• 대한임상독성학회지
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• 제13권1호
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• pp.11-18
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• 2015

Purpose: The aim of this study was to compare the clinical characteristics in emergency endotracheal intubation between patients with acute drug intoxication and medical disease. Methods: Data for airway registry collected in two emergency departments (ED) between April 2006 and March 2010 were reviewed retrospectively. The airway registry data included patient's demographic information and variables such as Cormack-Lehane grade, 3-3-2 finger analysis, success rate, the number of attempts at intubation, complications of intubation, and clinical outcomes after intubation. Results: A total of 1480 patients were enrolled; 62 patients were classified as belonging to the intubation group after the drug intoxication group. No significant differences in Cormack-Lehane grade, 3-3-2 finger analysis, success rate, the number of attempts at intubation, and complications after intubation were observed between patients with acute drug intoxication and medical disease. However, significant difference was observed for indication of emergency endotracheal intubation. While emergency endotracheal intubations were usually performed in medical patients because of failure of airway patency, they were performed in intoxicated patients with the goal of preventing serious complications. Conclusion: Anatomical structures related to endotracheal intubation, the process and clinical outcome of intoxicated patients are not significantly different from those for medical patients.

• The Korean Journal of Pain
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• 제7권2호
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• pp.175-180
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• 1994

The impact of cardiovascular changes occurred by endotracheal intubation is risky for patients with ischemic heart disease, or intracranial pathologic conditions typically impairing cerebral autoregulatory mechanisms. Therefore, multiple approaches have been utilized to limit the impact of intubation and reduce damage of central nervous and cardiovascular systems. These approaches include modifications in intubation technique to diminish circulatory stimuli and pharmacologic modifications of either the sensory afferent path or the circulatory response itself. We tried the stellate ganglion block, a kind of sympathetic block, for the same purpose and evaluated the results. The results of study are as follows, 1) Blood pressure and heart rate increased significantly after intubation as compared with preintubation in both control group and SGB group. 2) The difference of the two groups is not found. We conclude the above method does not control cardiovascular consequences of endotracheal intubation.

• 한국응급구조학회지
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• 제21권2호
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• pp.7-15
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• 2017

Purpose: This study investigated the effectiveness of education regarding cuff pressure following endotracheal tube intubation using a quasi-experimental design with a pre- and posttest non-equivalent control group. Methods: A total of 78 students from two universities participated in an education intervention on the importance of cuff pressure after endotracheal tube intubation between October and December, 2016. The intervention lasted 40 minutes. Data were collected from each student before the intervention and one week following the intervention. Analyses were conducted using chi-square tests, Fisher's exact tests, and analysis of covariance. Results: A total of 38 students were assigned to the experimental group and 40 to the control group. The educational intervention of cuff pressure following endotracheal tube intubation was associated with prevention of possible complications from excessive cuff pressure (F=121.02, p<.001). Conclusion: Training with a pressure gauge and an intubation manikin is necessary to determine the appropriate cuff pressure in the intubation protocol of the practical examination in the emergency medical technology.

• 한국응급구조학회지
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• 제23권1호
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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.

• 한국산학기술학회논문지
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• 제13권11호
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• pp.5292-5298
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• 2012

본 연구는 이동 중 구급차에서 응급구조사의 삽관자세 변화에 따른 시야의 높이 변화가 기관내 삽관의 신속성에 영향을 미치는지 비교하고 환자의 삽관자세 변화가 기관내 삽관의 신속성에 영향을 미치는지 분석하여 심정지 및 외상성 응급 환자에게 효과적인 전문기도관리를 시행하는데 목적이 있다. 연구대상은 C도 13개 소방서에 근무하고 있는 1급 응급구조사 60(대조군30명, 실험군30명)명을 편의추출하여 시행하였으며, 자료 분석은 SPSS WIN 14.0 Version을 사용하여 하였다. 연구결과 전문기도관리의 신속성 향상을 위해서는 환자의 냄새맡기 자세와 주들것과 응급구조사 시트 사이 공간에서의 기관내 삽관이 효과적일 것으로 사료되고 실험 후의 삽관 자신감이 유의하게 상승 하였으므로 전문기도관리의 효율성 향상을 위해서는 구급차 내에서의 삽관자세와 방법에 대한 지속적인 교육(훈련)이 필요할 것으로 사료된다.

