scholarly journals Endotracheal Intubations in Emergency Department: A Clinical Audit at a Tertiary Health Centre in South India

2021 ◽  
Vol 5 (2) ◽  
pp. 842-848
Author(s):  
Linu SM ◽  
Roopasree Sivam ◽  
Nikhil Paul ◽  
Mathen P George ◽  
Suresh Babu
Keyword(s):  
Emergency Department ◽  
Airway Management ◽  
Success Rate ◽  
Health Centre ◽  
Dental Trauma ◽  
Rapid Sequence Intubation ◽  
P Value ◽  
Success Rates ◽  
Management Skills ◽  
Cross Sectional

Background: Endotracheal intubation in the emergency department is challenging. Hence, regular audits can help us improve our critical airway management skills. Our study aimed to evaluate the practice of endotracheal intubations performed in the emergency department. Materials and Methods: A retrospective cross-sectional study was conducted among the patients intubated in our teaching hospital's emergency department. The study period was from November 1, 2019, to August 31, 2020. We analyzed first attempt success rates, drug use, indication, and complications. Results: We analysed 90 endotracheal intubations, out of which 70(77.8%) were performed by emergency physicians and 20(22.2%) by anaesthetists. The first attempt success rate was 81.11% (n=73) and had significant differences between the both departments. (p value= 0.003,  χ2= 7.48). More patients had medical indications compared to trauma for intubation (n=88 vs n=32) among which respiratory failure (n=25, 27.78%) was the most common indication. Rapid Sequence Intubation( RSI) adherence was 82.22% (n=74). Lignocaine (n=16, 19.75%), etomidate (n=35, 43.2%) and succinylcholine (n=65, 80.25%) were the commonly used drugs for premedication, induction and as relaxants respectively. 17(18.89%) out of 90 intubation had complications. Desaturation (n=10, 11.11%), bradycardia (n=1, 1.11%), hypotension (n=4, 44%), dental trauma (n=5, 5.55%) and oesophageal intubation (n=3, 3.33%) were observed in our study. Conclusion: Our study is the first  from India which describes the characteristics of endotracheal intubations done in the Emergency Department along with data on RSI adherence. The first attempt success rate, indications, and complications were comparable with other studies in the literature. We recommend future prospective studies to analyze success rates between different specialties and resident doctors to improve the airway management skills in the Department

scholarly journals The Success Rate of Endotracheal Intubation in the Emergency Department of Tertiary Care Hospital in Ethiopia, One-Year Retrospective Study

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Ayalew Zewdie ◽  
Dejene Tagesse ◽  
Selam Alemayehu ◽  
Tesfaye Getachew ◽  
Menbeu Sultan
Keyword(s):  
Emergency Department ◽  
Success Rate ◽  
Endotracheal Intubation ◽  
Addis Ababa ◽  
Tertiary Care ◽  
Tertiary Hospital ◽  
Rapid Sequence Intubation ◽  
Care Hospital ◽  
Success Rates ◽  
First Pass

Background. Emergency medical care starts with airway assessment and intervention management. Endotracheal intubation is the definitive airway management in the emergency department (ED) for patients requiring a definitive airway. Successful first pass is recommended as the main objective of emergency intubation. There exists no published research regarding the success rates or complications that occur within Ethiopian hospitals emergency department intubation practice. Objective. This study aimed to assess the success rate of emergency intubations in a tertiary hospital, Addis Ababa, Ethiopia. Methodology. This was a single institute retrospective documentation review on intubated patients from November 2017 to November 2018 in the emergency department of Addis Ababa Burn Emergency and Trauma Hospital. All intubations during the study period were included. Data were collected by trained data collectors from an intubation documentation sheet. Result. Of 15,933 patients seen in the department, 256 (1.6%) patients were intubated. Of these, 194 (74.9%) were male, 123 (47.5%) sustained trauma, 65 (25.1%) were medical cases, and 13(5%) had poisoning. The primary indications for intubation were for airway protection (160 (61.8%)), followed by respiratory failure (72(27.8%)). One hundred and twenty-nine (49.8%) had sedative-only intubation, 110 (42.5%) had rapid sequence intubation, and 16 (6.2%) had intubation without medication. The first-pass success rate in this sample was 70.3% (180/256), second-pass 21.4% (55/256), and third-pass 7.4% (19/256), while the overall success rate was 99.2% (254/256). Hypoxia was the most common complication. Conclusion. The intubation first-pass success rate was lower than existing studies, but the overall intubation success rate was satisfactory.

