[ { "key": "D4XQ8ZTD", "version": 137, "library": { "type": "group", "id": 504469, "name": "ALS 301 Cushing's Disease", "links": { "alternate": { "href": "https://www.zotero.org/groups/als_301_cushings_disease", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/504469/items/D4XQ8ZTD", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/als_301_cushings_disease/items/D4XQ8ZTD", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/504469/items/QBWSXEVK", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2623202, "username": "crishanacek", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/crishanacek", "type": "text/html" } } } }, "data": { "key": "D4XQ8ZTD", "version": 137, "parentItem": "QBWSXEVK", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2016-11-05T19:08:39Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/25979560", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2016-11-05T19:08:39Z", "dateModified": "2016-11-05T19:08:39Z" } }, { "key": "QBWSXEVK", "version": 137, "library": { "type": "group", "id": 504469, "name": "ALS 301 Cushing's Disease", "links": { "alternate": { "href": "https://www.zotero.org/groups/als_301_cushings_disease", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/504469/items/QBWSXEVK", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/als_301_cushings_disease/items/QBWSXEVK", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2623202, "username": "crishanacek", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/crishanacek", "type": "text/html" } } }, "creatorSummary": "Aekka et al.", "parsedDate": "2015-08", "numChildren": 1 }, "data": { "key": "QBWSXEVK", "version": 137, "itemType": "journalArticle", "title": "Prehospital trauma care education for first responders in India", "creators": [ { "creatorType": "author", "firstName": "Apoorva", "lastName": "Aekka" }, { "creatorType": "author", "firstName": "Rohit", "lastName": "Abraham" }, { "creatorType": "author", "firstName": "Michael", "lastName": "Hollis" }, { "creatorType": "author", "firstName": "Elizabeth", "lastName": "Boudiab" }, { "creatorType": "author", "firstName": "Gieric", "lastName": "Laput" }, { "creatorType": "author", "firstName": "Harshadha", "lastName": "Purohit" }, { "creatorType": "author", "firstName": "Richa", "lastName": "Kumar" }, { "creatorType": "author", "firstName": "Arpita", "lastName": "Vyas" }, { "creatorType": "author", "firstName": "Marc", "lastName": "Basson" }, { "creatorType": "author", "firstName": "Dinesh", "lastName": "Vyas" } ], "abstractNote": "BACKGROUND: A major factor contributing to global trauma mortality and morbidity is the lack of effective prehospital trauma services in developing settings. We developed a 2-d training course for nondoctor first responders featuring high-fidelity simulation and video-assisted debriefing, self-directed learning videos, and native language instruction.\nMATERIALS AND METHODS: A pilot session was conducted in Jodhpur, Rajasthan. Eighteen local instructors were recruited to train 48 layperson first responders in 10 essential subjects. Didactic sessions of 15-20 min consisting of self-directed learning videos were followed by 30-40 min skill sessions featuring high-fidelity simulation, and concluded with 15-20 min video-debriefing periods. Changes in competence were evaluated using pretraining and posttraining surveys.\nRESULTS: Results demonstrated that statistically significant competence increases in all areas of trauma management assessed: airway (t[46] = 7.30, P < 0.000), hemorrhage (t[46] = 9.96, P < 0.000), fractures (t[46] = 9.22, P < 0.000), cervical spine injury (t[46] = 12.12, P = 0.000), chest injury (t[46] = 7.84, P < 0.000), IV line placement (t[46] = 4.36, P < 0.000), extrication (t[46] = 2.81, P < 0.005), scene assessment (t[46] = 7.06, P < 0.000), triage (t[46] = 5.92, P < 0.000), and communication (t[46] = 5.56, P < 0.000). Highest increases in competence were observed in cervical spine injury and hemorrhage management, with lowest increases in IV line placement and extrication.\nCONCLUSIONS: Results suggest this approach may be effective in imparting prehospital trauma management concepts to layperson first responders. This study highlights an innovative educational avenue through which trauma management capacity can be enhanced in developing settings.", "publicationTitle": "The Journal of Surgical Research", "publisher": "", "place": "", "date": "Aug 2015", "volume": "197", "issue": "2", "section": "", "partNumber": "", "partTitle": "", "pages": "331-338", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "J. Surg. Res.", "DOI": "10.1016/j.jss.2015.03.047", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1095-8673", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "ENG", "libraryCatalog": "PubMed", "callNumber": "", "rights": "", "extra": "PMID: 25979560", "tags": [ { "tag": "Clinical Competence", "type": 1 }, { "tag": "Computer Simulation", "type": 1 }, { "tag": "Developing Countries", "type": 1 }, { "tag": "Education, Continuing", "type": 1 }, { "tag": "Emergency Medical Services", "type": 1 }, { "tag": "Emergency Responders", "type": 1 }, { "tag": "First responders", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "India", "type": 1 }, { "tag": "Manikins", "type": 1 }, { "tag": "Models, Educational", "type": 1 }, { "tag": "Program Evaluation", "type": 1 }, { "tag": "Trauma education", "type": 1 }, { "tag": "Video Recording", "type": 1 }, { "tag": "Wounds and Injuries", "type": 1 }, { "tag": "simulation", "type": 1 } ], "collections": [ "4UVVJVE4" ], "relations": {}, "dateAdded": "2016-11-05T19:08:39Z", "dateModified": "2016-11-05T19:08:39Z" } }, { "key": "39ECTFFB", "version": 136, "library": { "type": "group", "id": 504469, "name": "ALS 301 Cushing's Disease", "links": { "alternate": { "href": "https://www.zotero.org/groups/als_301_cushings_disease", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/504469/items/39ECTFFB", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/als_301_cushings_disease/items/39ECTFFB", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2623202, "username": "crishanacek", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/crishanacek", "type": "text/html" } } }, "creatorSummary": "Byars