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Related Concept Videos

Endotracheal Intubation II: Nursing Management01:17

Endotracheal Intubation II: Nursing Management

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Endotracheal intubation is a critical procedure that can be lifesaving for many patients with respiratory distress or failure. The role of nursing in managing endotracheal tubes is pivotal, as it involves pre-intubation preparation, assisting during the procedure, and post-extubation care.
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
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Endotracheal Intubation I: Procedure01:15

Endotracheal Intubation I: Procedure

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Endotracheal or ET intubation is a critical medical procedure used to secure a patient's airway, often in acute respiratory distress, apnea, upper airway obstruction, ineffective clearance of secretions, high risk for aspiration, or during general anesthesia.
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
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Endotracheal Tube Extubation01:24

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Endotracheal tube extubation is a critical procedure in weaning patients from mechanical ventilation. It involves physically removing the oral or nasal endotracheal (ET) tube, marking the final step in liberating a patient from ventilatory support.
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
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Tracheostomy Suctioning I: Pre-Procedural Steps01:26

Tracheostomy Suctioning I: Pre-Procedural Steps

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Tracheostomy suctioning is a critical procedure healthcare professionals perform to maintain a patent airway in patients with a tracheostomy tube. This procedure is necessary when secretions accumulate in the airway, causing respiratory distress. Here is a step-wise procedural guide for performing tracheostomy suctioning using an open system.
Equipment Required
First, gather all necessary equipment: a sterile suction catheter, a sterile disposable container, sterile gloves, a towel or...
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Tracheostomy Care I: Pre-procedural Steps01:16

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A tracheostomy is a surgical technique that involves making an incision in the neck to provide access to the trachea. It is frequently used in medical conditions such as airway obstruction and prolonged mechanical ventilation. Effective nursing management is crucial for the long-term success of a tracheostomy.
Required Equipment
The equipment necessary for tracheostomy care includes:
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The Effect of Prehospital Protocol Modification during COVID-19 on First-Pass Intubation Success Rates.

Abagayle E Bierowski1,2,3, Paul C Comber2,3, Alexander Kuc2,3

  • 1Department of Emergency Medicine, Thomas Jefferson University, Philadelphia, PennsylvaniaUSA.

Prehospital and Disaster Medicine
|April 2, 2025
PubMed
Summary
This summary is machine-generated.

The COVID-19 pandemic led to fewer tracheal intubations (TI), decreasing first-pass TI success rates. Agencies must use simulation and training to maintain proficiency in advanced airway management.

Keywords:
COVID-19first-pass successintubationprehospital airway managementsupraglottic airway

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Area of Science:

  • Emergency Medicine
  • Critical Care
  • Public Health

Background:

  • COVID-19 pandemic altered Emergency Medical Services (EMS) protocols, especially those increasing airborne exposure risk like tracheal intubation (TI).
  • Advanced Life Support (ALS) providers prioritized supraglottic airway (SGA) use in 2020, with TI rarely performed.

Purpose of the Study:

  • To evaluate the clinical impact of pandemic-related protocol changes on first-pass TI success rates.
  • To assess the effect on overall initial advanced airway placement success.

Main Methods:

  • Retrospective chart review of ALS encounters requiring advanced airway placement (January 2019 - June 2021).
  • Analysis of 452 out-of-hospital advanced airway placements from a single urban EMS agency.
  • Descriptive statistics and chi-square tests were used, with P < .05 for statistical significance.

Main Results:

  • TI attempts significantly decreased in 2020 compared to 2019 (P < .001).
  • First-pass TI success rates declined in 2021 (61.1%) versus 2019 (78.8%; P = .047).
  • SGA use increased significantly in 2020 (91.2%) and 2021 (70.7%) compared to 2019 (58.8%). Overall first-attempt advanced airway success rose in 2020 but fell in 2021.

Conclusions:

  • Reduced TI exposure during the pandemic likely caused decreased first-pass TI success in 2021.
  • EMS agencies need simulation and continuing education to maintain provider proficiency in TI.
  • Maintaining psychomotor skills is crucial, especially when protocol changes limit field practice.