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Advancing emergency airway management practice and research

Emergency airway management is one of the vital resuscitative procedures undertaken in the emergency department (ED). Despite its clinical and research importance in the care of critically ill and injured patients, earlier studies have documented suboptimal intubation performance and high adverse ev...

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Autores principales: Goto, Tadahiro, Goto, Yukari, Hagiwara, Yusuke, Okamoto, Hiroshi, Watase, Hiroko, Hasegawa, Kohei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6773646/
https://www.ncbi.nlm.nih.gov/pubmed/31592072
http://dx.doi.org/10.1002/ams2.428
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author Goto, Tadahiro
Goto, Yukari
Hagiwara, Yusuke
Okamoto, Hiroshi
Watase, Hiroko
Hasegawa, Kohei
author_facet Goto, Tadahiro
Goto, Yukari
Hagiwara, Yusuke
Okamoto, Hiroshi
Watase, Hiroko
Hasegawa, Kohei
author_sort Goto, Tadahiro
collection PubMed
description Emergency airway management is one of the vital resuscitative procedures undertaken in the emergency department (ED). Despite its clinical and research importance in the care of critically ill and injured patients, earlier studies have documented suboptimal intubation performance and high adverse event rates with a wide variation across the EDs. The optimal emergency airway management strategies remain to be established and their dissemination to the entire nation is a challenging task. This article reviews the current published works on emergency airway management with a focus on the use of airway management algorithms as well as the importance of first‐pass success and systematic use of rescue intubation strategies. Additionally, the review summarizes the current evidence for each of the important airway management processes, such as assessment of the difficult airway, preparation (e.g., positioning and oxygenation), intubation methods (e.g., rapid sequence intubation), medications (e.g., premedications, sedatives, and neuromuscular blockades), devices (e.g., direct and video laryngoscopy and supraglottic devises), and rescue intubation strategies (e.g., airway adjuncts and rescue intubators), as well as the airway management in distinct patient populations (i.e., trauma, cardiac arrest, and pediatric patients). Well‐designed, rigorously conducted, multicenter studies that prospectively and comprehensively characterize emergency airway management should provide clinicians with important opportunities for improving the quality and safety of airway management practice. Such data will not only advance research into the determination of optimal airway management strategies but also facilitate the development of clinical guidelines, which will, in turn, improve the outcomes of critically ill and injured patients in the ED.
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spelling pubmed-67736462019-10-07 Advancing emergency airway management practice and research Goto, Tadahiro Goto, Yukari Hagiwara, Yusuke Okamoto, Hiroshi Watase, Hiroko Hasegawa, Kohei Acute Med Surg Review Articles Emergency airway management is one of the vital resuscitative procedures undertaken in the emergency department (ED). Despite its clinical and research importance in the care of critically ill and injured patients, earlier studies have documented suboptimal intubation performance and high adverse event rates with a wide variation across the EDs. The optimal emergency airway management strategies remain to be established and their dissemination to the entire nation is a challenging task. This article reviews the current published works on emergency airway management with a focus on the use of airway management algorithms as well as the importance of first‐pass success and systematic use of rescue intubation strategies. Additionally, the review summarizes the current evidence for each of the important airway management processes, such as assessment of the difficult airway, preparation (e.g., positioning and oxygenation), intubation methods (e.g., rapid sequence intubation), medications (e.g., premedications, sedatives, and neuromuscular blockades), devices (e.g., direct and video laryngoscopy and supraglottic devises), and rescue intubation strategies (e.g., airway adjuncts and rescue intubators), as well as the airway management in distinct patient populations (i.e., trauma, cardiac arrest, and pediatric patients). Well‐designed, rigorously conducted, multicenter studies that prospectively and comprehensively characterize emergency airway management should provide clinicians with important opportunities for improving the quality and safety of airway management practice. Such data will not only advance research into the determination of optimal airway management strategies but also facilitate the development of clinical guidelines, which will, in turn, improve the outcomes of critically ill and injured patients in the ED. John Wiley and Sons Inc. 2019-05-21 /pmc/articles/PMC6773646/ /pubmed/31592072 http://dx.doi.org/10.1002/ams2.428 Text en © 2019 The Authors. Acute Medicine & Surgery published by John Wiley & Sons Australia, Ltd on behalf of Japanese Association for Acute Medicine This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Review Articles
Goto, Tadahiro
Goto, Yukari
Hagiwara, Yusuke
Okamoto, Hiroshi
Watase, Hiroko
Hasegawa, Kohei
Advancing emergency airway management practice and research
title Advancing emergency airway management practice and research
title_full Advancing emergency airway management practice and research
title_fullStr Advancing emergency airway management practice and research
title_full_unstemmed Advancing emergency airway management practice and research
title_short Advancing emergency airway management practice and research
title_sort advancing emergency airway management practice and research
topic Review Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6773646/
https://www.ncbi.nlm.nih.gov/pubmed/31592072
http://dx.doi.org/10.1002/ams2.428
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