et al.", "parsedDate": "2013-12", "numChildren": 1 }, "data": { "key": "39ECTFFB", "version": 136, "itemType": "journalArticle", "title": "Evaluation of paramedic utilization of the intubating laryngeal mask airway in high-fidelity simulated critical care scenarios", "creators": [ { "creatorType": "author", "firstName": "Donald", "lastName": "Byars" }, { "creatorType": "author", "firstName": "Bruce", "lastName": "Lo" }, { "creatorType": "author", "firstName": "Jeff", "lastName": "Yates" } ], "abstractNote": "INTRODUCTION: Successful oxygenation and ventilation can mean the difference between life and death in the prehospital setting. While airway challenges can be numerous within the confines of the emergency department, there are many additional confounding difficulties in the prehospital setting, which include limited access to equipment, poor lighting, extreme environments, limited personnel to assist, no immediate backup, and limited rescue airway options. The concept of an easy, reliable, and rapidly deployable alternative rescue airway device is critical, especially when considering the addition of rapid sequence intubation protocols in the prehospital setting. Hypothesis The primary objective of this study was to ascertain whether paramedics can be trained to deploy this alternative airway device with an acceptable success rate in a simulated critical care airway scenario. The secondary objective was to determine whether the previously-trained paramedics were able to retain their ability to deploy the device successfully at one year.\nMETHODS: This was a prospective, observational, single-group, descriptive cohort, educational trial. Forty paramedics were trained in the use of the Intubating Laryngeal Mask Airway (I-LMA) in a simulation medicine curriculum culminating in a simulated critical care difficult airway scenario requiring urgent oxygenation and ventilation after failed traditional endotracheal intubation. An emergency medicine physician proctor determined successful airway management. Repeat testing was then performed at approximately one year out, challenging the medics to intubate a mannequin using the I-LMA during an unrelated training session.\nRESULTS: Of the 40 paramedics who underwent complete simulation training, 39 were able to intubate and ventilate the simulated difficult airway using the I-LMA during the critical care scenario. This yields a success rate of 97.5% (95% CI, 87.1%-99.4%). At approximately one year out, 35 out of 35 medics were able to intubate the mannequin using the I-LMA, resulting in a success rate of 100% (95% CI, 91.4%-100%).\nCONCLUSIONS: In this study, paramedics were able to deploy the I-LMA with a high degree of success in a simulated difficult airway, with a high degree of skill retention at one year out.", "publicationTitle": "Prehospital and Disaster Medicine", "publisher": "", "place": "", "date": "Dec 2013", "volume": "28", "issue": "6", "section": "", "partNumber": "", "partTitle": "", "pages": "630-631", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Prehosp Disaster Med", "DOI": "10.1017/S1049023X13008856", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1049-023X", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "eng", "libraryCatalog": "PubMed", "callNumber": "", "rights": "", "extra": "PMID: 24001719", "tags": [ { "tag": "Critical Care", "type": 1 }, { "tag": "Emergency Medical Technicians", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Laryngeal Masks", "type": 1 }, { "tag": "Prospective Studies", "type": 1 } ], "collections": [ "4UVVJVE4" ], "relations": {}, "dateAdded": "2016-09-02T19:34:02Z", "dateModified": "2016-09-02T19:34:02Z" } }, { "key": "4E9ZI3HC", "version": 136, "library": { "type": "group", "id": 504469, "name": "ALS 301 Cushing's Disease", "links": { "alternate": { "href": "https://www.zotero.org/groups/als_301_cushings_disease", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/504469/items/4E9ZI3HC", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/als_301_cushings_disease/items/4E9ZI3HC", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/504469/items/39ECTFFB", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2623202, "username": "crishanacek", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/crishanacek", "type": "text/html" } } } }, "data": { "key": "4E9ZI3HC", "version": 136, "parentItem": "39ECTFFB", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2016-09-02T19:34:02Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/24001719", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2016-09-02T19:34:02Z", "dateModified": "2016-09-02T19:34:02Z" } }, { "key": "JWBTVZ9S", "version": 135, "library": { "type": "group", "id": 504469, "name": "ALS 301 Cushing's Disease", "links": { "alternate": { "href": "https://www.zotero.org/groups/als_301_cushings_disease", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/504469/items/JWBTVZ9S", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/als_301_cushings_disease/items/JWBTVZ9S", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2623202, "username": "crishanacek", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/crishanacek", "type": "text/html" } } }, "creatorSummary": "Tritsch et al.", "parsedDate": "2014-03", "numChildren": 1 }, "data": { "key": "JWBTVZ9S", "version": 135, "itemType": "journalArticle", "title": "Intubating laryngeal mask airway placement by non-physician healthcare providers in management out-of-hospital cardiac arrests: a case series", "creators": [ { "creatorType": "author", "firstName": "Laurent", "lastName": "Tritsch" }, { "creatorType": "author", "firstName": "Sylvain", "lastName": "Boet" }, { "creatorType": "author", "firstName": "Julien", "lastName": "Pottecher" }, { "creatorType": "author", "firstName": "Girish P.", "lastName": "Joshi" }, { "creatorType": "author", "firstName": "Pierre", "lastName": "Diemunsch" } ], "abstractNote": "AIM OF THE STUDY: The role of supralaryngeal devices in airway management in out-of-hospital cardiac arrests (OHCA) remains controversial. The aim of this prospective observational trial was to evaluate the feasibility and effectiveness of intubating laryngeal mask airway (ILMA) when used by trained prehospital emergency nurses in the setting of OHCA.