scholarly journals Videolaringoscopy Beyond Conventional Endotracheal Intubation in HEMS: A Real Flight Simulation

2021 ◽  
Author(s):  
Gianluca Facchetti ◽  
Aglaia Gyra ◽  
Chiara Angeletti ◽  
Francesco Masedu ◽  
Enrico Molineris ◽  
...  
Keyword(s):  
Success Rate ◽  
Hospital Setting ◽  
Primary Objective ◽  
Flight Simulation ◽  
Indirect Laryngoscopy ◽  
Sitting Position ◽  
Light Conditions ◽  
Comparable Level ◽  
The Mean ◽  
Mean Time

Abstract BackgroundIn pre-hospital setting, airway management may be required during hems transportation, when patients deteriorate while en route. Our primary objective was to assess whether in-flight indirect laryngoscopy in frontal right-lateral sitting position (FP) of the operator, is such effective as traditional indirect laryngoscopy methods onshore, considering, also, the association of success rate with influencing flight factors (flying, devices, position, comfort VAS, Lumen VAS). MethodsThis observational prospective study, aimed to estimate the success rate of in-flight FP indirect laryngoscopy intubation. The study conducted on an AW 169 helicopter (©Leonardo Company, Italy) equipped with transversal stretcher, during steady flight. Indirect laryngoscopy devices (GlideScope Ranger and AirTraq) were used on a HAL® manikin (Accurate, Gaumard® Scientific Company,Inc) with cervical collar. ResultsAll of the FP intubations with both devices were successful after two attempts maximum. The mean time for intubation was slightly greater using the Glide Scope Ranger (mean 45.4±32.2”) compared to AirTraq (mean 34.8±26.7”). ConclusionsBoth AirTraq and GlideScope Ranger used in in-flight FP guarantee a comparable level of effectiveness to traditional onshore method with 100% successful rate of intubation, Airtraq seems not been affected by Lumen, indicating that in this specific contest it guarantees a high visualisation regardless the light conditions. On the other hand, the FP results effective using AirTraq in both conditions.

scholarly journals Mid-stream clean catch urine collection in newborns: a non-invasive and safe technique

2019 ◽  
Vol 6 (2) ◽  
pp. 349 ◽  
Author(s):  
Rajendra Kumar ◽  
Nithin . ◽  
Sudha Rudrappa
Keyword(s):  
Success Rate ◽  
Urine Sample ◽  
Invasive Technique ◽  
Urine Collection ◽  
Non Invasive ◽  
Invasive Method ◽  
Safe Technique ◽  
The Mean ◽  
Invasive Techniques ◽  
Mean Time

Background: The aim of this study is to determine the success rate and safety of a non-invasive technique to obtain clean-catch midstream urine samples in newborns.Methods: Prospective bedside clinical study. After obtaining written informed consent,120 consecutive newborns admitted in NICU with no dehydration, poor feeding, need for immediate urine sample by invasive method  for whom urine collection was advised for various reasons who met the inclusion criteria were included in the study with consent being taken from the parents. After adequate milk intake supra pubic and lumbar para vertebral areas were stimulated in repeated cycles of 30 s until micturition began.Results: Success rate in obtaining a midstream urine sample within 5 min. The success rate was 90%. The mean time taken to collect urine was 64.24s, for males it was 62.55s and for females 65.93s.Conclusions: The technique has been demonstrated to be safe, quick and effective. The discomfort and time consumption usually associated with bag collection methods as well as invasive techniques can be avoided.

scholarly journals No Sedation, No Traction, and No Need for Assistance: Analysis of New Prakash’s Method of Shoulder Reduction

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Tolgahan Kuru ◽  
Haci Ali Olcar ◽  
Ali Bilge ◽  
Gurdal Nusran ◽  
Recai Ozkilic ◽  
...  
Keyword(s):  
Emergency Department ◽  
Success Rate ◽  
Shoulder Dislocation ◽  
Sitting Position ◽  
Success Rates ◽  
Procedure Time ◽  
Optimal Method ◽  
Reduction Methods ◽  
Novel Method ◽  
The Mean

