Emergency Intubations for Trauma: One Center's Experience Summary and Comment by Ron M. Walls, MD, FRCPC, FAAEM Published in Journal Watch Emergency Medicine.

Slides:

Advertisements

Similar presentations

AIRWAY MANAGEMENT AFTER CERVICAL SPINE INJURY DINO A. O. ALTMANN, M.D. HOSPITAL SÃO LUIZ BRAZIL.

Advertisements

Transitions of Care: From Hospital to SNF Steven Tam, MD Assistant Clinical Professor UCI Program in Geriatrics, Internal Medicine.

Context Sensitive Airway Management Orlando Hung Departments of Anesthesia and Surgery, Dalhousie University, Halifax, Nova Scotia.

Scholarly and Professional Communication: Other Topics for the Advanced Barbara Gastel, MD, MPH Texas A&M University

Pain Management in the Emergency Department Leslie S. Zun, MD, MBA, FAAEM Chairman and Professor Department of Emergency Medicine Chicago Medical School.

CDR JOHN P WEI, USN MC MD 4th Medical Battalion, 4th MLG BSRF-12 ABDOMINAL TRAUMA.

Copyright restrictions may apply JAMA Pediatrics Journal Club Slides: Isolated Loss of Consciousness in Head Trauma Lee LK, Monroe D, Bachman MC, et al;

How to Write a Case Report 101

Improving Communication in the Emergency Department: The 5 Cs Model of Consultation Educational Soundbites CORD Academic Assembly 2011 San Diego, CA Chad.

Clinical Evaluation of the Storz CMAC Video Laryngoscope in the Known or Predicted Difficult Airway Michael Aziz, MD. Dawn Dillman, MD. Ansgar Brambrink,

Abdullah Alsakka E.M. Consultant. Questions For The Emergency Physician: 1. Can I predict the difficult airway? 2. How often can I expect to be faced.

Cumulative Sum (CUSUM) charts for medical student peripheral venous cannulation; development of a difficulty-adjusted CUSUM Dr Harry Murgatroyd SpR Anaesthesia.

Assessing the Difficult Airway in the ED

Prevalence of Clinically Important Traumatic Brain Injuries in Children With Minor Blunt Head Trauma and Isolated Severe Injury Mechanisms Nigrovic LE,

Telephone Triage for Stroke by Ambulance Services in the U.K. Summary and Comment by J. Stephen Bohan, MD, MS, FACP, FACEP Published in Journal Watch Emergency.

Techniques, Success, and Adverse Events of Emergency Department Intubations Goals/Objectives: To describe the operators, techniques, success, and adverse.

Corrielle Caldwell September 2013 Paul Lewis, MD 22-year-old patient with spontaneous acute chest pain.

Benefits of Urgent Evaluation and Treatment for TIA and Minor Stroke Summary and Comment by Kristi L. Koenig, MD, FACEP Published in Journal Watch Emergency.

Memory in Elders: Food for Thought Summary and Comment by Jonathan Silver, MD Published in Journal Watch Psychiatry March 9, 2009Journal Watch Psychiatry.

Procedures. Chapter 15 page 448 Objectives Spell and define key terms State the purpose of endotracheal intubation and describe how to assist with this.

AEDs Do Not Improve Survival from In-Hospital Arrest Summary and Comment by Daniel J. Pallin, MD, MPH Dr. Pallin is an attending physician in the Department.

Combination Therapy for Hypertension Summary and Comment by Harlan M. Krumholz, MD, SM Published in Journal Watch Cardiology December 3, 2008Journal Watch.

Workshop on Medical Writing and Publication Bangladesh Society of Medicine Dhaka, Bangladesh 10–14 December 2011.

Better Outcomes at Level I vs. Level II Trauma Centers Summary and Comment by John A. Marx, MD, FAAEM, FACEP Published in Journal Watch Emergency Medicine.

Normal ECG During Chest Pain Does Not Rule Out ACS Summary and Comment by Diane M. Birnbaumer, MD, FACEP Published in Journal Watch Emergency Medicine.

Depression and Parkinson Disease: An Old Drug Still Works (Better) Summary and Comment by Jonathan Silver, MD Published in Journal Watch Psychiatry February.