\nMETHODS: After approval from the Research Ethics Board, prehospital emergency nurses trained in placement of ILMA (Fastrach™, LMA Vitaid, Toronto, Ontario, Canada) followed a formal protocol for airway control during OHCA. The primary outcome was the success rate of ILMA placement, while secondary outcomes were success rate of tracheal intubation through the ILMA, and the incidence of regurgitation of gastric contents.\nRESULTS: During the study period, 302 ILMA placements were attempted by emergency nurses during OHCA resuscitation. After ILMA placement, but before attempt for intubation, ventilation was possible in 290 patients (96%). Obstruction or major leaks were observed in 12 patients (4%). Tracheal tube insertion through the ILMA was attempted in 265 patients, and was performed in 254 (95.8%). This allowed for proper lung ventilation through the tracheal tube in 242 cases whereas 12 tubes were esophageal or proved obstructed. Regurgitation of gastric contents occurred in 43 (14.2%) patients; in 23 cases before arrival of the first aid team, in 18 cases before ILMA placement, and in 2 cases after the ILMA placement.\nCONCLUSION: The use of ILMA for airway management by trained emergency nurses during OHCA resuscitation is feasible and allows for effective airway management. The success rate of tracheal tube placement through the ILMA was high. In addition, the incidence of regurgitation was lower when using the ILMA than that previous historical reports with face-mask ventilation.", "publicationTitle": "Resuscitation", "publisher": "", "place": "", "date": "Mar 2014", "volume": "85", "issue": "3", "section": "", "partNumber": "", "partTitle": "", "pages": "320-325", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Resuscitation", "DOI": "10.1016/j.resuscitation.2013.11.006", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1873-1570", "archive": "", "archiveLocation": "", "shortTitle": "Intubating laryngeal mask airway placement by non-physician healthcare providers in management out-of-hospital cardiac arrests", "language": "eng", "libraryCatalog": "PubMed", "callNumber": "", "rights": "", "extra": "PMID: 24287330", "tags": [ { "tag": "Aged", "type": 1 }, { "tag": "Aged, 80 and over", "type": 1 }, { "tag": "Airway", "type": 1 }, { "tag": "Feasibility Studies", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Health Personnel", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Intubation, Intratracheal", "type": 1 }, { "tag": "Laryngeal Masks", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Middle Aged", "type": 1 }, { "tag": "Out-of-Hospital Cardiac Arrest", "type": 1 }, { "tag": "Prospective Studies", "type": 1 }, { "tag": "Regurgitation", "type": 1 }, { "tag": "Resuscitation", "type": 1 }, { "tag": "airway management", "type": 1 } ], "collections": [ "4UVVJVE4" ], "relations": {}, "dateAdded": "2016-09-02T19:33:07Z", "dateModified": "2016-09-02T19:33:07Z" } }, { "key": "GPEIBVWZ", "version": 135, "library": { "type": "group", "id": 504469, "name": "ALS 301 Cushing's Disease", "links": { "alternate": { "href": "https://www.zotero.org/groups/als_301_cushings_disease", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/504469/items/GPEIBVWZ", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/als_301_cushings_disease/items/GPEIBVWZ", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/504469/items/JWBTVZ9S", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2623202, "username": "crishanacek", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/crishanacek", "type": "text/html" } } } }, "data": { "key": "GPEIBVWZ", "version": 135, "parentItem": "JWBTVZ9S", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2016-09-02T19:33:07Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/24287330", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2016-09-02T19:33:07Z", "dateModified": "2016-09-02T19:33:07Z" } }, { "key": "IXHB73JN", "version": 134, "library": { "type": "group", "id": 504469, "name": "ALS 301 Cushing's Disease", "links": { "alternate": { "href": "https://www.zotero.org/groups/als_301_cushings_disease", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/504469/items/IXHB73JN", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/als_301_cushings_disease/items/IXHB73JN", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/504469/items/PQKKB22U", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2623202, "username": "crishanacek", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/crishanacek", "type": "text/html" } } } }, "data": { "key": "IXHB73JN", "version": 134, "parentItem": "PQKKB22U", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2016-09-02T19:32:37Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/24460509", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2016-09-02T19:32:37Z", "dateModified": "2016-09-02T19:32:37Z" } }, { "key": "PQKKB22U", "version": 134, "library": { "type": "group", "id": 504469, "name": "ALS 301 Cushing's Disease", "links": { "alternate": { "href": "https://www.zotero.org/groups/als_301_cushings_disease", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/504469/items/PQKKB22U", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/als_301_cushings_disease/items/PQKKB22U", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2623202, "username": "crishanacek", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/crishanacek", "type": "text/html" } } }, "creatorSummary": "Yun et al.", "parsedDate": "2014-09", "numChildren": 1 }, "data": { "key": "PQKKB22U", "version": 134, "itemType": "journalArticle", "title": "Comparison of video, optical, and direct laryngoscopy by experienced tactical paramedics", "creators": [ { "creatorType": "author", "firstName": "Brian J.", "lastName": "Yun" }, { "creatorType": "author", "firstName": "Calvin A.", "lastName": "Brown" }, { "creatorType": "author", "firstName": "Christopher J.", "lastName": "Grazioso" }, { "creatorType": "author", "firstName": "Charles N.", "lastName": "Pozner" }, { "creatorType": "author", "firstName": "Ali S.", "lastName": "Raja" } ], "abstractNote": "OBJECTIVES: While optical and video laryngoscopy have been studied in the emergency department, the operating room, and the routine prehospital setting, their efficacy in the tactical environment--in which operator safety is as important as intubation success--has not been evaluated. This study compared direct laryngoscopes to optical (AirTraq) and video (King Vision) laryngoscopes in a simulated tactical setting.