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Affichage des articles du juillet, 2011

A Reliable Method of Securing The Endotracheal Tube in Patients Undergoing Neurosurgical Procedure in the Prone Position

Background: Unplanned endotracheal tube dislodgement in the prone position can be catastrophic. Even after a perfect intubation, disconnection between the connector and the tube has been known to occur. It is on this background that we sought a reliable method of ensuring that the endotracheal tube remains in the intended position.Method: This was a prospective study done over a 4 year period. Following routine oro or nasotracheal intubation, the endotracheal tube connector was secured with an adhesive tape to the tube itself. The integrity of the connection was assessed physically and monitored throughout the course of the anaesthetic.Results: Of the 385 patients managed in this way, there was no incident of inadvertent extubation (100%).Conclusion: We conclude that securing the tube to the connector successfully prevents inadvertent extubation in the prone position. We advice that this technique be adopted in hospitals without a protocol for securing the endotracheal tu

The Airtraqtm Optical Laryngoscope: A Retrospective Audit Of Optimal Usage Characteristics In Clinical Practice

Abstract Purpose: To describe intubation success and the device manipulations needed to obtain adequate glottic views to facilitate successful first attempt tracheal tube passage with the Airtraq.Methods: Retrospective audit of anonymously collected prospective data from a departmental equipment purchasing committee sponsored device trial. Descriptive data is provided. The odds of successful passage of the tracheal tube on the first attempt without repositioning when the posterior arytenoids cleft was in the left lower quadrant of the view from the Airtraq was compared to its location in any of the other quadrants using a contingency table and presented as OR (95% CI).Results: All patients were successfully intubated with the Airtraq (median time 28 seconds). Device repositioning to attain adequate view of the glottis occurred in 30-48% of insertions depending on whether it was a back-up or rotational motion. The odds of successful intubation on fi