Improving first-pass success rates during emergency intubation at an academic emergency department: a quality improvement initiative

2021 ◽  
Vol 33 (3) ◽  
Author(s):  
Abdullah Bakhsh ◽  
Ahd Alharbi ◽  
Raghad Almehmadi ◽  
Sara Kamfar ◽  
Arwa Aldhahri ◽  
...  
Keyword(s):  
Emergency Department ◽  
Quality Improvement ◽  
Airway Management ◽  
Performance Monitoring ◽  
Video Laryngoscopy ◽  
Rapid Sequence Intubation ◽  
Quality Improvement Initiative ◽  
Success Rates ◽  
Improvement Program ◽  
First Pass

Abstract Background Airway management is a high-stakes procedure in emergency medicine. Continuously monitoring this procedure allows performance improvement while revealing safety issues. We instituted a quality improvement initiative in the emergency department to improve first-pass success rates in the emergency department. Methods This was a quality improvement initiative at an academic emergency department from 2018 to 2020. We developed a rapid sequence intubation guideline for procedure standardization and introduced an intubation procedure note for performance monitoring. Data were entered directly by the primary physician and nurse during intubation. The quality improvement team thereafter collected the data retrospectively and entered into a local airway database. More importantly, we introduced a culture of quality improvement and safety in airway management via regular education and feedback. Results We included a total of 146 intubations. The first-pass success rate started at 57.1% and increased to 80.0% during the study period (P < 0.01). Fifty-six percent were male, and the mean age (±SD) was 55.56 (±17.64). Video laryngoscopy was used in 101 (69.2%) patients, while direct laryngoscopy was used in only 44 (30.8%) patients. A logistic regression analysis was conducted to determine the independent factors associated with first-pass success. These factors included the use of video laryngoscopy (odds ratio (OR) 2.47 95% confidence interval (95% CI) [1.62–3.76]) (adjusted OR 3.87 [1.13–13.23]) and good Cormack–Lehane views (grades 1–2) (OR 2.71 95% CI [1.74–4.20]) (adjusted OR 7.88 [2.43–25.53]). Conclusion Our study shows that implementing and maintaining an airway quality improvement program improves first-pass intubation success. Moreover, the use of video laryngoscopy and obtaining good Cormack–Lehane views (grades 1–2) are independently associated with improved first-pass success.

scholarly journals HUBUNGAN BBLR DAN ASI EKSLUSIF DENGAN KEJADIAN STUNTING DI PUSKESMAS LIMA PULUH PEKANBARU

2018 ◽  
Vol 3 (1) ◽  
pp. 131
Author(s):  
Lidia Fitri
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Exclusive Breastfeeding ◽  
Health Centre ◽  
Sampling Technique ◽  
P Value ◽  
Not Given ◽  
Cross Sectional ◽  
Analysis Study