Background and Objective. Shoulder dislocations, which often occur anterior, account for about half of all dislocations. There are numerous reduction methods reported for the conservative treatment of acute anterior dislocations. However, there is still an ongoing search for an optimal method given the procedure time, possible complications, success rates, and need for sedation/analgesia in existing methods. This study seeks to explore the effectiveness and safety of Prakash’s method in the treatment of acute shoulder dislocations, which is a novel method in the treatment of anterior shoulder dislocations. Materials and Methods. A total of 19 patients who were admitted to the emergency department with the diagnosis of anterior shoulder dislocation participated in this study. The diagnosis of shoulder dislocation was established in the emergency department with physical examination and anteroposterior shoulder radiography. The method was applied only once to the patients in the sitting position by the same physician without using any help, traction, anesthesia, analgesia, and myorelaxant. Results. The mean age of the patients was 37.3 ± 13.1 years. Among them, 36.8% n=7 were female and 63.2% n=12 were male. Recurrent dislocations were observed in 21.1% n=4 of the patients. The success rate of the method was 94.7% n=18. No complication was noted in the patients. The mean procedure time was 243 ± 38 seconds. Conclusion. Prakash’s method is a safe method for anterior shoulder dislocations that can be quickly performed with no need for sedation, assistance, and traction and has a high success rate.

scholarly journals Cricothyrotomy Is Faster Than Tracheostomy for Emergency Front-of-Neck Airway Access in Dogs

2021 ◽  
Vol 7 ◽  
Author(s):  
Sureiyan Hardjo ◽  
Catriona Croton ◽  
Solomon Woldeyohannes ◽  
Sarah Leonie Purcell ◽  
Mark David Haworth
Keyword(s):  
Success Rate ◽  
Randomised Trial ◽  
Technical Difficulty ◽  
Estimating Equation ◽  
Procedure Time ◽  
Veterinary Students ◽  
The Mean ◽  
Study Participants ◽  
Airway Access ◽  
Mean Time

Objectives: In novice final year veterinary students, we sought to: (1) compare the procedure time between a novel cricothyrotomy (CTT) technique and an abbreviated tracheostomy (TT) technique in canine cadavers, (2) assess the success rate of each procedure, (3) assess the complication rate of each procedure via a damage score, (4) evaluate the technical difficulty of each procedure and (5) determine the preferred procedure of study participants for emergency front-of-neck access.Materials and Methods: A prospective, cross-over, block randomised trial was performed, where veterinary students completed CTT and TT procedures on cadaver dogs. Eight students were recruited and performed 32 procedures on 16 dogs. A generalised estimating equation approach to modelling the procedure times was used.Results: The procedure time was significantly faster for the CTT than the TT technique, on average (p < 0.001). The mean time taken to complete the CTT technique was 49.6 s (95% CI: 29.5–69.6) faster on average, with a mean CTT time of less than half that of the TT. When taking into account the attempt number, the procedure time for a CTT was 66.4 s (95% CI: 38.9–93.9) faster than TT for the first attempt, and for the second attempt, this was 32.7 s (95% CI: 15.2–50.2) faster, on average. The success rate for both procedures was 100% and there was no difference detected in the damage or difficulty scores (P = 0.13 and 0.08, respectively). Seven of eight participants preferred the CTT.Clinical Significance: CTT warrants consideration as the primary option for emergency front-of-neck airway access for dogs.

scholarly journals Short Term Clinical Outcome of a Porous Tantalum Implant for the Treatment of Advanced Osteonecrosis of the Femoral Head

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Melissa Nadeau ◽  
Chantal Séguin ◽  
John S Theodoropoulos ◽  
Edward J Harvey
Keyword(s):  
Femoral Head ◽  
Clinical Outcome ◽  
Success Rate ◽  
Donor Site ◽  
Core Decompression ◽  
Treatment Modalities ◽  
Harris Hip Score ◽  
Porous Tantalum ◽  
The Mean ◽  
Mean Time

Purpose of the study: Osteonecrosis of the hip mostly affects young individuals and oftenprogresses to a debilitating disease. Several treatment modalities exist, but none are completely satisfactory. This study evaluates the clinical outcome of patients treated with core decompression and insertion of a porous tantalum implant in the femoral head. This procedure is similar to commonly performed procedures, but has the additional advantages of providing structural support to the necrotic femoral head while having no donor-site morbidity. Methods: We evaluated 15 patients with 18 osteonecrotic hips with Steinberg stage III (3 hips) and IV (15 hips) disease. The mean age of the patients was 42 years-old (eldest 66), and the mean time for follow-up was 23 months. The outcome measure was hip function, evaluated with the Harris hip score, and the end point was total hip arthroplasty, or referral for this procedure. Results: The success rate at twelve months postoperatively was 77.8%, and the overall success rate was 44.5%. Failures occurred at a mean time of 11.7 months, and one complication, a periprosthetic fracture, occurred 4 months postoperatively. On average, patients who did well improved their Harris hip scores by 21.7 points, and patients who eventually required arthroplasty decreased their scores by 14 points. Conlusions: Core decompression with porous tantalum implants showed encouraging success rates and early clinical results in patients with advanced stage osteonecrosis, but further larger scale studies are required to identify the population best suited for this procedure.

