scholarly journals Endotracheal Tube Extubation Force: Adhesive Tape Versus Endotracheal Tube Holder

2011 ◽  
Vol 56 (11) ◽  
pp. 1825-1829 ◽  
Author(s):  
T. Shimizu ◽  
T. Mizutani ◽  
S. Yamashita ◽  
K. Hagiya ◽  
M. Tanaka
2020 ◽  
pp. bmjmilitary-2020-001402 ◽  
Author(s):  
Danny Epstein ◽  
R Strashewsky ◽  
A Furer ◽  
A M Tsur ◽  
J Chen ◽  
...  

IntroductionEndotracheal intubation is required in many emergency, trauma and prehospital scenarios. Endotracheal tube (ETT) fixation must be stable and quick to apply to enable rapid evacuation and patient transport. This study compares performance times of three common ETT securement techniques which are practical for out-of-hospital and combat scenarios.MethodsWe compared the time required by military medics to complete ETT fixation in three techniques—fixation of a wide gauze roll wrapped twice around the head and tied twice around the ETT (GR), using a Thomas Tube Holder (TH) and using a pre-tied non-adhesive tape (PT). 300 military medics were randomised to apply one technique each on a manikin, and time to completion was recorded.Results300 ETTs were successfully fixated by 300 military medics. Median times to complete ETT fixation by PT and TH techniques were 24 s (IQR (19 to 31) and (IQR 20 to 33), respectively). Both were significantly shorter to apply than the GR technique, with a median time of 57 s (IQR 47 to 81), p<0.001.ConclusionsIn time critical situations such as combat, severe trauma, mass casualties and whenever rapid evacuation might improve the clinical outcome, using a faster fixation technique such as Thomas Tube Holder or a pre-tied non-adhesive tape might enable faster evacuation than the use of traditional endotracheal tube fixation techniques.


2003 ◽  
Vol 9 (1-2) ◽  
pp. 108-112
Author(s):  
H. Kamalipour ◽  
K. Kardan

A problem faced by anaesthetists in Islamic countries is the unwillingness of patients to shave their facial hair. Adhesive tapes may not adequately secure an endotracheal tube in these patients, and a cotton b and around the neck may cause obstruction of the venous return. A new device, a synthetic leather mask, was compared with the two other methods in a r and omized trial on 900 patients undergoing general anaesthesia. No displacement of the endotracheal tube, pressure on the neck veins, or skin reaction were observed in the mask group compared with the adhesive tape and the cotton b and groups. The mask can be reused, autoclaved and made in several sizes, prevents allergies to adhesive tape and is suitable for laryngoscopy, suctioning and inserting the oral airway


Resuscitation ◽  
2009 ◽  
Vol 80 (11) ◽  
pp. 1296-1300 ◽  
Author(s):  
R. Owen ◽  
N. Castle ◽  
H. Hann ◽  
D. Reeves ◽  
R. Naidoo ◽  
...  

1994 ◽  
Vol 103 (9) ◽  
pp. 669-675 ◽  
Author(s):  
Steven M. Zeitels ◽  
Charles W. Vaughan

External laryngeal counterpressure and internal laryngeal distention produce forces that are helpful for enhancing laryngoscopic exposure of the anterior glottis. These principles were formally described in the early 20th century, but are seldom used today. Hand pressure has been the typical source for external counterpressure. Since this maneuver is unstable if provided by an assistant and wasteful if provided by the surgeon, it is often neglected. Current phonomicrosurgical techniques require wider glottal exposure; therefore, a reexamination of the value of external counterpressure and internal distention is worthwhile. During the last 2 years, 125 microlaryngoscopic procedures were performed for a variety of benign, premalignant, and malignant lesions. All patients were placed in the Boyce-Jackson position and sustained with a modified Killian gallows, with resulting elevated-vector suspension. Internal distention was achieved by placing the largest-lumen glottiscope possible between the endotracheal tube and the infrapetiole region. Exposure was also improved by using silk adhesive tape to apply external counterpressure to the lower laryngeal framework. The use of both external counterpressure and internal distention as an adjunct to microlaryngoscopy was most helpful for the surgical management of lesions located near the anterior commissure. Seemingly, the two resultant forces are in opposition to each other, but in fact they are complementary, both to each other and to the orthodox laryngoscopic principle of elevated-vector suspension.


Author(s):  
László G. Kömüves

Light microscopic immunohistochemistry based on the principle of capillary action staining is a widely used method to localize antigens. Capillary action immunostaining, however, has not been tested or applied to detect antigens at the ultrastructural level. The aim of this work was to establish a capillary action staining method for localization of intracellular antigens, using colloidal gold probes.Post-embedding capillary action immunocytochemistry was used to detect maternal IgG in the small intestine of newborn suckling piglets. Pieces of the jejunum of newborn piglets suckled for 12 h were fixed and embedded into LR White resin. Sections on nickel grids were secured on a capillary action glass slide (100 μm wide capillary gap, Bio-Tek Solutions, Santa Barbara CA, distributed by CMS, Houston, TX) by double sided adhesive tape. Immunolabeling was performed by applying reagents over the grids using capillary action and removing reagents by blotting on filter paper. Reagents for capillary action staining were from Biomeda (Foster City, CA). The following steps were performed: 1) wet the surface of the sections with automation buffer twice, 5 min each; 2) block non-specific binding sites with tissue conditioner, 10 min; 3) apply first antibody (affinity-purified rabbit anti-porcine IgG, Sigma Chem. Co., St. Louis, MO), diluted in probe diluent, 1 hour; 4) wash with automation buffer three times, 5 min each; 5) apply gold probe (goat anti-rabbit IgG conjugated to 10 nm colloidal gold, Zymed Laboratories, South San Francisco, CA) diluted in probe diluent, 30 min; 6) wash with automation buffer three times, 5 min each; 7) post-fix with 5% glutaraldehyde in PBS for 10 min; 8) wash with PBS twice, 5 min each; 9) contrast with 1% OSO4 in PBS for 15 min; 10) wash with PBS followed by distilled water for5 min each; 11) stain with 2% uranyl acetate for 10 min; 12) stain with lead citrate for 2 min; 13) wash with distilled water three times, 1 min each. The glass slides were separated, and the grids were air-dried, then removed from the adhesive tape. The following controls were used to ensure the specificity of labeling: i) omission of the first antibody; ii) normal rabbit IgG in lieu of first antibody; iii) rabbit anti-porcine IgG absorbed with porcine IgG.


2010 ◽  
Vol 222 (S 01) ◽  
Author(s):  
RA Mahmoud ◽  
H Proquitte ◽  
N Fawzy ◽  
SE Hadhood ◽  
C Bührer ◽  
...  
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