• Title/Summary/Keyword: Endotracheal Intubation

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The Effect of Stellate Ganglion Block on Endotracheal Intubation (성상 신경절 차단이 기관내 삽관에 따른 심혈관계 반응에 미치는 영향)

  • Rah, Eun-Gil;Yoon, Jung-Su;Oh, Hyun-Ju;Koo, Gill-Hoi
    • The Korean Journal of Pain
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    • v.7 no.2
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    • pp.175-180
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    • 1994
  • The impact of cardiovascular changes occurred by endotracheal intubation is risky for patients with ischemic heart disease, or intracranial pathologic conditions typically impairing cerebral autoregulatory mechanisms. Therefore, multiple approaches have been utilized to limit the impact of intubation and reduce damage of central nervous and cardiovascular systems. These approaches include modifications in intubation technique to diminish circulatory stimuli and pharmacologic modifications of either the sensory afferent path or the circulatory response itself. We tried the stellate ganglion block, a kind of sympathetic block, for the same purpose and evaluated the results. The results of study are as follows, 1) Blood pressure and heart rate increased significantly after intubation as compared with preintubation in both control group and SGB group. 2) The difference of the two groups is not found. We conclude the above method does not control cardiovascular consequences of endotracheal intubation.

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Effectiveness of education regarding cuff pressure after endotracheal intubation (기관내 튜브삽관 후 커프 압력에 대한 교육 효과)

  • Uhm, Dong-Choon;Koh, Bong-Yeun
    • The Korean Journal of Emergency Medical Services
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    • v.21 no.2
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    • pp.7-15
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    • 2017
  • Purpose: This study investigated the effectiveness of education regarding cuff pressure following endotracheal tube intubation using a quasi-experimental design with a pre- and posttest non-equivalent control group. Methods: A total of 78 students from two universities participated in an education intervention on the importance of cuff pressure after endotracheal tube intubation between October and December, 2016. The intervention lasted 40 minutes. Data were collected from each student before the intervention and one week following the intervention. Analyses were conducted using chi-square tests, Fisher's exact tests, and analysis of covariance. Results: A total of 38 students were assigned to the experimental group and 40 to the control group. The educational intervention of cuff pressure following endotracheal tube intubation was associated with prevention of possible complications from excessive cuff pressure (F=121.02, p<.001). Conclusion: Training with a pressure gauge and an intubation manikin is necessary to determine the appropriate cuff pressure in the intubation protocol of the practical examination in the emergency medical technology.

The necessity for education on endotracheal intubation through video laryngoscope - A focused on paramedic students - (비디오 후두경을 통한 기관내 삽관 교육의 필요성 - 응급구조과 학생을 중심으로 -)

  • Ham, Young-Lim;Kim, Jin-Hwa;Lee, Jae-Gook
    • The Korean Journal of Emergency Medical Services
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    • v.23 no.1
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    • pp.7-17
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    • 2019
  • Purpose: The aim of this study was to verify the necessity of endotracheal intubation through video laryngoscope and to provide basic data to inform the provision of video laryngoscope education. Methods: Eighty paramedic students participated in this study. A survey was conducted from November 5, 2018 to December 7, 2018. Data were analyzed with independent t-tests, and the chi-squared test. Results: The video laryngoscope is a highly usable instrument that can easily be applied during training. The instrument provides better visual evaluation of the normal airway (p=.004), the airway in case of cervical collar and head fixation (p=.000), and the airway in case of tongue edema (p=.000). The time of endotracheal intubation in the normal airway was significantly less with the video laryngoscope compared with the direct laryngoscope. The success rate of tracheal intubation was significantly higher in the video laryngoscope group than in the direct laryngoscope. Conclusion: This study suggests the necessity of education on endotracheal intubation through video laryngoscope in the professional airway maintenance training course of emergency department students. The video laryngoscope is easier to apply than the direct laryngoscope in cases of intubation in various clinical situations.