Journal Insights Into: Recommendations for Transition from Pediatric to Adult Diabetes Care Systems Supplemental Slides.

Issues in Trauma Lynne Fulton May 27, Intro No basics My backround “Demanded efficient and thoughful care by other team members” Observing a patient.

Does the Choice of Antihypertensive Agent Affect Risk for AFib? Summary and Comment by Joel M. Gore, MD Published in Journal Watch Cardiology February.

Decreasing Incidence of Cardiogenic Shock Summary and Comment by J. Stephen Bohan, MD, MS, FACP, FACEP Published in Journal Watch Emergency Medicine December.

Can you see the cords?. RSI in ED Core competency Direct laryngoscopy has long been the main stay management of the airway Advances in technology brings.

Prediction and Outcome of Impossible Mask Ventilation Diana Lee, D.O. PGY-1 Journal Club October 21, 2009.

Prehospital ECGs for Acute Coronary Syndromes Summary and Comment by Aaron E. Bair, MD, MSc, FAAEM, FACEP Published in Journal Watch Emergency Medicine.

Objective To assess the impact of the increasing use of MDCT angiography in the setting of blunt and penetrating neck trauma on the use of digital subtraction.

Providing brief addictions treatment in an emergency department: Experiences of University of New Mexico Hospital research interventionists in the SMART-ED.

CESAR SOTO PGY -2 STONY BROOK UNIVERSITY HOSPITAL Non-traumatic abdominal pain CT imaging review.

Is the conscientious explicit and judicious use of current best evidence in making decision about the care of the individual patient (Dr. David Sackett)

Validation and Refinement of a Prediction Rule to Identify Children at Low Risk for Acute Appendicitis Kharbanda AB, Dudley NC, Bajaj L, et al; Pediatric.

Adenosine for Regular Wide-Complex Tachycardia Summary and Comment by Daniel J. Pallin, MD, MPH Published in Journal Watch Emergency Medicine October 9,

Emergency Cricothyrotomy: Comparing Four Methods Summary and Comment by Aaron E. Bair, MD, MSc, FAAEM, FACEP Published in Journal Watch Emergency Medicine.

Which Beta-Blocker is Best for Patients with Heart Failure? Summary and Comment by Joel M. Gore, MD Published in Journal Watch Cardiology December 17,

Bigger Waist Means Higher Asthma Risk Summary and Comment by Wendy S. Biggs, MD Published in Journal Watch Women's Health September 24, 2009Journal Watch.

Discharge Instructions: Understanding the Misunderstandings Summary and Comment by Richard D. Zane, MD, FAAEM Published in Journal Watch Emergency Medicine.

Sharing and Learning. Our team members:  Physicians, MOAs, other staff One Chronic Pain Patient:  Male/female  Age  Occupation  Main complaint 

Short Sleep Duration as a Predictor of Cardiovascular Events Summary and Comment by Jamaluddin Moloo, MD, MPH Published in Journal Watch General Medicine.

The Burden of Angina Summary and Comment by Harlan M. Krumholz, MD, SM Published in Journal Watch Cardiology March 25, 2009Journal Watch Cardiology In.

Induced Hypothermia After VF Cardiac Arrest Improves Outcomes Summary and Comment by Kristi L. Koenig, MD, FACEP Published in Journal Watch Emergency Medicine.

Do IV Meds Matter in Out-of-Hospital Cardiac Arrest? Summary and Comment by John A. Marx, MD, FAAEM Published in Journal Watch Emergency Medicine December.

Minor head injury. What is it? Head injury GCS >12 Adults (16-65): LOC, amnesia, confusion Kids ??

A Resuscitation Protocol That Minimizes Hands- Off Time Improves Survival Summary and Comment by Aaron E. Bair, MD, MSc, FAAEM, FACEP Published in Journal.

Top 5 papers of Prehospital care Recommended by Torpong.

The 61th Ontario Medical Association Anesthesia Meeting

Cocaine-Related Chest Pain: The Year After

From: Using Process Analysis to Assess the Impact of Medical Education on the Delivery of Pain Services:A Natural Experiment Anesthes. 2012;116(4):

PeArLS (Personally Arranged Learning Session)

Indian Journal of Nuclear Medicine. ●Nuclear Medicine Journal focuses entirely on the technology crucial to nuclear medicine. In peer-reviewed articles,

Indian Journal of Nuclear Medicine. ●Nuclear Medicine Journal focuses entirely on the technology crucial to nuclear medicine. In today’s peer-reviewed.

