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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.
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Objective To investigate the feasibility and effect of visualization teaching method using HC visual laryngoscope for the standardized training of endotracheal intubation in emergency department.Methods Forty standard-trainee doctors were divided into two groups randomly.20 standard-trainee doctors in team N were taught using the conventional teaching method of emergency medicine for the standardized training of endotracheal intubation,and the other 20 standard-trainee doctors in team HC were taught by visualization teaching method using HC visual laryngoscope.After 1 month training,comparisons of the success rate of tracheal intubation in airway management simulator,the time consumed for intubation and the number of attempt on successful intubation cases,and the satisfaction score with the teaching mode scored by standard-trainee doctors between the two groups were done.Results The one-attempt success rate and the success rate of tracheal intubation in airway management simulator by the standard-trainee doctors in group HC were significantly higher than those in group N (40％ vs.10％,85％ vs.55％),while the number of attempt and the time consumed for successful intubation were significantly less than those in group N[(1.65±0.61) vs.(2.27±0.66),(79.00±8.35) s vs.(89.36±12.03) s).The satisfaction score with this teaching mode and teaching effect of standard-trainee doctors in group HC were significantly higher than those in group N (8.10±0.74 vs.6.55±1.05,8.15±0.80 vs.6.85±0.91).Conclusions The visualization teaching method with application of HC visual laryngoscope for standardized training of endotracheal intubation in emergency department could improve the success rate and efficiency of tracheal intubation in airway management simulator for standard-trainee doctors,and this teaching method may be better than the conventional teaching method on teaching mode presenting some feasibility.
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Visual endotracheal intubation technique was applied in the endotracheal intubation teaching for standardized resident training as a routine teaching appliance.The residents were divided into two groups,the anesthetic speciality group and the non-anesthetic speciality group.According to the different teaching targets,teaching periods and basic abilities,the differentiated teaching Settings were built and the different teaching schemes,evaluation index and teachers were applied for the two groups respectively for fulfilling the advantages of visual laryngoscope.Until now,more than a hundred residents were educated with the endotracheal intubation,and the teaching efficiency and quality were significantly improved,which also reduced the incidence of the complications related to endotracheal intubation.
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Objective To compare the clinical efficacy of orotracheal intubation with video intubationscope and visual laryngoscope in obese patients. Methods 60 ASA I or II obese patients, BMI >30 kg/m2, aged 22 ~ 60 years, underwent elective surgery requiring orotracheal intubation were randomly divided into two groups: the video intubationscope group (Group V) and the visual laryngoscope group (group K), 30 cases in each. Cormark-Lehane grade (C-L classification), tracheal intubation time, total intubation attempts, success rate of tracheal intubation and complications of tracheal intubation were recorded. Results Good glottic exposure view (C-L classification) was achieved in the two groups (P > 0.05), there were no significant difference in tracheal intubation time, the total success rate and the one-time success rate of tracheal intubation between the V and K groups [(24.4 ± 11.6) s vs (22.3 ± 13.2) s, 100.0% vs 100.0%, 90.0% vs 86.7%] (P > 0.05). There was no significant difference in the complications of tracheal intubation between the two groups (P > 0.05). Conclusion Video intubationscope and visual laryngoscope are suitable for tracheal intubation in obese patients, and has an advantage of good glottis exposure view, rapid intubation, great successful rate and few complications.
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Objective To use evidence-based nursing on patients with artificial airway to the practice of stomach tube, and to evaluate the self made guidance for difficult gastric tube placement in patients with artificial airway.Methods Forty patients with artificial airway and were difficult to put the tube, and admitted to Department of Critical Care Medicine of Harrison International Peace Hospital Affiliated to Hebei Medical University from April to December in 2016 were enrolled as observation group. Through the evidence-based nursing strategy, the related literatures at home and abroad were collected to search clinical evidence and formulate and implement the nursing program, the gastric tube was inserted into the stomach tube under the direct vision of the laryngoscope. Thirty-six patients of difficult gastric tube placement with artificial airway straightly under the direct vision of the laryngoscope from August 2015 to March 2016 were retrospectively analyzed as the control group. The success rate of first catheterization, indwelling time, throat edema and bleeding of pharyngeal mucosa were compared between the two groups.Results All patients were enrolled in the final analysis. In the control group, 28 patients were successfully placed once, while 8 failed. Only 1 patient in observation group failed to catheterize, and successful placed after symptomatic treatment, the one-time success rate of catheter was significantly higher than that of control group (97.5% vs. 77.8%), and catheter time was significantly shortened (minutes: 4.8±1.2 vs. 5.1±1.0), the difference was statistically significant (bothP < 0.05). There were 2 patients with laryngeal edema in the control group and 4 patients of pharyngeal mucosal hemorrhage. In the observation group, there was no laryngealedema and laryngeal edema occurred in the patients with laryngoscopy, and only 1 patient had a hemorrhage of pharyngeal mucosa.Conclusion Using self made guiding device can effectively insert the difficult gastric tube in patients with artificial airway, and increase the one-time success rate of intubation, shorten the catheter time, and have a trend in reduce complication as compared with traditional gastric tube placement.
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Objective To assess the clinical application values of HC visual laryngoscope in emergency tracheal intubation for severe craniocerebral trauma patients with basilar fracture.Methods Retrospective analysis was used to review 60 patients of severe traumatic brain injury with basilar fracture in emergency resuscitation room who needed the hospital emergency tracheal intubation.There were 30 patients operated with visual HC laryngoscope (the observation group), and the other 30 patients underwent common direct laryngoscope (the control group).The index of the degree of exposure,intubation time,success rate of intubation were compared between the two groups.ResultsThere were 28 cases (93.33%) of Cormark-Lehane grading Ⅰ to Ⅱ in observation group,which was significantly higher than 20 cases (66.67%) in the control group(P< 0.05).The average intubation time in observation group was (34.3±6.7) seconds,and it was shorter than (44.5±5.7) seconds in the control group (P<0.05).In observation group,26 cases (86.67%) were of one-time successful intubation,which was higher than 19 cases (63.33%) in the control group,and the difference was statistically significant(P<0.05).ConclusionHC visual laryngoscope in emergency tracheal intubation for severe craniocerebral trauma patients with basilar fracture can improve the success rate of intubation,shorten the intubation time,reduce adverse reactions,and it is worthy of clinical application.
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Objective To investigate the clinical application effects of tracheal intubation under general anesthesia guiding by HC visual laryngoscope in combination with fiberoptic bronchoscopy via clinical studies.Methods A total of 348 patients underwent the tracheal intubation under general anesthesia in the hospital between January 2013 and January 2015 were randomly selected and Divided into three groups according to different ways of guiding tracheal intubation.The first group was a simple fiber light guide bronchoscopy to guide the general anesthesia tracheal intubation was set to F group,In the second group,the general anesthesia tracheal intubation was set to H group for the simple HC video.The third group was HC video mirror combined with fiber light guide bronchoscopy to guide the general anesthesia tracheal intubation was set to H+F group.The general condition and intubation conditions such as the time and frequencies of intubation in three groups were recorded respectively.Results The general condition,age,BMI index,thyromental distance,interincisor distance value were similar among three groups.The time needed for intubation was the longest in group F up to (41 ± 11) s.The highest frequency of intubation was in group H with 30 times,and the time of glottis exposure was the longest in group F as (21 ± 9) s.The difference among groups and intra-groups has statistical significance (P＜0.05).Conclusion HC visual laryngoscope in combination with fiberoptic bronchoscopy guiding tracheal intubation under general anesthesia has a good effect in clinical practice,and is worthy of clinical promotion.
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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.