<p><em>Stunting is one of the long-term indicators for malnutrition. Stunting prevalence in Indonesia about 37.2%. Babies born with low birth weight is 10.2% and the achievement of exclusive breastfeeding is 30.2%. Survey in Limapuluh Health Centre Pekanbaru, from 18 children who perform measurements, obtained 13 infants suffered stunting. The result of interviews showed that three of them were born with low birth weight (BBLR) and five are not given exclusive breastfeeding. </em><em>This research is to find-out the correlation between low birth weight (BBLR) and exclusive breastfeeding</em><em> </em><em>with stunting in Limapuluh Health Centre Pekanbaru in 2017.  This study was a quantitative analysis study used cross sectional strategy. Population consists of 300 people, sample consists of 75 people by accidental sampling technique. Analysis using univariat and bivariate. The result were 25 infant (33,3%) are stunting, 22 infant (29,3%) with low birth weight (BBLR) and  not given exclusive breastfeeding are 55 infant (73,3%). There was a significant association between low birth weight (BBLR) with stunting was obtained p value 0.000 and association between exclusive breastfeeding with stunting was obtained p value 0.021 its mean p&lt;0,05. There is a relationship between BBLR and exclusive breastfeeding with stunting events, the Ha accepted.</em></p><p><em><br /></em></p><p><em>Stunting </em>merupakan salah satu indikasi buruknya status gizi pada anak. Prevalensi <em>stunting </em>di Indonesia sebesar 37,2%. Angka kejadian bayi dengan BBLR sebanyak 10,2% dan pencapaian ASI ekslusif 30,2%. Survey di Puskesmas Lima Puluh kota Pekanbaru Provinsi Riau didapatkan dari 18 orang balita yang di ukur, 13 orang diantaranya mengalami <em>stunting. </em>Hasil wawancara memperlihatkan bahwa 3 orang diantaranya lahir dengan BBLR dan 5 orang tidak diberikan ASI ekslusif. Tujuan penelitian untuk mengetahui hubungan berat badan lahir rendah (BBLR) dan ASI ekslusif dengan kejadian <em>stunting </em>di Puskesmas Lima Puluh Pekanbaru. Jenis penelitian analitik kuantitatif dengan desain <em>cross sectional</em>. Populasi berjumlah 300 orang balita, sampel 75 responden dengan teknik <em>accidental sampling</em>. Analisis data secara univariat dan bivariat. Hasil penelitian diperoleh sebanyak 25 orang (33,3%) balita mengalami <em>stunting, </em>balita dengan BBLR sebanyak 22 orang (29,3%) dan yang tidak diberikan ASI ekslusif sebanyak 55 orang (73,3%). Ada hubungan yang bermakna antara berat badan lahir rendah (BBLR) dengan kejadian <em>stunting </em>dimana p value 0.000 dan terdapat hubungan antara pemberian ASI ekslusif dengan kejadian <em>stunting </em>diperoleh nilai p value 0.021 artinya p&lt;0,05. Dapat disimpulkan terdapat hubungan antara BBLR dan ASI eklusif dengan kejadian <em>stunting</em>, maka Ha diterima.</p><p><em><br /></em></p>

scholarly journals SIKAP DAN PENGETAHUAN PERAWAT BERHUBUNGAN DENGAN PELAKSANAAN TRIAGE

2018 ◽  
Vol 9 (02) ◽  
pp. 154
Author(s):  
Dewi Ratna Sari ◽  
Sutanta .
Keyword(s):  
Emergency Department ◽  
Clinical Decision Making ◽  
Initial Assessment ◽  
Rank Test ◽  
P Value ◽  
Hospital Emergency Department ◽  
Hospital Emergency ◽  
Cross Sectional ◽  
Spearman Rank ◽  
Emergency Units