\nMETHODS: This prospective institutional review board-approved simulation study evaluated each of the laryngoscopes in the hands of seven experienced tactical paramedics. After a one-hour training session, each tactical paramedic used each of the laryngoscopes, in a random order, on each of four different airway manikins. A tactical environment was simulated using auditory and visual immersion, and the intubations occurred on the ground with the paramedics in full tactical gear. Outcomes included time to successful ventilation, first-pass success rate, Cormack-Lehane grade, and intubator head height during the intubation. Statistical analysis included chi-squared and Wilcoxon rank sum tests, and multivariate logistic regression was performed to determine contributing factors to outcomes with significant variation.\nRESULTS: A total of 84 intubations were performed by seven tactical paramedics. While there were no significant differences in time to successful ventilation or first-pass success rate, the optical and video laryngoscopes had significantly better Cormack-Lehane grades, defined as grade I or II (100% for both compared to 85.7%), while direct laryngoscopy resulted in significantly less maximum vertical exposure of the intubator (51.82 cm compared to AirTraq's 56.64 cm and King Vision's 56.13 cm).\nCONCLUSION: Video and optical laryngoscopes can be used successfully by experienced tactical paramedics in a simulated tactical setting. The King Vision and AirTraq resulted in improved Cormack-Lehane glottic views but similar times to ventilation and first-pass success compared to direct laryngoscopy. Intubator head height was lower with direct laryngoscopy. Clarifying the role of optical and video laryngoscopes in a tactical environment, especially in the hands of less experienced intubators, requires further research.", "publicationTitle": "Prehospital emergency care: official journal of the National Association of EMS Physicians and the National Association of State EMS Directors", "publisher": "", "place": "", "date": "2014 Jul-Sep", "volume": "18", "issue": "3", "section": "", "partNumber": "", "partTitle": "", "pages": "442-445", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Prehosp Emerg Care", "DOI": "10.3109/10903127.2013.864356", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1545-0066", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "eng", "libraryCatalog": "PubMed", "callNumber": "", "rights": "", "extra": "PMID: 24460509", "tags": [ { "tag": "Adult", "type": 1 }, { "tag": "Allied Health Personnel", "type": 1 }, { "tag": "Clinical Competence", "type": 1 }, { "tag": "Emergency Medical Services", "type": 1 }, { "tag": "Equipment Design", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Intubation", "type": 1 }, { "tag": "Intubation, Intratracheal", "type": 1 }, { "tag": "Laryngoscopes", "type": 1 }, { "tag": "Laryngoscopy", "type": 1 }, { "tag": "Logistic Models", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Manikins", "type": 1 }, { "tag": "Middle Aged", "type": 1 }, { "tag": "Multivariate Analysis", "type": 1 }, { "tag": "Optical Devices", "type": 1 }, { "tag": "Prospective Studies", "type": 1 }, { "tag": "Video Recording", "type": 1 }, { "tag": "airway management", "type": 1 }, { "tag": "simulation", "type": 1 }, { "tag": "tactical medicine", "type": 1 }, { "tag": "video laryngoscopy", "type": 1 } ], "collections": [ "4UVVJVE4" ], "relations": {}, "dateAdded": "2016-09-02T19:32:37Z", "dateModified": "2016-09-02T19:32:37Z" } }, { "key": "F57DUD8Q", "version": 133, "library": { "type": "group", "id": 504469, "name": "ALS 301 Cushing's Disease", "links": { "alternate": { "href": "https://www.zotero.org/groups/als_301_cushings_disease", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/504469/items/F57DUD8Q", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/als_301_cushings_disease/items/F57DUD8Q", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2623202, "username": "crishanacek", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/crishanacek", "type": "text/html" } } }, "creatorSummary": "Yun et al.", "parsedDate": "2014-09", "numChildren": 1 }, "data": { "key": "F57DUD8Q", "version": 133, "itemType": "journalArticle", "title": "Comparison of video, optical, and direct laryngoscopy by experienced tactical paramedics", "creators": [ { "creatorType": "author", "firstName": "Brian J.", "lastName": "Yun" }, { "creatorType": "author", "firstName": "Calvin A.", "lastName": "Brown" }, { "creatorType": "author", "firstName": "Christopher J.", "lastName": "Grazioso" }, { "creatorType": "author", "firstName": "Charles N.", "lastName": "Pozner" }, { "creatorType": "author", "firstName": "Ali S.", "lastName": "Raja" } ], "abstractNote": "OBJECTIVES: While optical and video laryngoscopy have been studied in the emergency department, the operating room, and the routine prehospital setting, their efficacy in the tactical environment--in which operator safety is as important as intubation success--has not been evaluated. This study compared direct laryngoscopes to optical (AirTraq) and video (King Vision) laryngoscopes in a simulated tactical setting.\nMETHODS: This prospective institutional review board-approved simulation study evaluated each of the laryngoscopes in the hands of seven experienced tactical paramedics. After a one-hour training session, each tactical paramedic used each of the laryngoscopes, in a random order, on each of four different airway manikins. A tactical environment was simulated using auditory and visual immersion, and the intubations occurred on the ground with the paramedics in full tactical gear. Outcomes included time to successful ventilation, first-pass success rate, Cormack-Lehane grade, and intubator head height during the intubation. Statistical analysis included chi-squared and Wilcoxon rank sum tests, and multivariate logistic regression was performed to determine contributing factors to outcomes with significant variation.