scholarly journals Countermeasures for intratracheal intubation difficulty.

1997 ◽  
Vol 17 (6) ◽  
pp. 349-356
Author(s):  
TETSUO INOUE
Keyword(s):  
Intratracheal Intubation ◽  
Intubation Difficulty

scholarly journals Correlation between clinical risk factors and tracheal intubation difficulty in infants with Pierre-Robin syndrome: A systematic review

2020 ◽  
Author(s):  
Yanli Liu ◽  
Jiashuo Wang ◽  
Shan Zhong
Keyword(s):  
Computed Tomography ◽  
Tracheal Intubation ◽  
Surface Area ◽  
Body Surface ◽  
Pierre Robin Syndrome ◽  
Intubation Difficulty ◽  
Computed Tomography Images ◽  
The Difference ◽  
And Gender ◽  
Pierre Robin

Abstract Background: Difficult tracheal intubation is a problem commonly encountered by anesthesiologists in the clinic. Methods: In this retrospective study, case-level clinical data and computed tomography images of 96 infants with Pierre-Robin syndrome were included in the analysis. First, computed tomography images were labeled by a clinically experienced physician. Then color space conversion, binarization, contour acquisition, and area calculation processing were performed on the annotated files. Finally, we calculated the correlation coefficient between the seven clinical factors and tracheal intubation difficulty, and the difference in each risk factor under tracheal intubation difficulty. Results: The absolute value of the correlation coefficient between throat area and tracheal intubation difficulty is 0.54, and the difference of throat area under tracheal intubation difficulty is significant. Body surface area, weight and gender also show significant difference under tracheal intubation difficulty. Conclusions: There is a significant correlation between throat area and tracheal intubation difficulty in infants with Pierre-Robin syndrome. Body surface area, weight and gender may have an impact on tracheal intubation difficulty in infants with Pierre-Robin syndrome.

scholarly journals Is there an optimal place to hold the endotracheal tube during direct laryngoscopy? Protocol for a Randomised Controlled Trial

2021 ◽  
Author(s):  
Manisha Sahoo ◽  
Swagata Tripathy ◽  
Nitasha Mishra
Keyword(s):  
Endotracheal Tube ◽  
Endotracheal Intubation ◽  
Controlled Trial ◽  
Scientific Evidence ◽  
Intubation Difficulty ◽  
The Mean ◽  
Randomised Controlled ◽  
Difficulty Score ◽  
Clinical Trials Registry ◽  
Rate Of Success

Abstract Background: Laryngoscopic endotracheal intubation (LEI) is a widely performed lifesaving technique. There are evidence and guidelines to help decide the optimal sized endotracheal tube (ET), laryngoscope, depth of insertion, and patient position for successful endotracheal intubation. We hypothesize that after glottic visualization, the point at which the ET is held will affect the time, ease, and success of the technique due to a difference in visualization and torque. We aim to compare two sites of holding the ET after optimal laryngeal-inlet visualization: time to intubation, rate of success of first pass intubation, intubation difficulty and complications.Methods: Supervised intubations on ASA 1-2 patients (>18 years) posted for surgery under general anesthesia performed by anesthesia trainees (experience <18 months) will be included. Patients with an anticipated difficult airway or unanticipated difficulty - CL grade > three or requiring the use of airway adjuncts will be excluded. A computer-generated numbers list will randomize patients; allocation concealed with opaque sealed envelopes. ET marked at the selected site will be handed to the intubator by the theatre-technician once she/he confirms the optimum laryngoscopic view. The entire procedure will be video recorded. Two blinded assessors will independently review the videos to document the time to intubation (TTI defined as the time from holding the ET to the removal of laryngoscope from the mouth after successful intubation) and intubation difficulty score. Postoperative sore throat and hoarseness will be recorded.Sample size: 54 experienced anesthetists were video-recorded during intubating. The site of holding ET and TTI were analyzed. The mean site was 3 SD 2.5 cm from the tip, yielding two sites for the study- 19 cm (Gr 1) and 24 cm (Gr 2). To detect a 20% difference in intubation time between groups, the confidence of 95%, and power 85%, we will need 298 patients: 180 per group after accounting for data loss.Discussion: This will be the first study to assess whether holding the tube at a particular site has any impact on the ease and time taken for intubation. This study's findings will provide the first scientific evidence for an appropriate place for holding the ET during LEI, which we feel will help trainees improve their LEI technique.Trial registration: CTRI/2019/09/021201, Clinical Trials Registry India. http://ctri.nic.in/Clinicaltrials/advsearch.php. Registered 12th September 2019,