Abstract WP29: Early U.S. Experience with the Trevo Retriever Device: A Multi-Center Analysis

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Michael J Alexander ◽  
Erol Veznedaroglu ◽  
Lei Feng ◽  
Gary Duckwiler ◽  
Adnan Siddiqui ◽  
...  
Keyword(s):  
Success Rate ◽  
Clinical Results ◽  
Technical Success ◽  
Femoral Access ◽  
Technical Success Rate ◽  
Clinical Exam ◽  
Post Procedure ◽  
The Mean ◽  
Number Of Passes ◽  
Mean Time

Introduction: The Trevo Retriever device (Stryker Neurovascular, Mountain View, CA) received FDA clearance as a 510K device in August 2012 for clot retrieval in acute ischemic stroke within eight hours of symptom onset. This study is an early look at the initial U.S. experience with the device following FDA clearance, examining the clinical results of the some of the first cases performed in the U.S. Methods: This was a retrospective analysis of prospectively collected clinical data from the early U.S. experience using the Trevo Retriever device. All physician operators were in-serviced on the use of the device and technique prior to first clinical use. Of the first patients treated, 6 were MCA occlusions, and 1 ICA occlusion. Four of the patients received intravenous tPA prior to their intervention, the remaining three patients did not did not qualify for IV tPA. The mean NIHSS pre-procedure was 19. Results: The Trevo device could be delivered across the intraluminal clot in all seven cases. There was a 100% success rate in revascularization of the target territory as judged by TICI score 2b or 3. One case resulted in an ACA embolus that was successfully revascularized. There was an average of 2.0 passes of the device to achieve this revascularization rate (range 1-4), with 71% of the cases needing 1 or 2 passes, and the remaining 3 or 4 passes. The mean time from femoral access to revascularization was 44 minutes (range 18-93 minutes, median 31 minutes). The average clot length was 11 mm. The clot was characterized as soft/friable in 2 cases, intermediate/rubbery in 3 cases, and hard/fibrous in 2 cases. The 24 hour post-procedure NIHSS was improved in 86% of the patients treated, and the mean NIHSS at 24 hours was 10 (range 0-27). Five of the seven patients had an improvement on the NIHSS of 9 points or greater. Conclusions: The technical success rate, as measured by a TICI score of 2b or 3, was excellent (100%) in this initial U.S. experience. With a high revascularization rate and a few number of passes, this shortened the endovascular revascularization time, and resulted in improved clinical exam in 6 of the 7 patients within 24 hours post-procedure.

The Burden of Blood Transfusion: A Utilization Analysis - A Pilot Study

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4342-4342
Author(s):  
John Reitan ◽  
Fred J. Kudrik ◽  
Kayleen Fox ◽  
Sanatan Shreay ◽  
Arletta van Breda ◽  
...  
Keyword(s):  
Pilot Study ◽  
Blood Transfusion ◽  
Retrospective Chart Review ◽  
Primary Objective ◽  
Blood Transfusions ◽  
Transfusion Center ◽  
Visit Duration ◽  
The Mean ◽  
Record Review ◽  
Mean Time