\nRESULTS: A total of 84 intubations were performed by seven tactical paramedics. While there were no significant differences in time to successful ventilation or first-pass success rate, the optical and video laryngoscopes had significantly better Cormack-Lehane grades, defined as grade I or II (100% for both compared to 85.7%), while direct laryngoscopy resulted in significantly less maximum vertical exposure of the intubator (51.82 cm compared to AirTraq's 56.64 cm and King Vision's 56.13 cm).\nCONCLUSION: Video and optical laryngoscopes can be used successfully by experienced tactical paramedics in a simulated tactical setting. The King Vision and AirTraq resulted in improved Cormack-Lehane glottic views but similar times to ventilation and first-pass success compared to direct laryngoscopy. Intubator head height was lower with direct laryngoscopy. Clarifying the role of optical and video laryngoscopes in a tactical environment, especially in the hands of less experienced intubators, requires further research.", "publicationTitle": "Prehospital emergency care: official journal of the National Association of EMS Physicians and the National Association of State EMS Directors", "publisher": "", "place": "", "date": "2014 Jul-Sep", "volume": "18", "issue": "3", "section": "", "partNumber": "", "partTitle": "", "pages": "442-445", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Prehosp Emerg Care", "DOI": "10.3109/10903127.2013.864356", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1545-0066", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "eng", "libraryCatalog": "PubMed", "callNumber": "", "rights": "", "extra": "PMID: 24460509", "tags": [ { "tag": "Adult", "type": 1 }, { "tag": "Allied Health Personnel", "type": 1 }, { "tag": "Clinical Competence", "type": 1 }, { "tag": "Emergency Medical Services", "type": 1 }, { "tag": "Equipment Design", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Intubation", "type": 1 }, { "tag": "Intubation, Intratracheal", "type": 1 }, { "tag": "Laryngoscopes", "type": 1 }, { "tag": "Laryngoscopy", "type": 1 }, { "tag": "Logistic Models", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Manikins", "type": 1 }, { "tag": "Middle Aged", "type": 1 }, { "tag": "Multivariate Analysis", "type": 1 }, { "tag": "Optical Devices", "type": 1 }, { "tag": "Prospective Studies", "type": 1 }, { "tag": "Video Recording", "type": 1 }, { "tag": "airway management", "type": 1 }, { "tag": "simulation", "type": 1 }, { "tag": "tactical medicine", "type": 1 }, { "tag": "video laryngoscopy", "type": 1 } ], "collections": [ "4UVVJVE4" ], "relations": {}, "dateAdded": "2016-09-02T19:32:17Z", "dateModified": "2016-09-02T19:32:17Z" } }, { "key": "QP92JKF5", "version": 133, "library": { "type": "group", "id": 504469, "name": "ALS 301 Cushing's Disease", "links": { "alternate": { "href": "https://www.zotero.org/groups/als_301_cushings_disease", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/504469/items/QP92JKF5", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/als_301_cushings_disease/items/QP92JKF5", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/504469/items/F57DUD8Q", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2623202, "username": "crishanacek", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/crishanacek", "type": "text/html" } } } }, "data": { "key": "QP92JKF5", "version": 133, "parentItem": "F57DUD8Q", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2016-09-02T19:32:17Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/24460509", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2016-09-02T19:32:17Z", "dateModified": "2016-09-02T19:32:17Z" } }, { "key": "3SN29WME", "version": 132, "library": { "type": "group", "id": 504469, "name": "ALS 301 Cushing's Disease", "links": { "alternate": { "href": "https://www.zotero.org/groups/als_301_cushings_disease", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/504469/items/3SN29WME", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/als_301_cushings_disease/items/3SN29WME", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/504469/items/PV9GE2H8", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2623202, "username": "crishanacek", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/crishanacek", "type": "text/html" } } } }, "data": { "key": "3SN29WME", "version": 132, "parentItem": "PV9GE2H8", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2016-09-02T19:31:08Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/25481340", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2016-09-02T19:31:08Z", "dateModified": "2016-09-02T19:31:08Z" } }, { "key": "PV9GE2H8", "version": 132, "library": { "type": "group", "id": 504469, "name": "ALS 301 Cushing's Disease", "links": { "alternate": { "href": "https://www.zotero.org/groups/als_301_cushings_disease", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/504469/items/PV9GE2H8", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/als_301_cushings_disease/items/PV9GE2H8", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2623202, "username": "crishanacek", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/crishanacek", "type": "text/html" } } }, "creatorSummary": "Budde et al.", "parsedDate": "2015-02", "numChildren": 1 }, "data": { "key": "PV9GE2H8", "version": 132, "itemType": "journalArticle", "title": "Comparison of 2 techniques of laryngeal tube exchange in a randomized controlled simulation study", "creators": [ { "creatorType": "author", "firstName": "Arne O.", "lastName": "Budde" }, { "creatorType": "author", "firstName": "Adam", "lastName": "Schwarz" }, { "creatorType": "author", "firstName": "Priti G.", "lastName": "Dalal" }, { "creatorType": "author", "firstName": "Elizabeth H.", "lastName": "Sinz" }, { "creatorType": "author", "firstName": "Sonia J.", "lastName": "Vaida" } ], "abstractNote": "BACKGROUND: Laryngeal tubes (LT) are often used as rescue airway devices. Among prehospital medical personnel, the success rates are high and significantly faster compared to an endotracheal tube (ETT). Therefore, LTs are increasingly used in the prehospital setting. The exchange of an LT for an ETT may often be desirable. Two fiberoptic bronchoscope-facilitated techniques have been described to exchange an LT for an ETT: an intraluminal technique using an Aintree intubating catheter and an extraluminal technique using a nasal route alongside the LT. In this randomized cross-over mannequin study, we compared the intraluminal with the extraluminal exchange technique. The primary outcome was time to achieve an effective airway through an ETT. We hypothesized that the intraluminal technique would be significantly faster.