Document Detail


Fiberoptic intubation in the emergency department.
MedLine Citation:
PMID:  2321818     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Fiberoptic-aided endotracheal intubation has been shown to be effective in difficult intubation secondary to anatomic abnormalities and traumatic conditions. A retrospective review of emergency airway management in an emergency department during a 30-month period found 35 patients who underwent fiberoptic-aided endotracheal intubation; 31 were treated for medical conditions, and four were trauma patients. Indications in the medical group included failed nasotracheal intubation (ten), anatomic abnormalities (six), and the initial airway maneuver attempted (15). Indications in the trauma group with suspected cervical-spine injury included failed nasotracheal intubation (one) and initial airway maneuver attempted (three). In the medical subgroup, 25 of 31 patients were intubated successfully fiberoptically. All four trauma patients were intubated successfully, and all attempts were done nasally. The limitations of the technique were varied. Twenty of the 25 successful intubations had times recorded for completion (mean time, 1.8 +/- 1.4 minutes [SD]). Four of the six failed attempts had recorded times of 7.8 +/- 1.4 minutes. The mean time of the four trauma cases was 3 +/- 2.2 minutes. The presence of secretions, blood, or vomitus was the cause in five of the six failed intubations. The sixth patient kept swallowing the distal end of the scope. Fiscal restraints may also limit its use. At our institution, the financial commitment has been approximately +17,000 during the past nine years. Repair or replacement of broken equipment appears to be necessary every two or three years. Immediate airway control is often difficult with fiberoptic-aided endotracheal intubation and should be used only in selected patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
E J Mlinek; J E Clinton; D Plummer; E Ruiz
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of emergency medicine     Volume:  19     ISSN:  0196-0644     ISO Abbreviation:  Ann Emerg Med     Publication Date:  1990 Apr 
Date Detail:
Created Date:  1990-05-03     Completed Date:  1990-05-03     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8002646     Medline TA:  Ann Emerg Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  359-62     Citation Subset:  AIM; IM    
Affiliation:
Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, Minnesota.
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MeSH Terms
Descriptor/Qualifier:
Costs and Cost Analysis / economics
Emergencies
Emergency Service, Hospital* / economics
Fiber Optic Technology / economics,  instrumentation
Humans
Intubation, Intratracheal / economics,  instrumentation,  utilization*
Minnesota
Resuscitation
Retrospective Studies
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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