Endotracheal Intubation of Paramedics in a Moving Ambulance (이동 중 구급차에서 1급 응급구조사의 기관내 삽관)

  • Shim, Gyu-Sik
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.11
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    • pp.5292-5298
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    • 2012
  • The purpose of this study is to perform the effectively advanced airway management in an emergency patient with cardiac arrest and trauma by comparing the appearance of influence in a change of visual-field height upon endotracheal intubation according to a change in position with intubation of paramedics in a moving ambulance and by analyzing the appearance of the influence in a patient's change in position with intubation upon speed in endotracheal intubation. Research subjects were randomly extracted 60(30 people for control group, 30 people for experimental group) people as the paramedics who are working at 13 fire stations in C Province. Data analysis was carried out ${\chi}^2$-test, independent t-test, paired t-test by using SPSS WIN 14.0 Version. As a result of research, to improve speed of the advanced airway management, it is considered to be likely effective in a patient's sniffing position and in the endotracheal intubation in the upper space of the main stretcher. The self-confidence in intubation after experiment increased significantly. Thus, the continuous education(training) on the intubation position and method within ambulance is considered to be likely needed for improving efficiency of the advanced airway management.

Comparison of Endotracheal Intubation in Difficult Postures by Using the SALT(Supraglottic Airway Laryngopharyneal Tube)

  • Yun, Seong-Woo
    • Journal of the Korea Society of Computer and Information
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    • v.25 no.12
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    • pp.227-233
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    • 2020
  • The purpose of this study is to compare the speed, confidence, and ease of endotracheal intubation in a difficult posture by using the SALT(Supraglottic Airway Laryngopharyngeal Tube), and a direct laryngoscope to improve the ability to implement professional airway management. The subject of the study was an experimental study by a randomized crossover design, targeting 30 first-class emergency medical technicians working in J-do fire station, and the SPSS 20.0 version was used for data analysis. The endotracheal intubation by using SALT showed a significant difference in speed compared to endotracheal intubation by using a direct laryngoscope(p<.001), and also showed a significant difference in confidence and ease(p<.001). If it is difficult to endotracheal intubation by direct laryngoscope, or in the case of trauma patients, if SALT is used, safe and rapid intubation will be possible. In addition, to improve the efficiency of professional airway management, it is believed that the introduction of SALT in domestic sites is necessary.

Comparison of Endotracheal Intubation to Transfer - A Study of Simulation Using the SALT - (이송 중 기관내 삽관의 효율성 비교 - SALT를 이용한 시뮬레이션 연구 -)

  • Yun, Seong-Woo;Jung, Jun-Ho;Lee, Hyo-Ju;Choi, Mi-Young
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2022.10a
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    • pp.300-302
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    • 2022
  • The purpose of this study is to compare the speed, confidence, and ease of endotracheal intubation in a transfer posture by using the SALT(Supraglottic Airway Laryngopharyngeal Tube), and a direct laryngoscope to improve the ability to implement professional airway management. The subject of the study was an experimental study by a randomized crossover design, targeting 28 first-class emergency medical technicians working in J-do fire station, and the SPSS 20.0 version was used for data analysis. The endotracheal intubation by using SALT showed a significant difference in speed compared to endotracheal intubation by using a direct laryngoscope(p<.001), and also showed a significant difference in confidence and ease(p<.001). If it is transfer to endotracheal intubation by direct laryngoscope, or in the case of transfer patients, if SALT is used, safe and rapid intubation will be possible.

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Use of laryngeal mask after repeated endotracheal intubation failure in a patient with tracheobronchopathia osteochondroplastica: case report

  • Kim, Sang Gyun;Kim, Hyun;Son, Jong Chul;Lee, Ji-Hyang;An, Jihyun;Kim, Eunju
    • Kosin Medical Journal
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    • v.33 no.2
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    • pp.252-256
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    • 2018
  • We report a case of difficult endotracheal intubation in a patient with tracheobronchopathia osteochondroplastica. A 65-year-old man was scheduled to undergo ulnar nerve decompression and ganglion excisional biopsy under general anesthesia. During induction of general anesthesia, an endotracheal tube could not be advanced through the vocal cords due to resistance. A large number of nodules were identified below the vocal cords using a $Glidescope^{(R)}$ video-laryngoscopy, and fiberoptic bronchoscopy revealed irregular nodules on the surface of the entire trachea and the main bronchus below the vocal cords. Use of a small endotracheal tube was attempted and failed. a laryngeal mask airway (LMA $Supreme^{TM}$) rather than further intubation was successfully used to maintain the airway.