New Clinical Approaches for Difficult Airway Situations

Breaking the Writer’s Block: The Clinical Image Write-a-Palooza

The limitations of thoracic endovascular aortic repair in altering the natural history of blunt aortic injury Jennifer L. Lang, MD, Joseph P. Minei,

Recent advances in mechanical ventilation

Volume 142, Issue 6, Pages (December 2012)

Expert Medical Opinion Program

The Human Body.

Observational study of the success rates of intubation and failed intubation airway rescue techniques in 7256 attempted intubations of trauma patients.

Summary of 2002 data. Summary of 2002 data. All patients with head injuries (HI) for the nine month control period are included. The new protocol was.

Summary of 2001 data. Summary of 2001 data. All patients with head injuries (HI) for the seven month control period are included. Royal College of Surgeons.

Expert Medical Opinion Program

Grace K. Mahoney, MS, Henry J. Henk, PhD, Rozalina G. McCoy, MD, MS

Presentation transcript:

Emergency Intubations for Trauma: One Center's Experience Summary and Comment by Ron M. Walls, MD, FRCPC, FAAEM Published in Journal Watch Emergency Medicine September 11, 2009Journal Watch Emergency Medicine Most patients were successfully intubated; few required cricothyrotomy. CopyrightCopyright © Massachusetts Medical Society. All rights reserved.Massachusetts Medical Society

Covering Stephens CT et al. The success of emergency endotracheal intubation in trauma patients: A 10-year experience at a major adult trauma referral center. Anesth Analg 2009 Sep; 109:866. CopyrightCopyright © Massachusetts Medical Society. All rights reserved.Massachusetts Medical Society

Background Researchers analyzed records of patients who were intubated within 1 hour and within 24 hours after arrival during 10 years (1996–2006) at a major trauma center in Maryland. All patients were intubated under the supervision of a dedicated trauma anesthesiologist who followed an emergency airway algorithm. CopyrightCopyright © Massachusetts Medical Society. All rights reserved.Massachusetts Medical Society

The Research Of 6088 patients who were intubated within 1 hour of arrival, 6008 (98.7%) were intubated orally, 59 (1.0%) were intubated nasotracheally, and 21 (0.3%) received surgical airways (17 cricothyrotomies and 4 tracheotomies). Data on number of intubation attempts, drugs used, methods used, and other intubation details could not be obtained with the medical record search methodology used in the study. The authors estimated that an additional 26,000 patients were intubated within 24 hours of arrival and that 10 required emergency surgical airways. Among the 31 patients who required emergency surgical airways, the mechanism of injury was most often blunt trauma, especially falls or motor vehicle collisions, followed by gunshot wounds to the chest, face, or neck, and then chemical blast. CopyrightCopyright © Massachusetts Medical Society. All rights reserved.Massachusetts Medical Society

Comment Even though no comparison groups were included in this study, the authors attribute the low rate of surgical airways to the anesthesiologists' experience and use of the algorithm. This might be true, but the reason for the low rate is impossible to determine given the paucity of data available in this report and the lack of a mechanism for capturing the number of intubation attempts or complications. Similar success was recently reported in another trauma system in which emergency physicians manage the airways (JW Emerg Med Feb ). The take-home message seems to be that with high-quality airway managers and availability of new devices — such as video laryngoscopes and rescue devices — the cricothyrotomy rate will continue to fall, making skill acquisition and retention of this surgical technique a challenge. CopyrightCopyright © Massachusetts Medical Society. All rights reserved.Massachusetts Medical Society

About Journal Watch Journal Watch helps physicians and allied heath professionals save time and stay informed by providing brief, clearly written, clinically focused perspectives on the medical developments that affect practice. Journal Watch is an independent, trustworthy source, from the publishers of the New England Journal of Medicine. These slides were derived from Journal Watch Emergency Medicine.Journal Watch Emergency Medicine The best way to stay informed with Journal Watch, is through our alerts. To sign up, visit the My Alerts page.My Alerts page CopyrightCopyright © Massachusetts Medical Society. All rights reserved.Massachusetts Medical Society