\nMETHODS: Thirty anesthesia providers were recruited to the study. Each participant attempted both techniques in an intubation simulation model. The tube exchange time was recorded from picking up the fiberoptic bronchoscope until confirmation of ventilation with the ETT.\nRESULTS: Four participants in each group had a failed attempt at intubation. Time to establish an endotracheal intubation was significantly shorter with the intraluminal technique vs the extraluminal technique (77.5 vs 140 seconds; P=.03).\nCONCLUSION: Based on the results of our study, we suggest that the intraluminal technique may be a suitable alternative for a fiberoptic-guided rapid exchange of an LT for an ETT to establish an effective airway in a challenging situation.", "publicationTitle": "The American Journal of Emergency Medicine", "publisher": "", "place": "", "date": "Feb 2015", "volume": "33", "issue": "2", "section": "", "partNumber": "", "partTitle": "", "pages": "173-176", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Am J Emerg Med", "DOI": "10.1016/j.ajem.2014.11.007", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1532-8171", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "eng", "libraryCatalog": "PubMed", "callNumber": "", "rights": "", "extra": "PMID: 25481340", "tags": [ { "tag": "Cross-Over Studies", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Intubation, Intratracheal", "type": 1 }, { "tag": "Laryngeal Masks", "type": 1 }, { "tag": "Manikins", "type": 1 }, { "tag": "Time Factors", "type": 1 } ], "collections": [ "4UVVJVE4" ], "relations": {}, "dateAdded": "2016-09-02T19:31:08Z", "dateModified": "2016-09-02T19:31:08Z" } }, { "key": "RWWBWKR3", "version": 131, "library": { "type": "group", "id": 504469, "name": "ALS 301 Cushing's Disease", "links": { "alternate": { "href": "https://www.zotero.org/groups/als_301_cushings_disease", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/504469/items/RWWBWKR3", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/als_301_cushings_disease/items/RWWBWKR3", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/504469/items/R2VBR52C", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2623202, "username": "crishanacek", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/crishanacek", "type": "text/html" } } } }, "data": { "key": "RWWBWKR3", "version": 131, "parentItem": "R2VBR52C", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2016-09-02T19:30:41Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/25894914", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2016-09-02T19:30:41Z", "dateModified": "2016-09-02T19:30:41Z" } }, { "key": "R2VBR52C", "version": 131, "library": { "type": "group", "id": 504469, "name": "ALS 301 Cushing's Disease", "links": { "alternate": { "href": "https://www.zotero.org/groups/als_301_cushings_disease", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/504469/items/R2VBR52C", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/als_301_cushings_disease/items/R2VBR52C", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2623202, "username": "crishanacek", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/crishanacek", "type": "text/html" } } }, "creatorSummary": "Szarpak et al.", "parsedDate": "2015-10", "numChildren": 1 }, "data": { "key": "R2VBR52C", "version": 131, "itemType": "journalArticle", "title": "Comparison of the TruView PCD video laryngoscope and macintosh laryngoscope for pediatric tracheal intubation by novice paramedics: a randomized crossover simulation trial", "creators": [ { "creatorType": "author", "firstName": "Łukasz", "lastName": "Szarpak" }, { "creatorType": "author", "firstName": "Łukasz", "lastName": "Czyżewski" }, { "creatorType": "author", "firstName": "Andrzej", "lastName": "Kurowski" }, { "creatorType": "author", "firstName": "Zenon", "lastName": "Truszewski" } ], "abstractNote": "The aim of the present study was to evaluate whether the TruView video laryngoscope (TruView) facilitates pediatric endotracheal intubation (ETI) more quickly and safely than conventional Macintosh laryngoscope (MAC) in three manikin-based airway scenarios. This was a randomized crossover manikin study including 120 novice paramedics. The participants performed tracheal intubations using both TruView and MAC on a pediatric manikin in a control scenario (A), chest compression scenario (B), and chest compression cervical stabilization scenario (C). The sequence of scenarios was randomized. The primary outcome was time to intubation. Secondary outcomes were overall success rates, incidence of dental trauma, and ease of intubation. All intubation attempts were assessed by a trained assistant. The overall success rate was significantly higher with the TruView compared than the MAC in scenario B (100 vs. 81.7 %; p = 0.011) and scenario C (100 vs. 68.3 %; p < 0.001). The intubation time was significantly lower with the TruView than the MAC (18.5 vs. 24.3 s, p = 0.017, for scenario A; 21.6 vs. 25.7 s, p = 0.023, for scenario B; and 28.9 vs. 45.4 s, p < 0.001, for scenario C). Glottic view quality was better with TruView than the MAC in all scenarios, p < 0.001.\nCONCLUSIONS: The TruView offers better intubation conditions than the MAC on a pediatric manikin in the control scenario, chest compression scenario, and chest compression scenario with cervical stabilization scenario. The TruView may be used to elevate the epiglottis for orotracheal intubation. Further clinical studies are necessary to confirm these initial positive findings.\nTRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT02289872.