Orotracheal intubation in a patient with difficult airway by using fiberoptic nasotracheal intubation: A case report

  • Yun, Hye Joo;So, Eunsun;Karm, Myong-Hwan;Kim, Hyun Jeong;Seo, Kwang-Suk
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.18 no.2
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    • pp.125-128
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    • 2018
  • In cases of a difficult intubation where numerous intubation methods, including laryngoscopy, have failed, yet oral intubation is still necessary, the method of tube exchange after fiberoptic nasal intubation may be attempted. Fiberoptic nasal intubation allows intubation to be performed relatively easily when the laryngeal view grade is poor. We report a case in which our attempt at oral intubation for total maxillectomy with laryngoscopy and fiberoptic oral intubation had failed due to an unexpected difficult airway; subsequently, we successfully completed the surgery by performing fiberoptic nasal intubation to secure the airway, followed by using a tube exchanger to exchange to an oral endotracheal tube.

Comparison of tracheal intubation using the Miller blade versus Macintosh blade in difficult airway: A manikin study among novice intern doctors (기도확보가 어려운 상황에서 Miller blade와 Macintosh blade를 이용한 기관내삽관의 비교 : 숙련되지 않은 인턴을 대상으로 한 마네킨 연구)

  • Lee, Mi-Lim;Kim, Chul-Tae;Lee, Hyo-Cheol
    • The Korean Journal of Emergency Medical Services
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    • v.22 no.3
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    • pp.35-45
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    • 2018
  • Purpose: The purpose of this study was to compare laryngoscopic views and ease of use and success of intubation, via the percentage of glottic opening (POGO) scale when using the Miller blade and Macintosh blade in paraglossal approach. Methods: Forty intern doctors were randomized for laryngoscopy to be performed in a crossover manner. They performed endotracheal intubation with Miller blade and Macintosh blade in two airway scenarios: normal airway and difficult airway with edema. We observed the rate of successful intubation, time required for visualizing the glottis, time to complete endotracheal intubation, ease of intubation, and the POGO scale. Results: In the normal airway, there was no difference in intubation between the two endoscopes. In the difficult airway, the time for visualizing the glottis (7.80 versus 10.24 sec; p=.006), the time to tube passage (19.38 versus 23.03 sec; p=.038) and the time to complete endotracheal intubation (21.84 versus 28.54 sec; p=.022) with Miller blade was shorter than with Macintosh blade. The POGO scale(%) of the Miller blade was higher than that of the Macintosh blade's (62.25 versus 56.32; p=.030). Conclusion: Compared to the Macintosh blade, Miller blade provided better visualization of the glottis and POGO scale, and faster time to completion of endotracheal intubation.

DEVELOPMENTAL DISTURBANCE OF PRIMARY INCISORS IN PRETERM INFANTS WITH ENDOTRACHEAL INTUBATION : A CASE REPORT (기관 삽관을 시행한 조산아에서 발생한 상악 유전치의 발육이상 : 증례보고)

  • Lim, So Young;Kim, Seong Oh;Lee, Jae-Ho;Kim, Ik Hwan
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.15 no.1
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    • pp.89-93
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    • 2019
  • Preterm infants have higher possibility of undergoing endotracheal intubation after birth than normal children due to medical conditions. Developmental disturbances of primary incisors following intubation can occur as crown malformation, enamel defects, delayed eruption, displacement of dental follicle in crypt, groove formation of palate or alveolar ridge, acquired cleft palate, and dental arch distortion. This clinical report presents the effect of intubation on primary dentition of preterm infants. A 2-year-old girl with cerebral palsy and premature birth history visited our clinic with chief complaint of unerupted primary upper incisor. A 1-year-old boy with cerebral palsy, status epilepticus and premature birth history visited our clinic due to crown malformation. Developmental disturbances of primary incisors in these cases were not related to the patients' systemic disease, and there were no history of dental trauma. A long term endotracheal intubation prior to tooth eruption might have caused local trauma on alveolar ridge. It is very important to monitor dental problems of preterm infants who had experienced endotracheal intubation during neonatal period. Due to influences on both primary and permanent teeth, periodic re-evaluation of affected areas and establishment of comprehensive treatment plans are necessary.