition to direct laryngoscopy, offers providers improved and varied tools to employ in management of the advanced airway. Over a nine-year period a helicopter emergency medical services team, comprised of a flight paramedic and flight nurse, intended to intubate 790 patients. Comparative data analysis was performed and demonstrated that the introduction of the CMAC video laryngoscope improved nearly every measure of success in airway management. Overall intubation success increased from 94.9% to 99.0%, first pass success rates increased from 75.4% to 94.9%, combined first and second pass success rates increased from 89.2% to 97.4%, and mean number of intubation attempts decreased from 1.33 to 1.08.

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Apneic oxygenation provides incremental benefit during intubation of patients in the emergency medicine and critical care settings

CJEM ◽

10.1017/cem.2018.29 ◽

2018 ◽

Vol 20 (5) ◽

pp. 770-773

Author(s):

Daniel K. Ting ◽

Eddy S. Lang

Keyword(s):

Systematic Review ◽

Emergency Department ◽

Emergency Medicine ◽

Critical Care ◽

Oxygen Saturation ◽

Meta Analysis ◽

Clinical Question ◽

Apneic Oxygenation ◽

Incremental Benefit ◽

First Pass

Clinical questionShould I use apneic oxygenation when intubating patients in the emergency department to increase peri-intubation oxygen saturation and first-pass success?Article chosenOliveira JE, Silva L, Cabrera D, Barrionuevo P, et al. Effectiveness of apneic oxygenation during intubation: a systematic review and meta-analysis. Ann Emerg Med 2017;70(4):483-94.ObjectiveThe purpose of this study was to synthesize and appraise the apneic oxygenation literature for its effect on peri-intubation outcomes.

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Embedding Procedure for Water Swollen Samples

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s042482010006951x ◽

1970 ◽

Vol 28 ◽

pp. 504-505

Author(s):

Ann M. Thomas ◽

Virginia Shemeley

Keyword(s):

Electron Microscopy ◽

Transmission Electron Microscopy ◽

Ion Exchange ◽

Structural Changes ◽

Cross Linking ◽

Ion Exchange Resins ◽

Transmission Electron ◽

First Pass ◽

Exchange Resins

Those samples which swell rapidly when exposed to water are, at best, difficult to section for transmission electron microscopy. Some materials literally burst out of the embedding block with the first pass by the knife, and even the most rapid cutting cycle produces sections of limited value. Many ion exchange resins swell in water; some undergo irreversible structural changes when dried. We developed our embedding procedure to handle this type of sample, but it should be applicable to many materials that present similar sectioning difficulties.The purpose of our embedding procedure is to build up a cross-linking network throughout the sample, while it is in a water swollen state. Our procedure was suggested to us by the work of Rosenberg, where he mentioned the formation of a tridimensional structure by the polymerization of the GMA biproduct, triglycol dimethacrylate.

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