Abstract Abstract 4342 Purpose: The primary objective of this pilot study is to evaluate the burden of blood transfusion on the institutional outpatient transfusion center. The burden of blood transfusion will be characterized by quantifying time and personnel resources associated with the administration of blood transfusions. Methods: This pilot study is a retrospective chart review (starting July 1, 2010, working backwards until 100 evaluable patients are accrued) that evaluated time and resources of blood transfusions at a single local institutional transfusion center located in the US. The record review currently includes 80 RBC transfusions. The mean and standard deviation (SD) were calculated for patient’s age, pre-transfusion Hgb level and other transfusion related activities. Results: The mean (SD) patient age was 59 (12) years, and the mean pre-transfusion Hgb was 8.0 (0.8) g/dL. The majority of RBC units administered were 2 units (n =66) with one unit received by n=8 and three units received by n=6. Mean (SD) times to administer the first, second and third units were 102 (12) minutes, 101 (19) minutes and 93 (14) minutes, respectively. The mean (SD) duration of a patient visit to the transfusion center was 313 (59) minutes, with a range of 135 – 448 minutes. When one, two and three units were administered, mean (SD) visit duration was 203 (40) minutes, 321 (46) minutes and 375 (25) minutes, respectively. Conclusions: In this preliminary analysis when transfusion is administered, the majority of patients received 2 units of RBCs and the mean time to administer these 2 units was about 3.3 hrs. The duration of patient visits on average was 5.2 hrs which could be a considerable burden on cancer patients. The cost and labor quantification of mean time of administering RBC transfusion would elicit burden to the transfusion center. Disclosures: Reitan: Amgen: Research Funding. Shreay:Amgen: Employment. Corey-Lisle:Amgen: Employment.

scholarly journals Surgical Outcome of Dacrystorhinostomy in Fistulous Dacryocystitis

2021 ◽  
Vol 37 (4) ◽  
Author(s):  
Noman Ahmed ◽  
Arsalan Ahmed Shaikh ◽  
Munawar Ahmed ◽  
Ashok Kumar Narsani ◽  
Muhammad Luqman Ali Bahoo
Keyword(s):  
Success Rate ◽  
Surgical Outcomes ◽  
University Hospital ◽  
P Value ◽  
Post Surgery ◽  
Quasi Experimental ◽  
The Mean ◽  
Mean Time ◽  
Good Success Rate

Purpose:  To study the surgical outcomes of Dacryocystorhinostomy (DCR) in fistulous dacryocystitis. Study Design:  Quasi Experimental study. Place and Duration of Study:  The detailed study was carried out in the Institute of Ophthalmology, Liaquat University Hospital Jamshoro, between September 2018 to August 2020. Material and Methods:  We analyzed the histories of 30 patients taking the DCR procedure and noted their mean age, standard deviation, follow-up time, complications and other details. We also reported the intraoperative anatomical results, postoperative analysis, and variable groups vs. outcomes post-surgery using SPSS Version 20. Results:  The mean patient's age was 44.2 ± 4.13years, where males to female percentages were 27% to 73%. We noted significant changes in patients with a success rate of 87% displayed by no relieved epiphora and lacrimal patency in 1 month, 3 months, and 6 months. The mean time of the patients was 4 months varying between 1 to 8 (months) and the variable group values vs. surgical outcomes showed no significant association between the variables (p-value ranging from 0.195 to 0.935). Conclusion:  Complications resulting in some patient’s post-surgery are manageable and the surgical technique has a good success rate. Key Words:  (DCR) Dacryocystorhinostomy, lacrimal Patency, fistulous Dacryocystitis, Scarring.

scholarly journals Six-month evaluation of ART one-surface restorations in a community with high caries experience in Brazil

2005 ◽  
Vol 13 (2) ◽  
pp. 180-186 ◽  
Author(s):  
Eduardo Bresciani ◽  
Wendell Lima de Carvalho ◽  
Lúcia Coelho Garcia Pereira ◽  
Terezinha de Jesus Esteves Barata ◽  
Franklin García-Godoy ◽  
...  
Keyword(s):  
Success Rate ◽  
Glass Ionomer Cement ◽  
Caries Experience ◽  
Glass Ionomer ◽  
Permanent Molars ◽  
The Mean ◽  
Mean Time ◽  
Postoperative Sensitivity ◽  
Amalgam Fillings

