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Rise in Video Laryngoscopy Has Not Affected Rates of Awake Intubation

Calvin A. Brown, III, MD   In this retrospective review at a single center, use of video laryngoscopy increased significantly over time, but the rate of awake intubation remained constant.   Awake intubation is used when glottic visualization with a laryngoscope and rescue mask ventilation are anticipated to be significantly difficult. It involves the... Read more..

Can the Modified LEMON Score Predict Difficult Intubation?

Daniel J. Pallin, MD, MPH   A Japanese registry study suggests the score has fair sensitivity and specificity.   The LEMON score is a mnemonic for predicting difficult intubation. It stands for Look, Evaluate the 3-3-2 rule, Mallampati score, Obstruction, and Neck mobility (NEJM JW Emerg Med Mar 2005 and Emerg Med... Read more..

Strategies to Prevent Ventilator-Associated Pneumonia

Neil M. Ampel, MD   In a decision model, use of the Institute for Healthcare Improvement VAP prevention bundle plus subglottic endotracheal suction and probiotics had the best cost‐benefit ratio.   Mortality from ventilator‐associated pneumonia (VAP) exceeds 10%. Many strategies to prevent this infection have been evaluated, but little is known about their comparative effectiveness. Such... Read more..

Need to Exchange a Tracheal Tube? Use Video Laryngoscopy

Calvin A. Brown, III, MD   Video laryngoscopy improved first‐attempt success and lowered rates of complications compared with direct laryngoscopy in a single‐center registry study of endotracheal tube exchanges using airway exchange catheters.   Endotracheal tube (ETT) exchange is required when ventilation is ineffective because of either cuff failure or tube size. The procedure... Read more..

Predictors of Swallowing Dysfunction During Deep Sedation with Propofol

Calvin A. Brown, III, MD   Increasing body‐mass index, age, and propofol dose were predictors of swallowing impairment and aspiration in this single‐center observational study.   Deep sedation is becoming increasingly popular in a variety of clinical settings to facilitate medical and surgical procedures. Sedatives have the potential to affect swallowing function and protective airway reflexes. During... Read more..