Systematic review and meta-analysis of first-pass success rates in emergency department intubation: Creating a benchmark for emergency airway care

2016 ◽  
Vol 29 (1) ◽  
pp. 40-47 ◽  
Author(s):  
Louise Park ◽  
Irene Zeng ◽  
Andrew Brainard
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Meta Analysis ◽  
Success Rates ◽  
Emergency Airway ◽  
First Pass

scholarly journals Efficacy of tracheal tube introducers and stylets for endotracheal intubation in the prehospital setting: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Jaden Tollman ◽  
Zubair Ahmed
Keyword(s):  
Systematic Review ◽  
Endotracheal Intubation ◽  
Tracheal Tube ◽  
Meta Analysis ◽  
Prehospital Setting ◽  
Cochrane Central Register ◽  
Success Rates ◽  
Video Technology ◽  
Summary Estimate ◽  
First Pass

Abstract Purpose Tracheal tube introducers and stylets remain some of the most widely used devices for aiding practitioners in performing endotracheal intubation (ETI). The purpose of this systematic review is to evaluate the efficacy of tracheal tube introducers and stylets for ETI in the prehospital setting. Methods A literature search was conducted on the 2nd of March 2021 across PubMed, Embase (Ovid) and the Cochrane Central Register of Controlled Trials (CENTRAL) to identify relevant studies. Included studies had their data extracted and both a quality assessment and statistical analysis were performed. Results The summary estimate of prehospital studies with video technology showed a statistically significant increase in first pass ETI success in favour of bougies (RR 1.15, CI 1.10–1.21, p < 0.0001). The summary estimates of prehospital studies without video technology and simulation studies with and without video technology showed no statistical difference between methods for first pass or overall ETI success. Some of the highest success rates were recorded by devices that incorporated video technology. Stylets lead to a shorter time to ETI while bougies were easier to use. Neither device was associated with a higher rate of ETI complications than the other. Conclusion Both tracheal tube introducers and stylets function as efficacious aids to intubation in the prehospital environment. Where video technology is available, bougies could offer a statistically significant advantage in terms of first pass ETI success. Where video technology is unavailable, a combination of clinical scenario, practitioner expertise and personal preference might ultimately guide the choice of device.

scholarly journals Apneic oxygenation provides incremental benefit during intubation of patients in the emergency medicine and critical care settings

CJEM ◽  
2018 ◽  
Vol 20 (5) ◽  
pp. 770-773
Author(s):  
Daniel K. Ting ◽  
Eddy S. Lang
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Emergency Medicine ◽  
Critical Care ◽  
Oxygen Saturation ◽  
Meta Analysis ◽  
Clinical Question ◽  
Apneic Oxygenation ◽  
Incremental Benefit ◽  
First Pass

Clinical questionShould I use apneic oxygenation when intubating patients in the emergency department to increase peri-intubation oxygen saturation and first-pass success?Article chosenOliveira JE, Silva L, Cabrera D, Barrionuevo P, et al. Effectiveness of apneic oxygenation during intubation: a systematic review and meta-analysis. Ann Emerg Med 2017;70(4):483-94.ObjectiveThe purpose of this study was to synthesize and appraise the apneic oxygenation literature for its effect on peri-intubation outcomes.

447 What Age is Best to Perform Myringoplasty?

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
L Wilks ◽  
R Mcleod ◽  
V Unadkat
Keyword(s):  
Systematic Review ◽  
Success Rate ◽  
Meta Analysis ◽  
Paediatric Population ◽  
Cochrane Library ◽  
Clear Correlation ◽  
Success Rates ◽  
Prisma Statement ◽  
Transitional Point ◽  
The Cochrane Library

Abstract Aim This systematic review and meta-analysis aims to assess this relationship and determine the most appropriate age for recommendation of surgery. Method According to the “Preferred Reporting items for systematic review and meta-analysis” (PRISMA) statement, a literature search was performed across Medline, EMBASE and the Cochrane library from 1946-2018. Articles examining a relationship between age and myringoplasty or type 1 tympanoplasty success rates were screened. Results 20 articles encompassing data from 2244 procedures were included. The overall results conveyed a clear correlation between increasing age and rising success rate. A t-test was conducted which demonstrated a significant (P = 0.05) transition at aged 10, whereby success rate below age 10 was 70.6% and above 10 was 86%. Conclusions This systematic review and meta-analysis has uncovered a clear correlation between increasing age and increasing success rate for myringoplasty in the paediatric population. Furthermore, a significant transitional point has been demonstrated at the age of 10 and We hope that knowledge of increased success rates particularly after the age of 10 helps clinicians make more informed decisions about when to operate

scholarly journals Endoscopic transmural drainage is associated with improved outcomes in disconnected pancreatic duct syndrome: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eric Chong ◽  
Chathura Bathiya Ratnayake ◽  
Samantha Saikia ◽  
Manu Nayar ◽  
Kofi Oppong ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pancreatic Duct ◽  
Meta Analysis ◽  
Fluid Collection ◽  
Significant Heterogeneity ◽  
Success Rates ◽  
Surgical Interventions ◽  
Transmural Drainage ◽  
Transpapillary Drainage ◽  
Duct Syndrome

