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Endotracheal Intubation of Difficult Airways in Emergency Settings: A Guide for Innovators

Over 400,000 Americans are intubated in emergency settings annually, with indications ranging from respiratory failure to airway obstructions to anaphylaxis. About 12.7% of emergency intubations are unsuccessful on the first attempt. Failure to intubate on the first attempt is associated with a high...

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Autores principales: Maguire, Samantha, Schmitt, Phillip R, Sternlicht, Eliza, Kofron, Celinda M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10362894/
https://www.ncbi.nlm.nih.gov/pubmed/37483393
http://dx.doi.org/10.2147/MDER.S419715
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author Maguire, Samantha
Schmitt, Phillip R
Sternlicht, Eliza
Kofron, Celinda M
author_facet Maguire, Samantha
Schmitt, Phillip R
Sternlicht, Eliza
Kofron, Celinda M
author_sort Maguire, Samantha
collection PubMed
description Over 400,000 Americans are intubated in emergency settings annually, with indications ranging from respiratory failure to airway obstructions to anaphylaxis. About 12.7% of emergency intubations are unsuccessful on the first attempt. Failure to intubate on the first attempt is associated with a higher likelihood of adverse events, including oxygen desaturation, aspiration, trauma to soft tissue, dysrhythmia, hypotension, and cardiac arrest. Difficult airways, as classified on an established clinical scale, are found in up to 30% of emergency department (ED) patients and are a significant contributor to failure to intubate. Difficult intubations have been associated with longer lengths of stay and significantly greater costs than standard intubations. There exists a wide range of airway management devices, both invasive and noninvasive, which are available in the emergency setting to accommodate difficult airways. Yet, first-pass success rates remain variable and leave room for improvement. In this article, we review the disease states most correlated with intubation, the current landscape of emergency airway management technologies, and the market potential for innovation. The aim of this review is to inspire new technologies to assist difficult airway management, given the substantial opportunity for translation due to two key-value signposts of medical innovation: the potential to decrease cost and the potential to improve clinical outcomes.
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spelling pubmed-103628942023-07-23 Endotracheal Intubation of Difficult Airways in Emergency Settings: A Guide for Innovators Maguire, Samantha Schmitt, Phillip R Sternlicht, Eliza Kofron, Celinda M Med Devices (Auckl) Review Over 400,000 Americans are intubated in emergency settings annually, with indications ranging from respiratory failure to airway obstructions to anaphylaxis. About 12.7% of emergency intubations are unsuccessful on the first attempt. Failure to intubate on the first attempt is associated with a higher likelihood of adverse events, including oxygen desaturation, aspiration, trauma to soft tissue, dysrhythmia, hypotension, and cardiac arrest. Difficult airways, as classified on an established clinical scale, are found in up to 30% of emergency department (ED) patients and are a significant contributor to failure to intubate. Difficult intubations have been associated with longer lengths of stay and significantly greater costs than standard intubations. There exists a wide range of airway management devices, both invasive and noninvasive, which are available in the emergency setting to accommodate difficult airways. Yet, first-pass success rates remain variable and leave room for improvement. In this article, we review the disease states most correlated with intubation, the current landscape of emergency airway management technologies, and the market potential for innovation. The aim of this review is to inspire new technologies to assist difficult airway management, given the substantial opportunity for translation due to two key-value signposts of medical innovation: the potential to decrease cost and the potential to improve clinical outcomes. Dove 2023-07-18 /pmc/articles/PMC10362894/ /pubmed/37483393 http://dx.doi.org/10.2147/MDER.S419715 Text en © 2023 Maguire et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Review
Maguire, Samantha
Schmitt, Phillip R
Sternlicht, Eliza
Kofron, Celinda M
Endotracheal Intubation of Difficult Airways in Emergency Settings: A Guide for Innovators
title Endotracheal Intubation of Difficult Airways in Emergency Settings: A Guide for Innovators
title_full Endotracheal Intubation of Difficult Airways in Emergency Settings: A Guide for Innovators
title_fullStr Endotracheal Intubation of Difficult Airways in Emergency Settings: A Guide for Innovators
title_full_unstemmed Endotracheal Intubation of Difficult Airways in Emergency Settings: A Guide for Innovators
title_short Endotracheal Intubation of Difficult Airways in Emergency Settings: A Guide for Innovators
title_sort endotracheal intubation of difficult airways in emergency settings: a guide for innovators
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10362894/
https://www.ncbi.nlm.nih.gov/pubmed/37483393
http://dx.doi.org/10.2147/MDER.S419715
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