ABSTRACT
Objective To investigate the effect and application value of HC visual laryngoscope used for the emergency tracheal intubation on obese patients in the Emergency Department. Methods Totally 80 obese patients enrolled from January 2014 to December 2016 from Emergency Department, Second affiliated hospital of Xi'an Jiaotong University who needed the emergency tracheal intubation were randomly (random number) divided into two groups. Patients in group T were operated with traditional laryngoscope, and patients in group HC with HC visual laryngoscope. Then the success rate of glottis exposure, the trial times, operative time, success rate and complication rate of tracheal intubation were compared between the two groups. Results The success rate of glottis exposure in group HC was significantly higher than that in group T (95％ vs 77.5％, P<0.05). The one-time success rate of tracheal intubation and the total success rate of tracheal intubation in group HC were significantly higher than those in group T (72.5％ vs 37.5％, and 95％ vs 62.5％, respectively, P<0.05). However, the trial times of successful intubation cases and the operative time of successful intubation cases were significantly less than those in group T (1.26±0.40) vs (1.64±0.82), and (30.74±6.17) s vs (44.2±7.68) s, respectively, P<0.05. The complication rate of tracheal intubation in group HC was significantly less than that in group T (12.5％ vs 35％, P<0.05). Conclusions HC visual laryngoscope used for the obese patients in Emergency Department can not only increase the success rate of glottis exposure, decrease trial times and shorten operative time of intubation, but also improve the success rate and decrease the complication rate of emergency tracheal intubation, thus having a certain application value.
ABSTRACT
Objective To design a flexible and convenient emergency tracheal intubation box for providing rapid artificial respiration support to critical and severe patients with sudden changes and implementing effective emergency rescue measures which enhance the success rate of emergency tracheal intubation in clinical departments.Methods The box had its size determined with considerations on the disadvantages of tracheal intubation by clinical departments and the requirements for difficult tracheal intubation,and then was customized by some specific plant.The items required for intubation were classified and placed according to proper sites,which were separated with boards adapting to their sizes.The boards divided the box into 7 compartments.Results The box gained advantages in size,carrying,structure and usage,and facilitated to establish artificial airway in emergency conditions.Conclusion The box is easy to manufacture,clean,sterilize,carry and store,and is applicable for emergency tracheal intubation in clinical departments and emergency conditions.
ABSTRACT
Objective To design a flexible and convenient emergency tracheal intubation box for providing rapid artificial respiration support to critical and severe patients with sudden changes and implementing effective emergency rescue measures which enhance the success rate of emergency tracheal intubation in clinical departments.Methods The box had its size determined with considerations on the disadvantages of tracheal intubation by clinical departments and the requirements for difficult tracheal intubation,and then was customized by some specific plant.The items required for intubation were classified and placed according to proper sites,which were separated with boards adapting to their sizes.The boards divided the box into 7 compartments.Results The box gained advantages in size,carrying,structure and usage,and facilitated to establish artificial airway in emergency conditions.Conclusion The box is easy to manufacture,clean,sterilize,carry and store,and is applicable for emergency tracheal intubation in clinical departments and emergency conditions.
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Objective To investigate the usefulness of HC visual laryngoscope designed for unskilled junior emergency resident doctors in respect of increasing the efficiency and success rate of emergency tracheal intubation.Methods A total of 80 patients needed the emergency tracheal intubation were at first divided into two groups randomly (random number).Patients in group A were operated by junior emergency resident doctors and patients in group B were operated by well experienced attending doctors.Then,the two groups of patients above were divided into two groups randomly (random number).Patients in group N were operated with conventional laryngoscope and patients in group HC were managed with HC visual laryngoscope.Then comparisons of the success rate of glottis exposure,the one-time success rate of tracheal intubation,the success rate of tracheal intubation,the complications,the number of attempt in successful intubation cases and the operative time consumed for successful intubation cases among the groups were done.Results (1)The success rate of glottis exposure,the one-time success rate and the success rate of tracheal intubation in group A-HC were 90%,70% and 90%,respectively which were significantly higher than those (50%,20% and 45%)in group A-N (P 0.05 ). Conclusions HC visual laryngoscope used by unskilled junior emergency resident doctors for emergency tracheal intubation,could increase success rate of glottis exposure,decrease the number of attempt of intubation,decrease rate of complication,shorten operative time required for intubation thus improving efficiency and success rate of emergency tracheal intubation,and maybe narrow the skill gap between unskilled junior resident doctors and well experienced attending doctors in respect of emergency tracheal intubation.
