ABSTRACT
INTRODUCTION: There has been a shift from endotracheal intubation (ETI) toward extraglottic devices (EGDs) for prehospital airway management. A concern exists that this may lead to more frequent cases of aspiration. METHODS: This was a retrospective study using a prehospital quality assurance database. Patients were assigned to groups based on the method that ultimately managed their airways (EGD or ETI). Cases with documented blood/emesis obscuring the airway were considered inevitable aspiration cases and excluded. Aspiration was defined by the radiology report within 48 hours. RESULTS: A total of 104 EGD and 152 ETI patients were identified. Aspiration data were available for 67 EGD and 94 ETI cases. Of those, 8 EGD and 3 ETI cases had blood/emesis obscuring the airway and were excluded as planned. After exclusions, there were 5 EGD and 11 ETI cases in which aspiration was later diagnosed (EGD aspiration rate = 8%, ETI aspiration rate = 12%; χ2: P = .359; relative risk = .841; 95% confidence interval, .329-2.152). CONCLUSION: In this small quality assurance database, aspiration rates were not significantly different for prehospital patients managed with an EGD versus ETI.
Subject(s)
Emergency Medical Services/methods , Intubation, Intratracheal/instrumentation , Respiratory Aspiration/etiology , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Databases, Factual , Female , Follow-Up Studies , Humans , Infant , Infant, Newborn , Intubation, Intratracheal/adverse effects , Intubation, Intratracheal/methods , Laryngeal Masks/adverse effects , Male , Middle Aged , Outcome Assessment, Health Care , Quality Assurance, Health Care , Respiratory Aspiration/epidemiology , Respiratory Aspiration/prevention & control , Retrospective Studies , Risk Factors , Young AdultABSTRACT
PURPOSE: The purpose of this study was to compare the surface topography of roots treated with a resin bonding demineralizing agent using either a "placed" or "burnished" application technique. MATERIALS AND METHODS: Fifteen roots of human teeth were sectioned in half and a treatment area prepared on the coronal portion of each proximal section. This area was root planed to expose dentin. Treatment areas were demineralized with (1) a commercially available demineralizing agent (10% citric acid with 3% ferric chloride) (Amalgambond; Parkell) or (2) 30% citric acid solution. Cotton pellets saturated in either solution were placed or burnished (vigorously rubbed) on the treatment area for 3 min. Sections were prepared for SEM analysis using liquid CO2 dehydration. RESULTS: Areas of cementum and dentin were evident on most treatment areas. Specimens of both placed groups lacked a smear layer and exhibited a cracked-eroded, flat surface of matted or ridged fibrous material. Specimens in both burnished groups also lacked a smear layer, yet in stark contrast, exhibited an abundant array of deeply tufted fibril material similar to that of a "shag carpet". Two types of tufted fibril patterns were present: a lace-like array of shorter fibrils seen on dentin, and a voluminous mass of longer fibrils seen on cementum. CONCLUSION: Root cementum and dentin, treated with either demineralizing agent using the burnishing application technique, were ultrastructurally similar in that both displayed an abundant array of deeply tufted fibril material. This differed from the flat/matted fibril material seen using the placed application technique.
