scholarly journals Use of GlideScope in Patients Undergoing NIM Thyroidectomy

2020 ◽  
pp. 014556132097482
Author(s):  
Kelsey Casano ◽  
C Ron Cannon ◽  
Ralph Didlake ◽  
William R. Replogle ◽  
Robert Cannon
Keyword(s):  
Prospective Study ◽  
Endotracheal Tube ◽  
Orotracheal Intubation ◽  
Tube Placement ◽  
Operative Data ◽  
Operating Suite

Objectives: Thyroidectomy and parathyroidectomy using the nerve integrity monitor (NIM) require proper placement of the endotracheal tube with electrodes aligned correctly within the larynx. The purpose of this study is to determine the percentage of patients who require positional adjustments of the endotracheal tube prior to beginning surgery and to understand the value of using the GlideScope to assure proper NIM tube placement within the larynx. Methods: This prospective study examines operative data from 297 patients who underwent NIM thyroidectomy and parathyroidectomy. After routine orotracheal intubation by an anesthesiologist and positioning of the patient for surgery, a GlideScope was used to check the position of the tube in 2 planes: depth of tube placement and rotation of the tube within the larynx assuring proper placement of the electromyogram electrodes within the glottis. Results: Tube adjustment was required for 66.5% of patients. In 48.1% of cases, tube retraction or advancement to a proper depth was needed. Tube rotation was required for 30.1% of patients, and 11.8% of patients required both adjustment of tube depth and tube rotation to properly align electrodes. Conclusions: After the anesthesiologist places the NIM endotracheal tube, and the patient is positioned for surgery, additional tube adjustment is often needed prior to the start of surgery. The GlideScope is readily available in the operating suite, its use adds little time to the procedure, and assures proper NIM tube placement. The use of the GlideScope is recommended.

DETERMINANTS OF ORAL ENDOTRACHEAL TUBE PLACEMENT: A CROSS SECTIONAL STUDY

2021 ◽  
pp. 66-68
Author(s):  
Pankaj Kumar ◽  
Sudha Singh ◽  
Aditya Prakash
Keyword(s):  
Endotracheal Tube ◽  
Pearson Correlation ◽  
Orotracheal Intubation ◽  
Cross Sectional Study ◽  
Tube Placement ◽  
Vocal Cords ◽  
Cross Sectional ◽  
Endotracheal Tube Placement ◽  
The Mean ◽  
The Right

Introduction: Finding the best depth of endotracheal tube (ET) placement has been a challenge because of the complications caused due to its malposition. Aims: To nd the best depth of placement of oral ET in Indian adult patients. Methods And Design: This study was conducted in 125 ASA I and II patients requiring general anaesthesia and orotracheal intubation. Methods: After placing the ET with the designated black mark at vocal cords, various airway distances were measured from the right angle of mouth using a bre optic bronchoscope. Statistical Analysis: Mean (SD) and median (range) of various parameters and Pearson correlation coefcient was calculated. Results: The mean lip-carina distance, i.e., total airway length was 23.52±1.72 cm and 22.11±1.26 cm in males and females, respectively. With black mark of ET between vocal cords, the mean ET tip-carina distance of 4.19±1.60 cm in males and 2.78±1.52 cm females was found to be less than the recommended safe distance. Conclusions: Height has the best correlation to lip to carina distance. Fixing the tube at recommended distances in both male and female will lead to carinal stimulation or endobronchial placement in many Indian patients. The formula “(Height in cm/7) -2.5.” gives us an idea about the approximate depth of ET placement.

Comparison of a Colorimetric End-Tidal CO2 Detector and an Esophageal Aspiration Device for Verifying Endotracheal Tube Placement in the Prehospital Setting: A Six-Month Experience

1997 ◽  
Vol 12 (1) ◽  
pp. 57-63 ◽  
Author(s):  
Richard J. Schaller ◽  
J. Stephen Huff ◽  
Allan Zahn
Keyword(s):  
Cardiac Arrest ◽  
Endotracheal Tube ◽  
Sensitivity And Specificity ◽  
Nasotracheal Intubation ◽  
Prehospital Setting ◽  
Tube Placement ◽  
Emergency Department Physician ◽  
Significant Difference ◽  
End Tidal ◽  
Chi Square Analysis

AbstractIntroduction:Hand held, colorimetric, end-tidal CO2 detector devices are being used to verify correct endotracheal tube (ETT) placement. The accuracy of these devices has been questioned in situations of cardiac arrest. The use of the esophageal detector device (EDD) is an easy alternative for detection of ETT placement, and may be more accurate in situations of cardiac arrest.Hypothesis:The use of the esophageal aspiration device in comparison with a colorimetric end-tidal CO2 detector is more accurate in detecting proper ETT placement and easier to use in the prehospital setting than is the colorimetric end-tidal CO2 detection device.Methods:This was a prospective alternating weeks, 6-month study in a prehospital setting. Participants included all patients older than 18 years who were intubated by the Portsmouth, Virginia Emergency Medical Services (EMS) personnel from 01 July 1993 through 31 December 1993. The aspiration device used, also known as an esophageal detector device (EDD), was a 60 ml, luer-lock syringe attached to a 15 mm ETT adapter. Its efficacy was compared with an already accepted method of ETT position detection, the colorimetric endtidal CO2 detector. Each device was used on alternating weeks, and correct ETT placement was determined by the receiving emergency department physician using standard techniques. Chi-square analysis and Fisher's Exact test were used to compare parameters, time of device use, and ease of use. Sensitivity and specificity were calculated, and provider preference was assessed using a survey instrument administered following completion of the study.Results:There were 49 patients who met the inclusion criteria, but six were excluded because of situational circumstances rendering use of the device a possible compromise of patient care. Twenty-five patients were in the EDD group, and 18 were in the endtidal CO2 detector group. There was no statistically significant difference detected between groups for the gender ratio, underlying condition, CPR in progress, perceived difficulty of intubation, or percentage of nasotracheal intubation. The EDD was significantly easier to use (p<0.005). There was no statistically significant difference in time required for use of end-tidal CO2 detector device versus the EDD. The sensitivity and specificity for correct tracheal placement using the EDD was 100%, and the sensitivity for correct tracheal placement using the end-tidal CO2 detector device was 78%. Use of the EDD was preferred over use of the end-tidal CO2 detector device by 75% of participating EMS providers. One case of nasotracheal intubation with an ETT placement above the cords raised the question of accuracy of this device in situations where direct visualization is not utilized.Conclusion:The EDD was accurate in all cases of orotracheal intubation, and was easier to use than was end-tidal CO2 detector device. It was preferred by 75% of participating EMS providers. In cases in which the ETT may be above the vocal cords, caution must be used with interpreting the results obtained by use of the EDD.