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Objective To evaluate the value of TruviewTM EVO2 optical laryngoscope for emergency endotracheal intubation in the clinical application.Methods Forty-four patients in need for emergency endotracheal intubation were randomly (random number) divided into two groups:the observation group (TruviewTM EVO2 optical laryngoscope for tracheal intubation,n =22) and the control group (ordinary laryngoscope for tracheal intubation,n =22).Parameters recordered included C/L (Cormack-Lehane)grade,the time taken for successful intubation,tracheal intubation times,lowerest SpO2 during the intubation and the incidences of complications after intubation.IDS (intubation difficulty scale) scores were calculated and the total effective rates were compared.Results The data showed that there were no significant differences in the duration of the successful endotracheal intubation attempts between the two groups,respectively (24.04 ±6.56) s and (21.97 ±8.92) s,P ＞0.05.The C/L grade with the observation group was 10∶ 9∶ 3∶0 (Ⅰ ∶ Ⅱ ∶ Ⅲ∶ Ⅳ),which was significantly better than that with the control group (3∶ 7∶ 9∶ 3,P ＜0.01).The tracheal intubation times of the observation group was 17∶ 5∶0 (one time∶ two times∶ three times),which was significantly better than that of the control group (9∶ 8∶ 5,P ＜0.01).The minimum of SpO2 in the observation group (97.31 ± 1.64)％ was significantly higher than that in the control group (92.03 ± 5.39)％,(P ＜ 0.01).The incidence of complications after intubation was lower in the observation group.The IDS score in the observation group (0.68 ± 0.38) was much lower than those in the control group (2.54 ± 1.49),(P ＜ 0.01).In addition,the total effective rate of the observation group (86.36％) was significantly higer than that in the control group (45.45％),(P ＜0.01).Conclusions Using optical laryngoscope for emergency endotracheal intubation could facilitate the glottis exposure and reduce C/L grade effectively.It could lead to lower the incidence of complications and increase the success rate of tracheal intubation.
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Objective To evaluate the effectiveness and advantage of the TruviewTM EVO2(R) optical laryngoscope in comparison with the commonly used laryngoscope for the endotracheal intubation in patients in the emergency setting. Method Thirty-six patients in need for emergency endotracheal intubation in our hospital from February to May 2009 were randomly assigned to give intubation by using a TruviewTM EVO2(R) optical laryngoscope (T group) or a commonly used laryngoscope(R group). Cormack and Lehane laryngoscope grade (the degree of exposure of glottis by using laryngoscope), IDS (Intubation Difficulty Scale) score, the time taken for successful intubation, lowest SpO2 and the complication during intubation were essential factors for comparison between two groups. Results Our data showed that there was no difference in duration of the successful endotracheal intubation attempts between these two groups (respectively 22.73 ± 7.66 s and 19.91 ± 8.03 s, P ＞ 0. 05). However, the glottis exposure condition was significantly improved with TruviewTM EVO2(R) optical laryngoscope (P ＜ 0.01). The average IDS score for patients in T group was 0.33 ± 0.49, which is much lower than those in the R group (4.11± 0.90, P ＜ 0.01). In addition, the average SpO2 value measured in T group during the intubation operation was significantly higher than that in R group (98.87±0.74% and 91.45 ±4.86% respectively, P ＜0.01) and there was less complication observed in patients of T group. Conclusions Using TruviewTM EVO2(R) optical laryngoscope for emergency endotracheal intubation could help to expose the glottis in an ideal view, predominately lower the C/L grade and thus decrease the difficulty in intubation for clinicians. Its specially designed oxygen supplier allows the SpO2 to be maintained at a high level during the operation as well as reduce the incidence of complication. It is therefore extremely useful for emergency tracheal intubation, particularly a difficulty intubation situation.