The aim of this study to evaluate the success rate in one-surface ART restorations placed in permanent molars using a glass ionomer cement especially developed for ART in a community with high caries experience; to evaluate the operator influence on its success, post-operative sensitivity and technique acceptance by patients. Prior to placement of the restorations, the Gingival Bleeding Index, Visible Plaque Index, DMFT, dmft indices and treatment needed were assessed. One hundred and fifty five one-surface restorations were placed in permanent molars of school children, according to the WHO ART manual, 1997. After 6 months, the success rate was verified clinically and by slides. At baseline, the mean DMFT was 2.56 (±1.08) and the mean dmft, 2.53 (±2.33). Operators A and B have placed 102 and 53 ART restorations respectively. The mean time of placement was 16 minutes and 25 seconds to operator A and 14 minutes and 43 seconds to operator B. At 6-month follow up, 152 ART restorations were evaluated and 97.3% were assessed to be successful. Two restorations were excluded from the sample because the ART restorations were replaced by amalgam fillings. Only 4 restorations have failed, in which 2 due to caries, 1 due to fistula presence and the other because the restoration was lost. Four patients reported postoperative sensitivity. At this study period, ART treatment seems to be suitable for its purpose. Further evaluations are necessary to the new glass ionomer cements especially developed for ART technique provided good results at 6-month follow up in a community with high DMFT and dmft indices. The success rate for one-surface cavities in permanent molars was 97.3%, and the studied indices seemed to have no influence in this early evolution period.

scholarly journals The influence of a Perspex intubation box on time to intubation: a simulation-based randomised crossover study

2021 ◽  
pp. 24-28
Author(s):  
R Swart ◽  
CMJ Strydom ◽  
G Joubert
Keyword(s):  
Crossover Study ◽  
Healthcare Workers ◽  
Primary Objective ◽  
Laryngoscopic View ◽  
Time To Completion ◽  
Glottic View ◽  
Simulation Based ◽  
The Mean ◽  
The Impact ◽  
Mean Time

Background: Standard personal protective equipment guidelines are insufficient to prevent contamination of healthcare workers with droplet spread during the COVID-19 crisis. The added challenge of adequate aerosol protection has led to the development of an initial prototype intubation box. The primary objective was to determine the impact of an intubation box on the mean time to completion of intubation in a simulated airway. Secondary objectives included the best laryngoscopic view, the effect of intubator seniority and mode of laryngoscopy on intubation. Methods: This was a randomised crossover study of the influence of an intubation box on mean time to completion of intubation of an airway management part-task trainer. Senior anaesthesiology staff were assigned to two groups and recordings of their attempts at intubation were analysed by two independent observers. Results: The intubation box led to a significantly longer mean time to completion of intubation of 7.6 seconds (95% CI 3.1; 12.2; p = 0.001) with direct laryngoscopy and 9.2 seconds (95% CI 3.8; 14.7; p = 0.001) with videolaryngoscopy. It did not influence best glottic view. Conclusion: We found that the use of an intubation box significantly prolonged the time to completion of intubation, but the clinical significance of the effect size is uncertain.

Efficiency of a New Fiberoptic Stylet Scope in Tracheal Intubation 

1999 ◽  
Vol 91 (6) ◽  
pp. 1628-1628 ◽  
Author(s):  
Takayuki Kitamura ◽  
Yoshitsugu Yamada ◽  
Hong-Lin Du ◽  
Kazuo Hanaoka
Keyword(s):  
Adverse Effects ◽  
Tracheal Intubation ◽  
Success Rate ◽  
Difficult Tracheal Intubation ◽  
Manual Control ◽  
Glottic Opening ◽  
Effective Technique ◽  
The Mean ◽  
External Light Source ◽  
Mean Time

Background Failed or difficult tracheal intubation is an important cause of morbidity and mortality during anesthesia. Although a number of fiberoptic devices are available to circumvent this problem, many do not allow manual control of the flexion of the tip and necessitate time-consuming preparation, special training, or the use of an external light source. To improve these limitations, the authors designed a new fiberoptic stylet scope (FSS) that has a simple form of a standard stylet with the fiberoptic view and maneuverability of its tip. This study was undertaken to prospectively evaluate the effectiveness of the FSS in tracheal intubation. Methods Thirty-two patients undergoing general surgery participated in this study. The authors used a standard laryngoscope only to elevate the tongue, then tracheal intubation was attempted with the glottic opening being viewed only through the FSS. The success rate, time necessary for intubation, hemodynamics, and adverse effects were recorded. Results The success rate of tracheal intubation on the first attempt using the FSS was 94% (30 of 32 patients), and the remaining two patients were intubated successfully on the second attempt. The mean time necessary for the intubation procedure was 29+/-14 s in all patients (mean +/- SD). Changes in hemodynamics during intubation were well within acceptable ranges. There were no major adverse effects, but minor sore throat (28%) and minor hoarseness (25%) on the first postoperative day. Conclusions Tracheal intubation using the FSS proved to be a simple and effective technique for airway management.

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