• The Korean Journal of Emergency Medical Services
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• v.24 no.2
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• pp.123-131
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• 2020

Purpose: This study aimed to find out the effectiveness of gum elastic bougies for intubation in comparison to stylet according to airway type using a manikin. Methods: The study subjects were 52 paramedic students who intubated using a Macintosh laryngoscope and compared stylet and gum elastic bougie use in a 7.5 mmID endotracheal tube, on a manikin with either normal or difficult airway. Difficult airway was made Philadelphia neck collar. Collected data included intubation time, accuracy and ease of intubation, later analyzed by frequency analysis, descriptive analysis, independent t-test, chi square test, paired t-test, and McNemar test using SPSS Statistics 18.0. Results: There was a significant difference in intubation time according to intubation device and airway type (p=.000). There was no significant difference in accuracy of intubation according to intubation device or airway type (normal airway p=1.000, difficult airway p=.052). There was a significant difference in ease of intubation scale according to intubation device and airway type (p=.000, p=.000). Conclusion: Based on the speed and ease of intubation, gum elastic bougie is recommended for intubation in patients with difficult airways such as those with cervical injury.

• The Korean Journal of Emergency Medical Services
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• v.21 no.1
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• pp.99-109
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• 2017

Purpose: There is no recommended bag-squeezing technique for emergency medical providers to maintain correct tidal volume during mechanical ventilation. This study compared the tidal volume of two different bag-squeezing techniques during mechanical ventilation. Methods: The subjects were 38 paramedic students who were trained in airway management techniques. Two different bag-squeezing techniques were used with a bag valve mask on an intubated manikin: a conventional technique and a finger-marked, in which the bag is squeezed until the thumb and the middle finger come into contact. Hand size and grip strength were measured and analyzed statistically. Results: The mean tidal volumes for the finger-marked were significantly higher than those for the conventional technique ($542.6{\pm}35.92mL$ versus $338.0{\pm}111.15 mL$, p<.001). There was a correlation between the two techniques (Pearson $x^2=1.160$, p<.001). The subject's characteristics, including sex, hand size, and grip strength, showed no correlation with tidal volume. Conclusion: A finger-marked bag-squeezing technique provides adequate and correct tidal volumes during mechanical ventilation.

• Journal of The Korean Dental Society of Anesthesiology
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• v.9 no.2
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• pp.91-97
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• 2009

Background: Nasotracheal intubation for general anesthesia is preferred for oral and maxillofacial procedures because it provides improved access to the operative site. Fiberopic nasotracheal intubation is a useful technique when airway management seems difficult. But, intaoral bleeding is considered as the important factor that makes fiberopic nasotracheal intubation difficult. The purpose of our study was to elucidate the effect of laryngeal view and bleeding on intubation difficulty during fiberopic intubation. Methods: We studied 461 patients undergoing nasotracheal intubation with permission. Laryngeal view grades were examined with laryngoscope and were recorded. Then, intubation time and the amounts of bleeding were measured during fibroptic nasotracheal intubation under general anesthesia. Results: There was no significant difference between laryngeal view grade and intubation difficulty (P > 0.05). But severity of bleeding increased intubation difficulty (P < 0.05). Conclusions: In this study, the significant amounts of bleeding had an effect on intubation difficulty.

• The Korean Journal of Emergency Medical Services
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• v.23 no.1
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• pp.7-17
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• 2019

Purpose: The aim of this study was to verify the necessity of endotracheal intubation through video laryngoscope and to provide basic data to inform the provision of video laryngoscope education. Methods: Eighty paramedic students participated in this study. A survey was conducted from November 5, 2018 to December 7, 2018. Data were analyzed with independent t-tests, and the chi-squared test. Results: The video laryngoscope is a highly usable instrument that can easily be applied during training. The instrument provides better visual evaluation of the normal airway (p=.004), the airway in case of cervical collar and head fixation (p=.000), and the airway in case of tongue edema (p=.000). The time of endotracheal intubation in the normal airway was significantly less with the video laryngoscope compared with the direct laryngoscope. The success rate of tracheal intubation was significantly higher in the video laryngoscope group than in the direct laryngoscope. Conclusion: This study suggests the necessity of education on endotracheal intubation through video laryngoscope in the professional airway maintenance training course of emergency department students. The video laryngoscope is easier to apply than the direct laryngoscope in cases of intubation in various clinical situations.

