IMPORTANCE Endotracheal intubation of critically ill patients is a high-risk procedure. Checklists have been advocated to improve outcomes. OBJECTIVE To assess whether the available evidence supports an association of use of airway checklists with improved clinical outcomes in patients undergoing endotracheal intubation.

We have fabricated miniature planar IR waveguides with thicknesses of 30-50 mum, consisting of 12-mm long, 2-mm wide strips of Ge supported on ZnS substrates. Evidence for efficient propagation of broadband IR light through these waveguides is provided by the presence of characteristic high- and low-frequency optical cutoffs of Ge; by the observation of an oscillatory interference pattern in the transmittance spectrum, which exhibits a dependence on waveguide thickness and propagation angle that closely matches waveguide theory; and by the detection of strong evanescent-wave absorption from small (2 mm(2)) droplets of liquid, e.g., water, on the waveguide surface. As also predicted by theory, the surface sensitivity (detected light absorbance per unit area of sample-waveguide contact) is shown to increase as a function of incidence or bevel angle.

IMPORTANCE Diagnosing posterior chamber ocular abnormalities typically requires specialist assessment. Point-of-care ultrasonography (POCUS) performed by nonspecialists, if accurate, could negate the need for urgent ophthalmologist evaluation. OBJECTIVE This meta-analysis sought to define the diagnostic test characteristics of emergency practitioner-performed ocular POCUS to diagnose multiple posterior chamber abnormalities in adults. DATA SOURCES PubMed (OVID), MEDLINE, EMBASE, Cochrane, CINAHL, and SCOPUS were searched from inception through June 2019 without restrictions. Conference abstracts and trial registries were also searched. Bibliographies of included studies and relevant reviews were manually searched, and experts in the field were queried. STUDY SELECTION Included studies compared ocular POCUS performed by emergency practitioners with a reference standard of ophthalmologist evaluation. Pediatric studies were excluded. All 116 studies identified during abstract screening as potentially relevant underwent fulltext review by multiple authors, and 9 studies were included. DATA EXTRACTION AND SYNTHESIS In accordance with PRISMA guidelines, multiple authors extracted data from included studies. Results were meta-analyzed for each diagnosis using a bivariate random-effects model. Data analysis was performed in July 2019. MAIN OUTCOMES AND MEASURES The outcomes of interest were diagnostic test characteristics of ocular POCUS for the following diagnoses: retinal detachment, vitreous hemorrhage, vitreous detachment, intraocular foreign body, globe rupture, and lens dislocation. RESULTS Nine studies (1189 eyes) were included. All studies evaluated retinal detachment, but up to 5 studies assessed each of the other diagnoses of interest. For retinal detachment, sensitivity was 0.94 (95% CI, 0.88-0.97) and specificity was 0.94 (95% CI, 0.85-0.98). Sensitivity and specificity were 0.90 (95% CI, 0.65-0.98) and 0.92 (95% CI, 0.75-0.98), respectively, for vitreous hemorrhage and were 0.67 (95% CI, 0.51-0.81) and 0.89 (95% CI, 0.53-0.98), respectively, for vitreous detachment. Sensitivity and specificity were high for lens dislocation (0.97 [95% CI, 0.83-0.99] and 0.99 [95% CI, 0.97-1.00]), intraocular foreign body (1.00 [95% CI, 0.81-1.00] and 0.99 [95% CI, 0.99-1.00]), and globe rupture (1.00 [95% CI, 0.63-1.00] and 0.99 [95% CI, 0.99-1.00]). Results were generally unchanged in sensitivity analyses of studies with low risk of bias.