• 한국컴퓨터정보학회논문지
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• 제25권12호
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• pp.227-233
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• 2020

본 연구는 성문위기도기 인후두 튜브(Supraglottic Airway Laryngopharyngeal Tube, SALT)와 직접 후두경을 이용하여 어려운 자세에서 기관내삽관의 신속성과 자신감, 용이성 등을 비교하여 전문기도관리 시행 능력을 향상 시키는데 있다. 연구대상은 J도 소방서에서 근무하고 있는 1급 응급구조사 30명을 대상으로 무작위 교차방법(Randomized crossover design)으로 디자인한 실험연구로 자료 분석은 SPSS 20.0 Version을 사용하였다. 어려운 자세에서 SALT를 이용한 기관내삽관은 직접 후두경을 이용한 기관내삽관 보다 신속성에서 유의한 차이를 보였으며(p<.001), 자신감과 용이성에서도 유의한 차이를 나타냈다(p<.001). 직접 후두경을 사용한 기관내삽관이 어려운 환경이나 외상환자의 경우 SALT를 이용한다면 안전하고 신속한 삽관을 할 수 있을 것이다. 또한 전문기도관리의 효율성 향상을 위해서 국내 현장에 SALT의 도입이 필요 할 것으로 사료된다.

• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2022년도 추계학술대회
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• pp.300-302
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• 2022

이 연구는 성무위기도기 인후두 튜브(SALT)와 직접 후두경을 사용하여 이동중 기관내 삽관의 신속성과 자신감, 용이성 등을 비교하여 전문 기도 관리 시행능력을 향상 시키는데 있다. 연구대상은 J도 소방서에서 근무하고 있는 1급 응급구조사 30명을 대상으로 무작위 교차방법(Randomized crossover design)으로 디자인한 실험연구로 자료 분석은 SPSS 20.0 Version을 사용하였다. 어려운 자세에서 SALT를 이용한 기관내삽관은 직접 후두경을 이용한 기관내삽관 보다 신속성에서 유의한 차이를 보였으며(p<.001), 자신감과 용이성에서도 유의한 차이를 나타냈다(p<.001). 직접 후두경을 사용한 기관내삽관이 어려운 환경이나 이동시 SALT를 이용한다면 안전하고 신속한 삽관을 할 수 있을 것이다.

• 고신대학교 의과대학 학술지
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• 제33권2호
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• pp.252-256
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• 2018

We report a case of difficult endotracheal intubation in a patient with tracheobronchopathia osteochondroplastica. A 65-year-old man was scheduled to undergo ulnar nerve decompression and ganglion excisional biopsy under general anesthesia. During induction of general anesthesia, an endotracheal tube could not be advanced through the vocal cords due to resistance. A large number of nodules were identified below the vocal cords using a $Glidescope^{(R)}$ video-laryngoscopy, and fiberoptic bronchoscopy revealed irregular nodules on the surface of the entire trachea and the main bronchus below the vocal cords. Use of a small endotracheal tube was attempted and failed. a laryngeal mask airway (LMA $Supreme^{TM}$) rather than further intubation was successfully used to maintain the airway.

• Journal of Dental Anesthesia and Pain Medicine
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• 제18권2호
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• pp.125-128
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• 2018

In cases of a difficult intubation where numerous intubation methods, including laryngoscopy, have failed, yet oral intubation is still necessary, the method of tube exchange after fiberoptic nasal intubation may be attempted. Fiberoptic nasal intubation allows intubation to be performed relatively easily when the laryngeal view grade is poor. We report a case in which our attempt at oral intubation for total maxillectomy with laryngoscopy and fiberoptic oral intubation had failed due to an unexpected difficult airway; subsequently, we successfully completed the surgery by performing fiberoptic nasal intubation to secure the airway, followed by using a tube exchanger to exchange to an oral endotracheal tube.

• 한국응급구조학회지
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• 제22권3호
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• pp.35-45
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• 2018

Purpose: The purpose of this study was to compare laryngoscopic views and ease of use and success of intubation, via the percentage of glottic opening (POGO) scale when using the Miller blade and Macintosh blade in paraglossal approach. Methods: Forty intern doctors were randomized for laryngoscopy to be performed in a crossover manner. They performed endotracheal intubation with Miller blade and Macintosh blade in two airway scenarios: normal airway and difficult airway with edema. We observed the rate of successful intubation, time required for visualizing the glottis, time to complete endotracheal intubation, ease of intubation, and the POGO scale. Results: In the normal airway, there was no difference in intubation between the two endoscopes. In the difficult airway, the time for visualizing the glottis (7.80 versus 10.24 sec; p=.006), the time to tube passage (19.38 versus 23.03 sec; p=.038) and the time to complete endotracheal intubation (21.84 versus 28.54 sec; p=.022) with Miller blade was shorter than with Macintosh blade. The POGO scale(%) of the Miller blade was higher than that of the Macintosh blade's (62.25 versus 56.32; p=.030). Conclusion: Compared to the Macintosh blade, Miller blade provided better visualization of the glottis and POGO scale, and faster time to completion of endotracheal intubation.