Determination of the utility of the Intubation Difficulty Scale for use with indirect laryngoscopes

Anaesthesia ◽  
2011 ◽  
Vol 66 (12) ◽  
pp. 1127-1133 ◽  
Author(s):  
J. McElwain ◽  
A. Simpkin ◽  
J. Newell ◽  
J. G. Laffey
Keyword(s):  
Intubation Difficulty ◽  
Difficulty Scale

scholarly journals SPIDS – simplified predictive intubation difficulty score

2020 ◽  
Vol 70 (6) ◽  
pp. 569
Author(s):  
Vinícius Caldeira Quintão ◽  
Cláudia Marquez Simões ◽  
Maria José Carvalho Carmona
Keyword(s):  
Intubation Difficulty ◽  
Difficulty Score

scholarly journals Effect of an aerosol box on tracheal intubation difficulty

2020 ◽  
Vol 34 (5) ◽  
pp. 790-793
Author(s):  
Ryo Wakabayashi ◽  
Takashi Ishida ◽  
Tomokatsu Yamada ◽  
Mikito Kawamata
Keyword(s):  
Tracheal Intubation ◽  
Intubation Difficulty

scholarly journals Comparison of Laryngoscopic Views between C-MAC™ and Conventional Laryngoscopy in Patients with Multiple Preoperative Prognostic Criteria of Difficult Intubation. An Observational Cross-Sectional Study

Medicina ◽  
2019 ◽  
Vol 55 (12) ◽  
pp. 760
Author(s):  
Aikaterini Amaniti ◽  
Panagiota Papakonstantinou ◽  
Dimitrios Gkinas ◽  
Ioannis Dalakakis ◽  
Evangelia Papapostolou ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Difficult Intubation ◽  
Elective Surgery ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Cross Sectional Study ◽  
Laryngoscopic View ◽  
Cross Sectional ◽  
Intubation Difficulty ◽  
Difficulty Scale

Background and Objectives: Video laryngoscopy has been proven useful under difficult airway scenarios, but it is unclear whether anticipated improvement of visualization is related to specific difficult intubation prognostic factors. The present study evaluated the change in laryngoscopic view between conventional and C-MAC® laryngoscopy and the presence of multiple difficult intubation risk factors. Materials and Methods: Patients scheduled for elective surgery with >2 difficult intubation factors, (Mallampati, thyromental distance (TMD), interinscisor gap, buck teeth, upper lip bite test, cervical motility, body mass index (BMI)) were eligible. Patients underwent direct laryngoscopy (DL) followed by C-MAC™ laryngoscopy (VL) and intubation. Change of view between DL and VL, time for best view, intubation difficulty scale (IDS) and correlation between prognostic factors, laryngoscopic view improvement, and IDS were measured. Results: One-hundred and seventy-six patients completed the study. VL lead to fewer Cormarck–Lehane (C/L) III-IV, compared to DL (13.6% versus 54.6%, p < 0.001). The time to best view was also shorter (VL: 10.82 s, DL: 12.08 s, p = 0.19). Mallampati III-IV and TMD ≤ 6 cm were related to improvement of C/L between DL and VL. Logistic regression showed these two factors to be a significant risk factor of the glottis view change (p = 0.006, AUC-ROC = 0.57, 95% CI: 0.47–0.66). 175/176 patients were intubated with VL. 108/176 were graded as 0 < IDS ≤ 5 and 12/176 as IDS > 5. IDS was only correlated to the VL view (p < 0.0001). Conclusion: VL improved laryngoscopic view in patients with multiple factors of difficult intubation. Mallampati and TMD were related to the improved view. However, intubation difficulty was only related to the VL view and not to prognostic factors.