\nWHAT IS KNOWN: •Prehospital pediatric intubation using a standard laryngoscope is varied and ranges from 63.4 to 82 %. What is New: •This is the first study showing efficiency of pediatric endotracheal intubation using the TruView PCD by paramedics in tree simulation scenarios. •TruView PCD offers better pediatric intubation conditions than the Macintosh laryngoscope.", "publicationTitle": "European Journal of Pediatrics", "publisher": "", "place": "", "date": "Oct 2015", "volume": "174", "issue": "10", "section": "", "partNumber": "", "partTitle": "", "pages": "1325-1332", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Eur. J. Pediatr.", "DOI": "10.1007/s00431-015-2538-0", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1432-1076", "archive": "", "archiveLocation": "", "shortTitle": "Comparison of the TruView PCD video laryngoscope and macintosh laryngoscope for pediatric tracheal intubation by novice paramedics", "language": "eng", "libraryCatalog": "PubMed", "callNumber": "", "rights": "", "extra": "PMID: 25894914\nPMCID: PMC4575358", "tags": [ { "tag": "Adult", "type": 1 }, { "tag": "Allied Health Personnel", "type": 1 }, { "tag": "Cardiopulmonary Resuscitation", "type": 1 }, { "tag": "Child", "type": 1 }, { "tag": "Cross-Over Studies", "type": 1 }, { "tag": "Equipment Design", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Follow-Up Studies", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Intubation, Intratracheal", "type": 1 }, { "tag": "Laryngoscope", "type": 1 }, { "tag": "Laryngoscopes", "type": 1 }, { "tag": "Macintosh", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Manikins", "type": 1 }, { "tag": "Paramedic", "type": 1 }, { "tag": "Prospective Studies", "type": 1 }, { "tag": "Time Factors", "type": 1 }, { "tag": "TruView", "type": 1 }, { "tag": "Video Recording", "type": 1 }, { "tag": "simulation", "type": 1 } ], "collections": [ "4UVVJVE4" ], "relations": {}, "dateAdded": "2016-09-02T19:30:41Z", "dateModified": "2016-09-02T19:30:41Z" } }, { "key": "ZZIR98IV", "version": 130, "library": { "type": "group", "id": 504469, "name": "ALS 301 Cushing's Disease", "links": { "alternate": { "href": "https://www.zotero.org/groups/als_301_cushings_disease", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/504469/items/ZZIR98IV", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/als_301_cushings_disease/items/ZZIR98IV", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2623202, "username": "crishanacek", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/crishanacek", "type": "text/html" } } }, "creatorSummary": "Yildirim et al.", "parsedDate": "2016-03-21", "numChildren": 1 }, "data": { "key": "ZZIR98IV", "version": 130, "itemType": "journalArticle", "title": "Comparison of Macintosh, McCoy and C-MAC D-Blade video laryngoscope intubation by prehospital emergency health workers: a simulation study", "creators": [ { "creatorType": "author", "firstName": "Ahmet", "lastName": "Yildirim" }, { "creatorType": "author", "firstName": "Hasan A.", "lastName": "Kiraz" }, { "creatorType": "author", "firstName": "İbrahim", "lastName": "Ağaoğlu" }, { "creatorType": "author", "firstName": "Okhan", "lastName": "Akdur" } ], "abstractNote": "The aim of the this study is to evaluate the intubation success rates of emergency medical technicians using a Macintosh laryngoscope (ML), McCoy laryngoscope (MCL), and C MAC D-Blade (CMDB) video laryngoscope on manikin models with immobilized cervical spines. This randomized crossover study included 40 EMTs with at least 2 years' active service in ambulances. All participating technicians completed intubations in three scenarios-a normal airway model, a rigid cervical collar model, and a manual in-line cervical stabilization model-with three different laryngoscopes. The scenario and laryngoscope model were determined randomly. We recorded the scenario, laryngoscope method, intubation time in seconds, tooth pressure, and intubation on a previously prepared study form. We performed Friedman tests to determine whether there is a significant change in the intubation success rate, duration of tracheal intubation, tooth pressure, and visual analog scale scores due to violations of parametric test assumptions. We performed the Wilcoxon test to determine the significance of pairwise differences for multiple comparisons. An overall 5 % type I error level was used to infer statistical significance. We considered a p value of less than 0.05 statistically significant. The CMDB and MCL success rates were significantly higher than the ML rates in all scenario models (p < 0.05). The CMDB intubation duration was significantly shorter when compared with ML and MCL in all models. CMDB and MCL may provide an easier, faster intubation by prehospital emergency health care workers in patients with immobilized cervical spines.", "publicationTitle": "Internal and Emergency Medicine", "publisher": "", "place": "", "date": "Mar 21, 2016", "volume": "", "issue": "", "section": "", "partNumber": "", "partTitle": "", "pages": "", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Intern Emerg Med", "DOI": "10.1007/s11739-016-1437-3", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1970-9366", "archive": "", "archiveLocation": "", "shortTitle": "Comparison of Macintosh, McCoy and C-MAC D-Blade video laryngoscope intubation by prehospital emergency health workers", "language": "ENG", "libraryCatalog": "PubMed", "callNumber": "", "rights": "", "extra": "PMID: 27001885", "tags": [ { "tag": "Intubation", "type": 1 }, { "tag": "Laryngoscope", "type": 1 }, { "tag": "Manikin", "type": 1 }, { "tag": "Video", "type": 1 }, { "tag": "prehospital", "type": 1 } ], "collections": [ "4UVVJVE4" ], "relations": {}, "dateAdded": "2016-09-02T19:29:38Z", "dateModified": "2016-09-02T19:29:38Z" } }, { "key": "IWQPVPGP", "version": 130, "library": { "type": "group", "id": 504469, "name": "ALS 301 Cushing's Disease", "links": { "alternate": { "href": "https://www.zotero.org/groups/als_301_cushings_disease", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/504469/items/IWQPVPGP", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/als_301_cushings_disease/items/IWQPVPGP", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/504469/items/ZZIR98IV", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2623202, "username": "crishanacek", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/crishanacek", "type": "text/html" } } } }, "data": { "key": "IWQPVPGP", "version": 