ABSTRAKPerawat yang bekerja di unit gawat darurat (UGD) harus memiliki sikap, ketrampilan dan kemampuan untuk mengatur kemampuan fungsional dalam berbagai kondisi. Perawat harus mampu memprioritaskan perawatan pasien atas dasar pengambilan keputusan klinis dimana keterampilan penting bagi perawat dalam penilaian awal. Untuk mendukung hal tersebut diperlukan pengetahuan, sikap dan ketrampilan dalam hal pemisahan jenis dan kegawatan pasien dalam triage, sehingga dalam penanganan pasien bisa lebih optimal dan terarah. Tujuan penelitian untuk mengetahui hubungan sikap dan pengetahuan perawat dalam pelaksanaan triage di UGD RSUD Wonosari. Penelitian ini menggunakan survei analitik korelasi dengan pendekatan cross sectional. Populasi penelitian berjumlah 15 perawat yang bekerja di ruang gawat darurat, dengan metode pengambilan sampel secara total sampling. Instrumen penelitian berupa kuisioner, metode analisa data menggunakan uji spearman rank dan regresi linier berganda. Hasil penelitian tidak terdapat hubungan antara sikap dengan pelaksanaan triage di UGD RSUD Wonosari, hal ini ditunjukkan dari hasil uji Spearman rank dengan nilai sig 0,354>p-value 0,05. Terdapat hubungan antara pengetahuan dengan pelaksanaan triage di UGD RSUD Wonosari. Hal ini ditunjukkan dari nilai rank spearman 0,004 < p-value 0,05. Sehingga pelaksanaan triage dipengaruhi faktor lain yang tidak terangkum dalam analisis ini. Kesimpulan tidak ada hubungan antara sikap dengan pelaksanaan triage di UGD RSUD Wonosari. Ada hubungan antara pengetahuan dengan pelaksanaan triage di UGD RSUD Wonosari.Kata Kunci: sikap, pengetahuan, pelaksanaan triageNURSE’S ATTITUDE AND KNOWLEDGE RELATED WITH IMPLEMENTATION OF TRIAGEABSTRACTNurses working in emergency units must have the attitude, skills and ability to organize functional abilities under various conditions. Nurses should be able to prioritize patient care on the basis of clinical decision-making where skills are important to nurses in the initial assessment. To support it requires knowledge, attitude and skills in terms of separation of types and gravity of patients in triage, so that in the handling of patients can be more optimal and directed. The purpose of this research is to know the relationship of attitude and knowledge of nurses in the implementation of triage in emergency units Wonosari Hospital. This research uses analytic correlation survey with cross sectional approach. The study population was 15 nurses working in the emergency room, with sampling method in total sampling. The research instrument is questionnaire, data analysis method using spearman rank test and multiple linear regression. The result of this research shows that there is no correlation between attitude with triage implementation in emergency units Wonosari Hospital, it is shown from Spearman rank test with sig value 0,354> p-value 0,05. There is a relationship between knowledge with triage implementation at Wonosari Hospital emergency department. It is shown from spearman rank value 0,004 <p-value 0,05. So the implementation of triage is influenced by other factors not summarized in this analysis. Conclusion there is no relation between attitude with triage implementation in Wonosari Hospital emergency department. There is a relationship between knowledge with triage implementation in emergency units Wonosari Hospital.Keywords: attitude, knowledge, implementation of triage

scholarly journals The higher reading interest of pregnant mother improves the utilization of MCH book

2019 ◽  
Vol 1 (1) ◽  
pp. 114-119
Author(s):  
Apriliana Apriliana ◽  
Intan Mutiara Putri ◽  
Suyani Suyani ◽  
Istri Utami
Keyword(s):  
Health Centre ◽  
Primary Data ◽  
P Value ◽  
Daily Routine ◽  
Chi Square ◽  
Cross Sectional ◽  
Chi Square Test ◽  
Close Relatives ◽  
Reading Interest ◽  
Pregnant Mothers

The utilization of MCH book could be defined to be an activity when a mother and her close relatives actively participate in reading, learning, comprehending the contents of MCH book, and implementing it in daily routine. This research aims to discover the correlation between the reading interest of pregnant mothers and the use of MCH book. This study has been approved by the research ethics committee of Yogyakarta ‘Aisyiyah University. This cross-sectional research was performed at the Community Health Centre of Mlati II Sleman Yogyakarta. Seventy-four pregnant mothers who owned MCH book were derived from incidental sampling technic. The retrieval of primary data used questioner method. The result of chi-square test states that pregnant mothers with higher reading interest will be utilizing the MCH book four times more effective compared to those with lower interest in reading (p-value: 0,005 and 95% CI: 1,488-10,902).

scholarly journals HUBUNGAN MOTIVASI DAN PEKERJAAN IBU DENGAN PEMBERIAN MAKANAN PENDAMPING AIR SUSU IBU (MP-ASI) DINI PADA BAYI DI BAWAH USIA 6 BULAN

2021 ◽  
Vol 5 (1) ◽  
pp. 263-270
Author(s):  
Pandu Sandika ◽  
Nur Afrinis ◽  
Emdas Yahya
Keyword(s):  
Community Health ◽  
Complementary Feeding ◽  
Health Workers ◽  
Health Centre ◽  
Community Health Centre ◽  
Bivariate Analysis ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Work Area