scholarly journals Neutral Position Facilitates Nasotracheal Intubation with a GlideScope Video Laryngoscope: A Randomized Controlled Trial

2020 ◽  
Vol 9 (3) ◽  
pp. 671
Author(s):  
RyungA Kang ◽  
Ji Seon Jeong ◽  
Justin Sangwook Ko ◽  
Jaemyung Ahn ◽  
Mi Sook Gwak ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Nasotracheal Intubation ◽  
Head Position ◽  
Neutral Position ◽  
Dental Surgery ◽  
Intubation Difficulty ◽  
Difficulty Scale ◽  
Nasotracheal Tube ◽  
Glidescope Video Laryngoscope ◽  
Position Group

The optimal head position for GlideScope facilitated nasotracheal intubation has not yet been determined. We compared the neutral and sniffing positions to establish the degree of intubation difficulty. A total of 88 ASA I-II patients requiring nasotracheal intubation for elective dental surgery with normal airways were divided into two groups according to head position, neutral position (group N), and sniffing position (group S). The primary outcome was the degree of intubation difficulty according to the Intubation Difficulty Scale (IDS): Easy (IDS = 0), mildly difficult (IDS = 1 to 4), and moderately to severely difficult (IDS ≥ 5). Eighty-seven patients completed the study and their data were analyzed. The degree of intubation difficulty was significantly different between the two groups (p = 0.004). The frequency of difficult intubation (IDS > 0) was 12 (27.9%) in group N and 28 (63.6%) in group S (difference in proportion, 35.7%; 95% confidence interval [CI], 14.8 to 52.6%; p = 0.001). The neutral position facilitates nasotracheal intubation with GlideScope by aligning the nasotracheal tube and the glottis inlet more accurately than the sniffing position.

Effectiveness of an Advanced Airway Training “Boot Camp” for Family Medicine Physician Trainees

2020 ◽  
Vol 163 (2) ◽  
pp. 204-208 ◽  
Author(s):  
Kastley Marvin ◽  
Paige Bowman ◽  
Matthew W. Keller ◽  
Art A. Ambrosio
Keyword(s):  
Family Medicine ◽  
Airway Management ◽  
Family Medicine Residency ◽  
Training Course ◽  
Intubation Difficulty ◽  
Advanced Airway ◽  
Medicine Physician ◽  
Hands On ◽  
Difficulty Scale ◽  
The Impact

Objective This course was designed to characterize the impact of a curriculum for training family medicine physicians in advanced airway techniques with respect to intubation performance and learner confidence. Methods A training course was introduced into the curriculum in a single-group pretest-posttest model at a community family medicine residency program. Training consisted of a didactic teaching session on airway management and hands-on skill session with direct laryngoscopy (DL) and video-assisted laryngoscopy (VAL) on normal and difficult airway simulators. Participants were scored with the Intubation Difficulty Scale and completed surveys before and after the training. Results Twenty-eight residents of all levels participated. The mean time to successful intubation was significantly decreased after training from 51.96 to 23.71 seconds for DL and from 27.89 to 17.07 seconds for VAL. Participant scores with the Intubation Difficulty Scale were also significantly improved for DL and VAL. All participants rated their comfort levels with both techniques as high following training. Discussion Advanced airway management is a critical skill for any physician involved in caring for critically ill patients, though few trainees receive formal training. Addition of an airway training course with simulation and hands-on experience can improve trainee proficiency and comfort with advanced airway techniques. Implications for Practice Training on airway management should be included in the curriculum for trainees who require the requisite skills and knowledge necessary for advanced airway interventions. This introductory project demonstrates the efficacy and feasibility of a relatively brief training as part of a family medicine residency curriculum.

Sign in / Sign up

Export Citation Format

Share Document