130, "parentItem": "ZZIR98IV", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2016-09-02T19:29:38Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/27001885", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2016-09-02T19:29:38Z", "dateModified": "2016-09-02T19:29:38Z" } }, { "key": "U6AEUSUJ", "version": 129, "library": { "type": "group", "id": 504469, "name": "ALS 301 Cushing's Disease", "links": { "alternate": { "href": "https://www.zotero.org/groups/als_301_cushings_disease", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/504469/items/U6AEUSUJ", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/als_301_cushings_disease/items/U6AEUSUJ", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/504469/items/3QPFZQDD", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2623202, "username": "crishanacek", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/crishanacek", "type": "text/html" } } } }, "data": { "key": "U6AEUSUJ", "version": 129, "parentItem": "3QPFZQDD", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2016-09-02T19:29:05Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/27530816", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2016-09-02T19:29:05Z", "dateModified": "2016-09-02T19:29:05Z" } }, { "key": "3QPFZQDD", "version": 129, "library": { "type": "group", "id": 504469, "name": "ALS 301 Cushing's Disease", "links": { "alternate": { "href": "https://www.zotero.org/groups/als_301_cushings_disease", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/504469/items/3QPFZQDD", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/als_301_cushings_disease/items/3QPFZQDD", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2623202, "username": "crishanacek", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/crishanacek", "type": "text/html" } } }, "creatorSummary": "Bischof et al.", "parsedDate": "2016-08-17", "numChildren": 1 }, "data": { "key": "3QPFZQDD", "version": 129, "itemType": "journalArticle", "title": "Creation and Validation of a Novel Mobile Simulation Laboratory for High Fidelity, Prehospital, Difficult Airway Simulation", "creators": [ { "creatorType": "author", "firstName": "Jason J.", "lastName": "Bischof" }, { "creatorType": "author", "firstName": "Ashish R.", "lastName": "Panchal" }, { "creatorType": "author", "firstName": "Geoffrey I.", "lastName": "Finnegan" }, { "creatorType": "author", "firstName": "Thomas E.", "lastName": "Terndrup" } ], "abstractNote": "Introduction Endotracheal intubation (ETI) is a complex clinical skill complicated by the inherent challenge of providing care in the prehospital setting. Literature reports a low success rate of prehospital ETI attempts, partly due to the care environment and partly to the lack of consistent standardized training opportunities of prehospital providers in ETI. Hypothesis/Problem The availability of a mobile simulation laboratory (MSL) to study clinically critical interventions is needed in the prehospital setting to enhance instruction and maintain proficiency. This report is on the development and validation of a prehospital airway simulator and MSL that mimics in situ care provided in an ambulance.\nMETHODS: The MSL was a Type 3 ambulance with four cameras allowing audio-video recordings of observable behaviors. The prehospital airway simulator is a modified airway mannequin with increased static tongue pressure and a rigid cervical collar. Airway experts validated the model in a static setting through ETI at varying tongue pressures with a goal of a Grade 3 Cormack-Lehane (CL) laryngeal view. Following completion of this development, the MSL was launched with the prehospital airway simulator to distant communities utilizing a single facilitator/driver. Paramedics were recruited to perform ETI in the MSL, and the detailed airway management observations were stored for further analysis.\nRESULTS: Nineteen airway experts performed 57 ETI attempts at varying tongue pressures demonstrating increased CL views at higher tongue pressures. Tongue pressure of 60 mm Hg generated 31% Grade 3/4 CL view and was chosen for the prehospital trials. The MSL was launched and tested by 18 paramedics. First pass success was 33% with another 33% failing to intubate within three attempts.\nCONCLUSIONS: The MSL created was configured to deliver, record, and assess intubator behaviors with a difficult airway simulation. The MSL created a reproducible, high fidelity, mobile learning environment for assessment of simulated ETI performance by prehospital providers. Bischof JJ , Panchal AR , Finnegan GI , Terndrup TE . Creation and validation of a novel mobile simulation laboratory for high fidelity, prehospital, difficult airway simulation. 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Early diagnosis and treatment of Cushing’s syndrome is associated with a decrease in morbidity and mortality. Clinical presentation can be highly variable, and establishing the diagnosis can often be difficult. Surgery (resection of the pituitary or ectopic source of adrenocorticotropic hormone, or unilateral or bilateral adrenalectomy) remains the optimal treatment in all forms of Cushing’s syndrome, but may not always lead to remission. Medical therapy (steroidogenesis inhibitors, agents that decrease adrenocorticotropic hormone levels or glucocorticoid receptor antagonists) and pituitary radiotherapy may be needed as an adjunct. 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Early diagnosis and treatment of Cushing’s syndrome is associated with a decrease in morbidity and mortality. Clinical presentation can be highly variable, and establishing the diagnosis can often be difficult. Surgery (resection of the pituitary or ectopic source of adrenocorticotropic hormone, or unilateral or bilateral adrenalectomy) remains the optimal treatment in all forms of Cushing’s syndrome, but may not always lead to remission. Medical therapy (steroidogenesis inhibitors, agents that decrease adrenocorticotropic hormone levels or glucocorticoid receptor antagonists) and pituitary radiotherapy may be needed as an adjunct. 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