Abstract Background Disconnected pancreatic duct syndrome (DPDS) is a complication of acute necrotizing pancreatitis in the neck and body of the pancreas often manifesting as persistent pancreatic fluid collection (PFC) or external pancreatic fistula (EPF). This systematic review and pairwise meta-analysis aimed to review the definitions, clinical presentation, intervention, and outcomes for DPDS. Methods The PubMed, EMBASE, MEDLINE, and SCOPUS databases were systematically searched until February 2020 using the PRISMA framework. A meta-analysis was performed to assess the success rates of endoscopic and surgical interventions for the treatment of DPDS. Success of DPDS treatment was defined as long-term resolution of symptoms without recurrence of PFC, EPF, or pancreatic ascites. Results Thirty studies were included in the quantitative analysis comprising 1355 patients. Acute pancreatitis was the most common etiology (95.3%, 936/982), followed by chronic pancreatitis (3.1%, 30/982). DPDS commonly presented with PFC (83.2%, 948/1140) and EPF (13.4%, 153/1140). There was significant heterogeneity in the definition of DPDS in the literature. Weighted success rate of endoscopic transmural drainage (90.6%, 95%-CI 81.0–95.6%) was significantly higher than transpapillary drainage (58.5%, 95%-CI 36.7–77.4). Pairwise meta-analysis showed comparable success rates between endoscopic and surgical intervention, which were 82% (weighted 95%-CI 68.6–90.5) and 87.4% (95%-CI 81.2–91.8), respectively (P = 0.389). Conclusions Endoscopic transmural drainage was superior to transpapillary drainage for the management of DPDS. Endoscopic and surgical interventions had comparable success rates. The significant variability in the definitions and treatment strategies for DPDS warrant standardisation for further research.

scholarly journals A Systematic Review and Meta‐analysis of Ketamine as an Alternative to Opioids for Acute Pain in the Emergency Department

2018 ◽  
Vol 25 (10) ◽  
pp. 1086-1097 ◽  
Author(s):  
Nicholas Karlow ◽  
Charles H. Schlaepfer ◽  
Carolyn R. T. Stoll ◽  
Michelle Doering ◽  
Christopher R. Carpenter ◽  
...  
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Acute Pain ◽  
Meta Analysis

scholarly journals P097: The characteristics and effectiveness of interventions targeting chronic pain patients in the emergency department: A systematic review and meta-analysis

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S98-S99
Author(s):  
C. O'Rielly ◽  
L. Sutherland ◽  
C. Wong
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Chronic Pain ◽  
Meta Analysis ◽  
Grey Literature ◽  
Opioid Prescription ◽  
Care Plans ◽  
Individualized Care ◽  
High Utilizers ◽  
Ed Visits

Introduction: Patients with chronic non-cancer pain (CNCP) and opioid-use disorders make up a category of patients who present a challenge to emergency department (ED) providers and healthcare administrators. Their conditions predispose them to frequent ED utilization. This problem has been compounded by a worsening opioid epidemic that has rendered clinicians apprehensive about how they approach pain care. A systematic review has not yet been performed to inform the management of CNCP patients in the ED. As such, the purpose of this project was to identify and describe the effectiveness of interventions to reduce ED visits for high-utilizers with CNCP. Methods: Included participants were high-utilizers presenting with CNCP. All study designs were eligible for inclusion if they examined an intervention aimed at reducing ED utilization. The outcomes of interest were the number of ED visits as well as the amount and type of opioids prescribed in the ED and after discharge. We searched Medline, EMBASE, CINAHL, CENTRAL, SCOPUS, Web of Science, and the grey literature from inception to June 16, 2018. Two independent investigators assessed articles for inclusion following PRISMA guidelines. Risk of bias will be assessed using the Cochrane ROBINS-I and RoB 2 tools for non-randomized and randomized trials, respectively. Results: Following review, 14 of the 5,018 identified articles were included for analysis. These articles assessed a total of 1,670 patients from both urban and rural settings. Interventions included pain protocols or policies (n = 5), individualized care plans (n = 5), ED care coordination (n = 2), a chronic pain management pathway (n = 1), and a behavioural health intervention (n = 1). Intervention effects trended towards the reduction of both ED visits and opioid prescriptions. The meta-analysis is in progress. Conclusion: Preliminary results suggest that interventions aimed at high-utilizers with CNCP can reduce ED visits and ED opioid prescription. ED opioid-restriction policies that sought to disincentivize drug-related ED visits were most successful, especially when accompanied by an electronic medical record (EMR) alert to ensure consistent application of the policy by all clinicians and administrators involved in the care of these patients. This review was limited by inconsistencies in the definition of ‘high-utilizer’ and by the lack of high-powered randomized studies.

Sign in / Sign up

Export Citation Format

Share Document