Complementary feeding of breastmilk to infants aged less than 6 months can cause health problems such as constipation, diarrhea and allergies. It will have an impact on the nutritional status of the infant. The purpose of this study was to determine the relationship between motivation and mother occupation with complementary feeding of breastmilk to infants under the age of 6 months in Naga Beralih village the work area of Community Health centre Kampar Utara in 2020. This type of research was analytic with cross sectional design. The population of this research was mothers who have infants aged 0-6 months in Naga Beralih village, the working area of Community Health centre Kampar Utara, totaling 41 people. Data collection tools in this study used a questionnaire. Data analysis in this study used univariate and bivariate analysis with chi square. The results showed that most of the respondents have high motivation in giving complementary breastfeeding, most of the respondents work, most of the respondents give complementary foods to infant under the age of 6 months. There was a relationship of motivation with complementary feeding with p value of 0.001. There was a work relationship with the provision of complementary feeding under the age of 6 months in Naga Beralih village the work area of Community Health centre Kampar Utara in 2020 with a p value of 0.002. For health workers, in order to increase education about the importance of complementary breastfeeding by forming classes for infants and toddlers to provide information and demonstrations, especially regarding the amount of complementary breastfeeding, types of food and timing of complementary feeding.

scholarly journals Prevalence and aetiology of dental trauma in 8-14 year old school-going children of Hyderabad city, India

2020 ◽  
Vol 6 (3) ◽  
pp. 32-38
Author(s):  
Tanzeem Ahmed ◽  
Nikhil Kaushal ◽  
Sujeet Singh ◽  
Rashmi Agarwal
Keyword(s):  
Social Sciences ◽  
Dental Trauma ◽  
Cross Sectional Study ◽  
P Value ◽  
Cross Sectional ◽  
Traumatic Injuries ◽  
Anterior Teeth ◽  
Traumatic Dental Injuries ◽  
Dental Injuries ◽  
Type Of Fracture

Aims and Objectives: To determine the prevalence and etiology of fractured anterior teeth due to trauma among 8–14 years old school going children of Hyderabad city. Materials and method: A cross-sectional study was carried out in 8-14 year old children studying in various schools of Hyderabad for the assessment of traumatic injuries of anterior teeth. Clinical examination was carried out and type of teeth affected, type of fracture, overjet and lip competence were noted. A closed end questionnaire was given to children with questions regarding etiology of trauma, place of injury, symptoms or outcomes after the injury, whether a dentist was consulted, type of treatment done by dentist and time elapsed between trauma and treatment. All the results were analyzed using “statistical package for social sciences” (SPSS) 20.0 software. Results: The prevalence of dental trauma was found to be 7.84%. 11-14year old children showed higher prevalence. Males were more affected than females. Maxillary central incisors were most affected. Fracture involving enamel and dentin were recorded the highest. Children having overjet of >3mm and incompetent lips were at a higher risk of dental trauma (p value = 0.001). The most common cause of injury was sports and home was the most common place of occurrence of injury. Most of the traumatic dental injuries (TDI) did not undergo any treatment. Conclusion: Increasing the awareness of the parents and teachers about the prevention of TDI and the importance of consulting the dentist after trauma should be instituted.

scholarly journals Factors Affecting Nursing Ability To Know Acute Coroner Syndrome In Emergency Installation

2018 ◽  
Vol 2 (1) ◽  
pp. 64-72
Author(s):  
Agus Riyadi ◽  
Karmiati Karmiati
Keyword(s):  
Emergency Department ◽  
Acute Coronary Syndrome ◽  
Emergency Services ◽  
P Value ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Research Education ◽  
Coronary Syndrome ◽  
Coronary Syndromes ◽  
Almost All