• Tuberculosis and Respiratory Diseases
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• v.59 no.1
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• pp.62-68
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• 2005

Background : The clinical results of a Natural stent in patients with a benign tracheobronchial stenosis were examined by comparing the clinical outcomes and complications of those patients who underwent Dumon and Natural stenting in the management of benign airway stenosis. Methods : The medical records of 94 patients (39 Dumon and 55 Natural stent) with a benign tracheobronchial stenosis were reviewed and analyzed. Results : Post-tuberculous stenosis was the leading indication for airway stenting (74%), which was followed by post-intubation stenosis (21%). After intervention, the dyspnea had improved among those patients who underwent Dumon (90%) and Natural (86%) stenting. After stabilizing the dyspnea, the stent could be successfully removed in half of the patients who underwent both Dumon (54%) and Natural (49%) stenting. During the 42 month follow-up period, the complication rate was similar in those patients who underwent Dumon and Natural stenting: migration (46% vs 53%), granulation tissue formation (36% vs 49%), mucostasis (21% vs 16%) and restenosis (51% vs 36%). Conclusion : The clinical results of Natural airway stent was similar to those of Dumon stent in the management of benign tracheobronchial stenosis.

• Journal of Korean Biological Nursing Science
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• v.16 no.2
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• pp.123-132
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• 2014

Purpose: The purpose of this study was to compare and analyze the effects of gargling using normal saline or essential oil on oral bacterial colonization of the subjects who did transoral endotracheal intubation for general anesthesia. Methods: A repeated measures, non-equivalent control group pretest-posttest design was used in this study. The subjects of the study included 58 people; the gargling group with normal saline (n=19); the gargling group with essential oil (n=20); and the control group (n=19). Data were collected from University hospitals in a Korean province from August 13-31, 2012. The collected data were analyzed with $X^2$-test, t-test, ANOVA and Scheff$\acute{e}$ test using SPSS 19.0. Results: Although statistically significant differences among the three groups did not appear in the change of the aerobic bacterial colony before and after the experiments, the aerobic bacterial colony of the gargling group with normal saline ($71.58{\pm}143.39$) and the group with essential oil ($6.95{\pm}332.07$) have increased less compared to the control group ($145.42{\pm}385.01$). The change of the anaerobic bacterial colony before and after the experiments, the control group was ($167.58{\pm}483.58$) and the gargling group with essential oil was ($169.70{\pm}291.60$) and increased, while the gargling group with normal saline ($-42{\pm}331.09$) reduced, but statistically significant differences have not appeared. Conclusion: These findings indicated that oral gargling with normal saline is effective in reducing anaerobic bacterial colonization.

• Pediatric Infection and Vaccine
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• v.25 no.2
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• pp.101-106
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• 2018

A 6-year-old boy with underlying hemolytic anemia of unknown etiology, atopic dermatitis, and recurrent urticaria visited our hospital because of acute respiratory failure induced by influenza A. Despite mechanical ventilation after endotracheal intubation along with inhalation of nitric oxide, respiratory acidosis and hypoxemia persisted. Veno-venous extracorporeal membrane oxygenation (VV ECMO) insertion was performed to provide respiratory support. After performing flexible bronchoscopy, we found that thick mucus plugs were obstructing the right bronchus intermedius and the upper lobe orifice. After bronchial washing and removal of the plugs, we were able to wean the patient off VV ECMO and transfer him to the general ward. He was discharged without any neurologic or pulmonary sequelae.