Assessment of gas flow waves for endotracheal tube placement in an ovine model of neonatal resuscitation

Resuscitation ◽  
2010 ◽  
Vol 81 (6) ◽  
pp. 737-741 ◽  
Author(s):  
G.M. Schmölzer ◽  
S.B. Hooper ◽  
K.J. Crossley ◽  
B.J. Allison ◽  
C.J. Morley ◽  
...  
Keyword(s):  
Endotracheal Tube ◽  
Gas Flow ◽  
Neonatal Resuscitation ◽  
Tube Placement ◽  
Ovine Model ◽  
Endotracheal Tube Placement

THE SENSITIVITY, SPECIFICITY AND ACCURACY OF STATIC METHOD OF ULTRASONOGRAPHY TO CONFIRM ENDOTRACHEAL INTUBATION IN EMERGENCY DEPARTMENT.

2021 ◽  
pp. 8-13
Author(s):  
Pankaj Kumar Singh ◽  
Budhaditya Sanyal ◽  
Mohit Bhatnagar ◽  
Mandeep Joshi ◽  
Shreya Verma
Keyword(s):  
Diagnostic Accuracy ◽  
Endotracheal Tube ◽  
Predictive Value ◽  
Static Method ◽  
Tube Placement ◽  
Short Course ◽  
Endotracheal Tube Placement ◽  
Linear Probe ◽  
Post Intubation ◽  
Sensitivity Specificity

Aims and objectives: This study aims to assess the diagnostic accuracy and timeliness of ultrasonography by static method only for identication of Endotracheal tube (ET Tube) placement in the trachea in emergency settings vs existing clinical methods. Material and Methods: This prospective study was carried out in the emergency room from October 2018 till the end of March 2019. The ultrasonography was performed in 120 emergency patients only after the intubation had been completed ie, static phase. A linear probe was used over the neck to identify the predened signs of ET intubation. Residents who perform ultrasound examination ll a form after assessment of each patient. Results: It was found that Tracheal Intubation-USG Sensitivity was 99.1, Specicity was 91.7, Positive Predictive Value: 99.1, Negative Predictive Value was 91.7 and Accuracy was 98.3%. Ultrasonography can be used as an adjunct tool to verify the ETTposition by Emergency Physicians which can be performed easily after a brieng or short-course training.Conclusion:This study demonstrates that US imaging has a high diagnostic accuracy to immediately conrm proper ETT placement post-intubation in an emergency setup. Therefore, it seems that ultrasonography using a static technique only is a proper screening tool in determining endotracheal tube placement.

scholarly journals Pulmonary atelectasis in newborns with clinically treatable diseases who are on mechanical ventilation: clinical and radiological aspects

2018 ◽  
Vol 51 (1) ◽  
pp. 20-25 ◽  
Author(s):  
Mariana Chiaradia Dominguez ◽  
Beatriz Regina Alvares
Keyword(s):  
Mechanical Ventilation ◽  
Endotracheal Tube ◽  
Left Lung ◽  
Hyaline Membrane Disease ◽  
Relevant Information ◽  
Tube Placement ◽  
Cross Sectional ◽  
Pulmonary Atelectasis ◽  
Radiology Reports ◽  
Endotracheal Tube Placement

Abstract Objective: To analyze the radiological aspects of pulmonary atelectasis in newborns on mechanical ventilation and treated in an intensive care unit, associating the characteristics of atelectasis with the positioning of the head and endotracheal tube seen on the chest X-ray, as well as with the clinical variables. Materials and Methods: This was a retrospective cross-sectional study of 60 newborns treated between 1985 and 2015. Data were collected from medical records and radiology reports. To identify associations between variables, we used Fisher's exact test. The level of significance was set at p < 0.05. Results: The clinical characteristics associated with improper positioning of the endotracheal tube were prematurity and a birth weight of less than 1000 g. Among the newborns evaluated, the most common comorbidity was hyaline membrane disease. Atelectasis was seen most frequently in the right upper lobe, although cases of total atelectasis were more common in the left lung. Malpositioning of the head showed a trend toward an association with atelectasis in the left upper lobe. Conclusion: Pulmonary atelectasis is a common complication in newborns on mechanical ventilation. Radiological evaluation of the endotracheal tube placement provides relevant information for the early correction of this condition.

Pulmonary Reverse Mismatches Due to Endotracheal Tube Placement

1995 ◽  
Vol 20 (10) ◽  
pp. 939-940
Author(s):  
RONALD J. ROSENBERG ◽  
RICHARDO E. SANTIAG ◽  
RICHARD P. SPENCER
Keyword(s):  
Endotracheal Tube ◽  
Tube Placement ◽  
Endotracheal Tube Placement
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