Background: Coronary heart disease is the most cardiovascular disease that causes death in the world. The ability of nurses to recognize acute coronary syndromes is very necessary as part of the emergency services team. Purpose : The purpose of this study was to determine the description of the factors that influence the ability of nurses to know acute coronary syndrome in the emergency department of dr. Iskak Tulungagung. Methods : The design of this research is descriptive analytic with a cross sectional approach with the population of all nurses who work in the Emergency Department of dr. Iskak Tulungagung. The population is 55 nurses. The sample is all of the population, namely 55 respondents with total sampling sampling techniques. The data that has been collected is processed by a statistical test of Multivariate Analysis, Ordinal Regression with significance α = 0.05. Result : The results showed that most of the respondents with D3 education were 33 respondents (60.0%), almost all respondents had never attended ECG training in the amount of 50 respondents (90.9%) and almost half of the respondents had a working period of 2-5 year is 25 respondents (45.5%). The results of the regression regression analysis showed that the p-value = 0.855 on the education factor which means that H0 was accepted, the p-value = 0.041 in the training factor which means H1 is received, the p-value = 0.003 on the working period, which means that H1 is accepted Conclusion : Based on research, education does not affect the ability to recognize acute coronary syndrome. The education obtained will develop according to the increase in the work period and the frequent training that is obtained and practiced directly in real situations

scholarly journals Comparison of Glidescope Core, C-MAC Miller and conventional Miller laryngoscope for difficult airway management by anesthetists with limited and extensive experience in a simulated Pierre Robin sequence: A randomized crossover manikin study

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250369
Author(s):  
Andreas Moritz ◽  
Luise Holzhauser ◽  
Tobias Fuchte ◽  
Sven Kremer ◽  
Joachim Schmidt ◽  
...  
Keyword(s):  
Airway Management ◽  
Success Rate ◽  
Failure Rate ◽  
Dental Trauma ◽  
Previous Experience ◽  
Pierre Robin Sequence ◽  
Vocal Cords ◽  
Extensive Experience ◽  
Robin Sequence ◽  
Pierre Robin

Background Video laryngoscopy is an effective tool in the management of difficult pediatric airway. However, evidence to guide the choice of the most appropriate video laryngoscope (VL) for airway management in pediatric patients with Pierre Robin syndrome (PRS) is insufficient. Therefore, the aim of this study was to compare the efficacy of the Glidescope® Core™ with a hyperangulated blade, the C-MAC® with a nonangulated Miller blade (C-MAC® Miller) and a conventional Miller laryngoscope when used by anesthetists with limited and extensive experience in simulated Pierre Robin sequence. Methods Forty-three anesthetists with limited experience and forty-three anesthetists with extensive experience participated in our randomized crossover manikin trial. Each performed endotracheal intubation with the Glidescope® Core™ with a hyperangulated blade, the C-MAC® with a Miller blade and the conventional Miller laryngoscope. “Time to intubate” was the primary endpoint. Secondary endpoints were “time to vocal cords”, “time to ventilate”, overall success rate, number of intubation attempts and optimization maneuvers, Cormack-Lehane score, severity of dental trauma and subjective impressions. Results Both hyperangulated and nonangulated VLs provided superior intubation conditions. The Glidescope® Core™ enabled the best glottic view, caused the least dental trauma and significantly decreased the “time to vocal cords”. However, the failure rate of intubation was 14% with the Glidescope® Core™, 4.7% with the Miller laryngoscope and only 2.3% with the C-MAC® Miller when used by anesthetists with extensive previous experience. In addition, the “time to intubate”, the “time to ventilate” and the number of optimization maneuvers were significantly increased using the Glidescope® Core™. In the hands of anesthetists with limited previous experience, the failure rate was 11.6% with the Glidescope® Core™ and 7% with the Miller laryngoscope. Using the C-MAC® Miller, the overall success rate increased to 100%. No differences in the “time to intubate” or “time to ventilate” were observed. Conclusions The nonangulated C-MAC® Miller facilitated correct placement of the endotracheal tube and showed the highest overall success rate. Our results therefore suggest that the C-MAC® Miller could be beneficial and may contribute to increased safety in the airway management of infants with PRS when used by anesthetists with limited and extensive experience.

Sign in / Sign up

Export Citation Format

Share Document