• Journal of Korean Academy of Nursing
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• v.49 no.2
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• pp.215-224
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• 2019

Purpose: To investigate the differences in postoperative sore throat and hoarseness by adjustment of endotracheal tube cuff pressure (CP) during nitrous oxide ($N_2O$) and air anesthesia. Methods: A one-equivalent control group pretest-posttest design was used. Data were collected from August 8 to October 19, 2017 and analyzed using the independent t-test and repeated measures ANOVA. Eighty-four participants were enrolled and divided into three groups: 28 in the Control Group (CP adjusted every 30 minutes using $N_2O$), 28 in Experimental Group 1 (CP adjusted every 10 minutes using $N_2O$), and 28 in Experimental Group 2 (non-adjusted CP using air), all of whom underwent urologic, gynecologic, and orthopedic surgeries at the G University hospital. Sore throat was assessed using a numeric rating scale; hoarseness was evaluate using the Stout classification at 1, 6, and 24 hours after surgery. Results: Scores for sore throat and hoarseness were significantly different between the groups at each measurement time, and scores were consistently higher in the control group. During subsequent measurements, sore throat and hoarseness scores were significantly lower at 6 hours. Cuff pressure changed significantly using air anesthesia (${\chi}^2=10.41$, p=.015) up to 2 hours after induction. Severe sore throat and hoarseness was observed for up to 6 hours after surgery. Conclusion: Cuff pressure adjustment at short time intervals would be helpful in reducing postoperative sore throat and hoarseness. Nursing intervention focused on prevention of sore throat and hoarseness should be required up to 6 hours postoperatively in patients undergoing endotracheal intubation.

• Journal of Chest Surgery
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• v.34 no.8
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• pp.591-596
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• 2001

Coronary artery bypass graft with cardiopulmonary bypass is a conventional method of operative revascularization of coronary artery disease. Because of many troubles of cardiopulmonary bypass such as systemic inflammatory reaction, mechanical trauma of blood components and coagulopathy, coronary artery bypass graft without cardiopulmonary bypass has been popularized. Material and Method: From March 1999 to September 2000, 35 patients under went CABG at our institution. Among them, 14 patients received CABG without the use of CPB and 21 patients under went CABG with the use of CPB. Mean operative time, mean postoperative tracheal intubation time, mean ICU stay, mean hospital stay, the amount of transfusion, postoperative use of inotropic agents, and postoperative changes of cardiac enzymes were compared in both groups. Result: There were differences between the CABG without CPB group and CABG with CPB group with regard to mean tracheal intubation time, the amount of transfusion and the elevation of postoperative cardiac enzymes(p<0.05). Conclusion: While CABG without CPB provided satisfactory results, more long term follow-up is required.

• Journal of Chest Surgery
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• v.38 no.7 s.252
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• pp.461-467
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• 2005

Pleura, diaphragm, pericardial fat pad, intercostal muscles and omentum can be used to protect and revascularize the bronchial suture line of tracheal transplantation, lung transplantation and pulmonary resection. The purpose of the present study is to compare the influence of the pleura, diaphragm and omentum in survival of isolated tracheal segments in the experimental animals. Material and Method: Sprague-Dawley rats weighing 250- 350g were used. The animals were divided in three groups; the pleura, omentum and diaphragm. Following intraperitoneal anesthesia, endotracheal intubation was performed. Then the trachea was exposed. A three-ring sec- tion of cervical trachea was excised. The resected trachea was implanted at each sites. After 2 weeks, rats were sacrificed. Histopathological examination of the tracheal segments was performed. For comparison of each groups, histopathological viability of resected tracheal segment was scored by three tissue layers; epithelium, submucosa, and cartilage. The results were presented as average score. Result: In histopathological examination, submucosa and cartilage using tracheal segment necrosis scoring system. The pleural group showed well preserved tissue. There was minimal necrosis and inflammation compared with other groups. In the pleural group, tracheal necrosis scores were $2.17\pm0.983$at epithelium, $1.67\pm0.516$ at submucosa and $2.17\pm0.753$ at cartilage. At the omental group, scores were $1.00\pm0.00,\;1.60\pm0.548\;and\;1.80\m0.447$. In the diaphragmatic group, scores were $1.40:\pm0.894,\;2.40\pm0.547\;and\;2.20\pm0.447$. Total necrosis score were $6.00\pm1.789$ in the pleural group, $4.40\pm0.894$ in the omental group and $6.00\pm1.414$ in the diaphragmatic group. Conclusion: There were no significant viability differences in terms of total necrosis score for the viability of resected tracheal segment. But the best result was achieved in the omental group. Therefore, omental wrapping on tracheal graft site will be beneficial for the prevention of graft necrosis.